Have you ever noticed that there's no ingredients list on a box of tampons? We're all more than happy to scrutinize the number of carbs in our morning cereal, but when it comes to sticking products in our lower orifice, it's kind of a crapshoot. Even researchers who study the materials in tampons aren't totally sure if they have any long-term effects on our bodies.
That's why Congresswoman Carolyn Maloney (D-NY) recently introduced a bill that would require the National Institutes of Health to conduct research on the long-term effects of feminine hygiene products, as well as ask the Food and Drug Administration to publish information about the ingredients in these items.
In particular, Maloney raises concerns about dioxin (a by-product of the bleaching process most tampons go through), synthetic fibers (like rayon, of which many tampons are partially made), and components like chemical fragrances that are often added to feminine hygiene products. Tampon manufacturers test their own products and the FDA reports that they only contain trace amounts of dioxin, at most, and says the risk of any negative health effects are "negligible."
But the Environmental Protection Agency and the International Agency for Research on Cancer (a branch of the World Health Organization) have both identified dioxins as possible carcinogens. Considering a women can use as many as 16,800 tampons over the course of her lifetime, Maloney figures it's only prudent to do some research into whether or not dioxins (or rayon or anything else we're inserting into our bodies) might have some long-term effects.
"Imagine if we only examined the health effects of smoking a single cigarette," Maloney wrote in an op-ed about the bill for The Guardian.
There hasn't been a ton of research focus on the possible effects of long-term tampon use. Since tampons and some other women's hygiene products (like the cup or certain creams and gels) are worn internally, it's important to understand how the different ingredients might affect the vaginal ecosystem, Maloney argues.
"Most of the vagina is covered with multiple layers of dead and dying cells that do a lot to protect it against infection, but [this] is nowhere near the thick leathery surface of our skin," Richard Cone, a biophysicist at Johns Hopkins University, said in an article published in the journal Environmental Health Perspectives. Because of this, the vagina is more susceptible to absorbing chemicals than external parts of the body, Cone said. (Side note: this was kind of the whole idea behind that vodka-soaked tampon urban legend).
There's also still a lot we don't understand about Toxic Shock Syndrome: an often deadly bacterial infection that's linked to tampon use. Though cases of TSS are increasingly rare, there's a knowledge gap about how some super absorbent tampon materials are associated with the illness.
Since tampons and sanitary napkins are considered medical devices by the FDA, manufacturers aren't required to put ingredients lists on the packaging. All things considered, it doesn't seem that ridiculous for Maloney to ask for some actual research to be done on products that a majority of US women report using monthly.
The bill is short and pretty modest; Maloney wants to "establish a program of research" about the potential "risks posed by the presence of dioxin, synthetic fibers, chemical fragrances, and other components of feminine hygiene products." It would also "encourage" the FDA to do more to inform consumers about the ingredients in these products.
Yet the 2015 version of the bill marks the seventh time Maloney has brought the bill to the House, and not once has it even made it to vote. Last time around, in 2014, it got sent to the House Energy and Commerce: Health committee, but was never passed on. This has been a recurring theme for Maloney's attempts to get this bill some attention in 1999, 2003, 2005, 2008, 2011, and last year.
Since the bill hasn't even made it to vote, it's difficult to pin down why it's not getting much support in the house. Philip Tierno, a clinical microbiology and pathology professor at New York University, studies TSS. In the EHP article, Tierno suggested the 2011 version of Maloney's bill was rejected because it was considered a waste of money. But Thierno said "You can bet your bottom dollar if the bulk of the representatives were female, or if these males menstruated, they would have passed it by now."