Tampons – and cancer?

Some mainstream and social media claims were alarming and went far beyond the study’s actual findings. For example:
•    ‘chemicals found in some synthetic tampons disrupt hormone regulation and are associated with breast and ovarian cancers’
•    ‘cancer link’ (with picture of tampons)
•    ‘increased risk of cancer’

Who—amongst tampon users and people who care about tampon users—wouldn’t be concerned?

But fear not. The study didn’t establish any link between the use of tampons and any health effects. Or provide any evidence of a difference in the safety of organic and conventional tampons.

This ABC Media Watch clip succinctly and comprehensively slams the false claims made (see also on TikTok or YouTube).

The study was commissioned by an organic tampon manufacturer in New Zealand. Its aim was to determine if there were endocrine-disrupting chemicals [link to Health Concerns - defined'] present in tampons available on the New Zealand market.  

To do this, the study measured the level of oestrogenic activity of four tampon brands, one organic and three conventional. ‘Measurable oestrogen activity’ was found in just one non-organic tampon brand. However, the chemical or chemical/s responsible for this activity were not identified, nor the levels present, and certainly not the impact of these undetermined chemical/s in the context of the route of exposure and frequency of product use.

What is oestrogenic activity?

Oestrogenic activity refers to how natural oestrogen acts in the body, or how substances other than natural oestrogen mimic its effects or interfere with its normal action.

These substances may be called ‘oestrogenic compounds’, ‘xenoestrogens’ or ‘endocrine-disrupting chemicals’.

The study’s lead author Dr Alison Heather was reported in New Zealand media as follows: ‘Dr Heather says researchers don’t know what this particular chemical is yet or if it is able to leach out of the tampon, cross the tissue of the vagina, get into a woman’s bloodstream and cause a physiological effect’.²

Dr Heather also told Media Watch that ‘our pilot study did not establish a direct link between tampons and an increased risk of cancer’.

The study had not (at the time of the media reports) been reviewed by qualified peers.

Other studies have looked for and found certain chemicals—such as fragrances, volatile organic compounds, dioxins and phthalates—in menstrual products. A 2023 review³ considered all these studies and said that more research was needed, rather than claiming any link to adverse health effects.

Following the alarmist media on this topic in November 2023, experts weighed in on what conclusions could be drawn from the study.

For example, regarding the study’s conclusion of ‘significant’ endocrine-disrupting activity, University of Adelaide molecular pharmacologist Dr Ian Musgrave said that the level was too low to worry about. ‘Even if all this “oestrogenic material” was released at once, this would have no biological effect.’⁴

University of Melbourne gynaecologist Alex Polyakov said ‘no meaningful conclusions’ could be drawn from the research.⁴

Some of the media arising from the New Zealand study suggested that organic tampons are a safer option. This was not supported by the study’s findings and the study authors made no such claims.

First, two of the conventional brands showed no oestrogenic activity.

Second, as explained above, no link to any adverse health effects were found for the one conventional brand that did show oestrogenic activity.

The study was commissioned by an organic tampons manufacturer, which requested a study on the prevalence of endocrine-disrupting chemicals, with xenoestrogenic potential, in feminine hygiene products. (The study report is up-front about this affiliation.) This manufacturer was featured in some media reports advocating the use of certified organic products (like theirs).

The media is often sceptical of studies by companies or industry groups.

But, in this case?

The findings of one non-peer-reviewed study, funded by one tampon company, were not only drastically overblown but the very company behind the study was given airtime on mainstream media to promote their product type.

Not fantastic. 

In Australia, all tampons are regulated by the Therapeutic Goods Administration (TGA) and are required to comply with Therapeutic Goods (Standards for Tampons) (TGO 103) Order 2019.

This order states that menstrual tampons must meet the Australian Standard (AS) 2869:2022 Tampons - Menstrual. This standard ensures that tampons are manufactured to minimise recognised health risks associated with the use of these products, including toxicity and irritation.

You can read more on tampon regulation at 'Manufacturing or supplying tampons'.

You may have heard of toxic shock syndrome (TSS) – especially if you are a tampon user (or a parent of girls). The use of tampons has been associated with an increased risk of TSS, although they are not the direct cause and tampon-associated TSS is rare.

TSS is a serious condition. But some sensible precautions can minimise your risk. See Health Direct's Toxic Shock Syndrome webpage for more information.