There are endocrine disrupting chemicals presenting in menstrual products, according to a recent review published in BJOG An International Journal of Obstetrics & Gynaecology.
Takeaways
- The review highlights the presence of endocrine-disrupting chemicals in menstrual hygiene products, posing potential risks to reproductive and gynecological health.
- The average menstruating individual uses a substantial amount of menstrual products throughout their lifetime, with prolonged exposure over approximately 1800 days. Those with heavy menstrual bleeding may have even higher exposure rates.
- Vaginal and vulvar tissues are highly vascular and permeable, making them susceptible to absorption of chemicals present in menstrual products, potentially increasing the risk of exposure-related health conditions.
- Significant variations exist in the levels of chemicals such as phthalates, dioxins, VOCs, and fragrances across different brands and types of menstrual products, indicating a need for standardized regulation and monitoring.
- The presence of endocrine-disrupting chemicals in menstrual products raises concerns about their potential contribution to gynecological and reproductive diseases such as endometriosis, adenomyosis, and uterine fibroids, underscoring the importance of further research and regulation in this area.
The average menstruating women uses approximately 11,000 menstrual products between menarche and menopause, with use occurring for approximately 1800 days. In women with heavy menstrual bleeding, these numbers are even higher.
Chemicals are easily absorbed by the vaginal and vulvar tissue because they are highly vascular and permeable. Therefore, menstruators may be at risk of chemical exposure from menstrual products. Understanding these exposures may help indicate risks of conditions such as endometriosis, adenomyosis, and uterine fibroids.
Investigators conducted a review to summarize literature about chemicals in menstrual hygiene products. The Pubmed, EBSCO, Web of Science, and Engineering Compendex were evaluated for relevant literature.
Eligibility criteria included full-text research article, available in English, published between 2000 and 2021 in a peer-review journal, and measuring chemicals in menstrual products. As significant differences were observed in methods of chemical management across studies, results were reported individually per study,
There were 12 peer-reviewed studies evaluating chemicals in menstrual products and 3 evaluating biospecimen to determine chemical contributions from menstrual products included in the analysis. Evaluated exposures included phthalates, dioxins, volatile organic compounds (VOCs), fragrances, environmental phenols, other chemicals, and human biospecimens.
Five studies measured phthalates in sanitary pads and 2 in tampons. Sanitary pads from Japan, South Korea, the United States, the United Kingdom, Australia, and Germany had the greatest levels of di(2-ethylhexyl) phthalate (DEHP), with a median of 0.58 to 1.44 mg/g.
This was followed by di-isobutyl phthalate and di-n-butyl phthalate, with medians of 0.435 to 1.424 mg/g and 0.470 to 0.909 mg/g, respectively. DEHP levels in tampons were a median 0.267 mg/g compared to pads at 0.0387 mg/g, indicating increased DEHP among these products.
Polychlorinated dibenzo-p-dioxins (PCDD) was also reported, with a highest PCDD level of 0.2 to 20.7 pg/g observed in tampons. In sanitary pads, this level was 0.214–8.854 pg/g. In comparison polychlorinated dibenzofurans had increased levels in sanitary pans from the United States, Japan, Germany, China, and Korea, at 0.128 to 14.295 pg/g.
VOCs were evaluated in 5 studies, and the highest reports levels were 6.9 to 2402 ng/g in tampons and 4.30 to 75 266 ng/g in pads, seen for alkanes. One study measured VOCs in air samples from the packaging of pads and found Xylene in all pads. This study also found 38.4% of the reference dose for toluene could be absorbed from pad use.
When 504 sanitary pads from Korea were assessed, 50 of 74 VOCs were detected. The highest target total of VOCs was reported in tampons, at a median 102 ng/g.
Fragrance chemicals were measured in 2 studies, with 24 sensitizing allergens found in scented products. The highest hexyl cinnamal levels of 82.69 to 95.85 μg/g were reported in a panty liner, which also had μ-isomethyl ionone and benzyl salicylate.
For environmental bisphenol A (BPA) and bisphenol F (BPF) were reported in over 92% of tampons and 69% of panty liners. Of pads, 72% had detectable levels of BPA and 22% detectable levels of BPF. Median BPA levels in pads, panty liners, and tampons were 5.12 ng/g, 2.77 ng/g, and 0.70 ng/g, respectively.
Other chemicals found in menstrual producs include tributyl phosphate, polydimethylsiloxane, tris(2,4-di-tert-butylphenyl) phosphate, tris(2,4-di-tert-butylphenyl) phosphite, triethyl citrate, tributyl citrate, and erucamide. When evaluating VOC exposure in human biospecimens, researchers found urinary concentrations of 98 VOCs.
These results indicated the presence of endocrine-disrupting chemicals in menstrual products. Investigators concluded “menstrual products may have underappreciated implications for gynecological and reproductive disease.”
Reference
Marroqin J, Kiomourtzoglou M, Scranton A, Pollack AZ. Chemicals in menstrual products: A systematic review. BJOG An International Journal of Obstetrics & Gynaecology. 2023. doi:10.1111/1471-0528.17668
