Period Activists Want Tampon Makers to Disclose Ingredients

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Have you ever wondered what chemicals and other ingredients are in your tampons?

The answer typically is not on the label. Unlike candy bars, frozen dinners and eye shadow, tampons and menstrual pads are not required to carry a list of ingredients.

Instead, many tampon makers give a suggested ingredient list saying their product “may” contain cotton or rayon or polyester, or possibly a combination of them. And many sanitary pads, don’t list any ingredients at all on the package, though companies may offer information on their websites, noting that the pads contain materials like “absorbent wood cellulose” and polyolefin, a chemical compound.

Now a vocal group of health activists focused on “menstrual equity” are calling for new rules to force companies to disclose the chemicals and materials used to manufacture feminine care products.

“I call this ‘the other tampon tax,’ ” said Laura Strausfeld, co-founder of Period Equity, a law and policy institute focused on menstrual equity issues, referring to a lack of transparency that prevents women from knowing exactly what’s in an intimate product, with potential consequences for their health.

Until just a couple of years ago, the subject of menstruation wasn’t discussed in mixed company. Women kept tampons out of sight, and girls used code language to refer to their periods. But over the past few years, activists have attempted to normalize the subject of monthly periods. They have called for an end to sales tax on sanitary products in some states, and pushed to make feminine products free in schools and homeless shelters.

Now activists are calling for more scrutiny of the manufacturing process of a consumer product used by a woman for about a week out of every month of her childbearing years.

Earlier this month, Representative Grace Meng, Democrat of New York, introduced a bill called the Menstrual Products Right to Know Act, which would require menstrual hygiene products — including tampons, pads, and menstrual cups – to list their ingredients on the package.

On Tuesday, members of Women’s Voices for the Earth, a nonprofit organization whose 2013 report “Chem Fatale,” focused on toxic chemicals in feminine care products, rallied in Washington to express their support for the proposed legislation.

Representative Carolyn B. Maloney, another Democrat from New York, also has reintroduced a bill directing the National Institutes of Health to do research to determine whether chemicals used in feminine hygiene products pose health risks. The bill, which Ms. Maloney is introducing for the 10th time, has never moved out of committee. The prospects for both bills most likely are dim, given the complicated legislative agenda and divisive political climate.

But proponents are convinced that the proposed legislation and rallies can leverage public support for the changes, and put pressure on tampon and pad makers to disclose ingredients and ensure their products are safe for women.

“We want women to be able to know what chemicals are in these products, which come in direct contact with our bodies,” said Ms. Meng.

The Food and Drug Administration regulates menstrual hygiene products as medical devices, a category that also includes dental floss and condoms.The agency recommends manufacturers provide general information on the label about the material composition of the product – such as whether the product is made of cotton or rayon — but does not require the individual ingredients, said Deborah Kotz, an F.D.A. spokeswoman.

“Disclosure of ingredients in pads and tampons right now is entirely voluntary,” said Sarada Tangirala, the national campaigns manager for Women’s Voices for the Earth.

There are two types of ingredients that most interest women’s health activists. One category is added ingredients like fragrances, gels and other additives, including those used to enhance absorbency or provide adhesives for pantyliners. The other category includes incidental contaminants that may be toxic, such as persistent pesticide residues in cotton or toxic byproducts created during the manufacturing process.

One longtime concern about menstrual products has been whether the process of purifying or bleaching cotton and rayon with chlorine compounds may leave worrisome traces of toxic dioxins behind. Some research in nonhuman primates has linked exposure to dioxins to endometriosis.

But several other studies of dioxin content in different brands of tampons and disposable diapers found no evidence of the most toxic dioxin, and reported that other dioxin exposures were of a magnitude thousands of times smaller than exposures that occur routinely through the diet.

The F.D.A. has also analyzed dioxin content in tampons in the past and determined that for the average woman, the typical monthly exposure from tampons does not exceed tolerable levels set by the Joint Expert Committee on Food Additives, though the amounts that were detected varied between tampon brands and types.

Several large manufacturers say the issue is moot because they have abandoned the use of chlorine in the purification process. Both Procter & Gamble, maker of Always and Tampax, and Kimberly-Clark, which makes Kotex, state on their websites that they use a process called elemental chlorine-free bleaching, which does not create dioxins during the bleaching process. “Increasingly women want to know more about their feminine hygiene products and we take our responsibility to provide that information seriously,” said Maria Burquest, a spokeswoman for P &G Feminine Care.

Many gynecologists discourage their patients from using scented products, which can trigger allergic reactions, and encourage them to use the least absorbent product they require, said Dr. Nichole Tyson, a gynecologist with Kaiser Permanente who spoke on behalf of the American College of Obstetricians and Gynecologists. But overall, she said, there is no evidence that ingredients in tampons cause long-term harm. “There are probably a lot of other things in the food, water and the world around us, that are more risky than the very low levels of pesticides that exist in a tampon,” Dr. Tyson said.

Women’s Voices suggests women reduce their exposures by choosing unscented tampons and menstrual pads; purchasing either organic menstrual products made from 100 percent organic cotton or reusable, washable pads, and looking for brands that disclose all their ingredients.