Organic cotton tampons have officially gone mainstream—but do you *really* need to make the switch?

By Mara Santilli
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Credit: Megan Madden / Refinery29 for Getty Images

You probably aren't talking about your tampon preferences as openly as say, your favorite clean skin-care brand. After all, the question "Does anyone have a tampon?" is literally still whispered by most women in mixed company. But considering tampons literally go inside your body every month, it's about time the conversation around the available options—and their potential health impact—gets a little louder.

Chances are, you've seen a plethora of new tampon brands on the market. Startups that deliver organic cotton tampons straight to your door every month, like Lola and Cora, have become enormously popular, due in part to their millennial marketing and convenience factor. Even drugstore brands that have been around since the creation of tampons themselves have jumped on board the organic trend thanks to consumer demand. Tampon brand o.b. recently launched 100 percent certified organic cotton tampons free of chlorine, dyes, pesticides, and fragrances, plus a new version with a plant-based applicator. Just this week, Tampax also followed suit, launching its first organic product, Tampax PURE. In other words, organic tampons are no longer a niche category available online and in specialty stores, but a new option on the drugstore shelf for all women.

According to the strictly organic brands, making the switch is crucial for your health. Though, the veteran tampon brands offering both organic and conventional options say it just comes down to personal preference. So, what do health experts have to say about the necessity of going organic? We got to the bottom of the debate.

The History of Tampon Regulation In the U.S.

To understand the controversy, it's important to understand how the tampon industry works and how they're regulated. Tampons, believe it or not, were once classified as "cosmetics", but since 1976 have been FDA-regulated as medical devices. This means that the FDA thoroughly reviews the ingredients and makes sure that none of the additives or synthetic materials used in producing the tampons are harmful to users. However, consumers are not necessarily notified of exactly what those ingredients are—the materials in menstrual products only need to be listed for FDA clearance, and don't currently need to be spelled out on a box for consumers.

Despite this designation, it took a few major safety concerns for key changes to be made in the tampon manufacturing process. Cases of Toxic Shock Syndrome (TSS), triggered by a bacterial toxin tied to tampon use, spiked in 1980, which led super high-absorbency tampons to be pulled from the market. Tampon manufacturers also removed three of the four synthetic ingredients used to make tampons that were associated with the increased production of TSS toxin.

Tampons are made of cotton, rayon, or a blend of the two. (Rayon is made from cellulose fibers derived from wood pulp.) "In this process, the wood pulp is bleached," the FDA explains. In the past, bleaching the wood pulp was a potential source of trace amounts of dioxins in tampons, but that bleaching method is no longer used, the organization says. "Rayon raw material used in U.S. tampons is now produced using elemental chlorine-free or totally chlorine-free bleaching processes," they write, noting that tampons that are totally chlorine-free may use hydrogen peroxide as the bleaching agent instead.

ICYDK, 'normal' tampons are typically made from a cotton-rayon blend, and bleaching those fibers is a part of that process (nope, that bright white color isn't natural!). In the 1990s though, after the Environmental Protection Agency (EPA) released concerning research linking dioxin, a pollutant released during the chlorine bleaching process of rayon, to cancer, the FDA required tampon manufacturers switch over to a non-chlorine, dioxin-free bleaching process, which is still the requirement today.

In 2005, the FDA issued a more detailed document with guidelines for manufacturers spelling out their safety expectations. This included a requirement that tampons be thoroughly laboratory tested to ensure there aren't detectable amounts of the bacterial toxin that causes TSS. Manufacturers are also required to disclose any chemicals or additives in the products to the FDA along with any risks those pose, such as infections, that could possibly be associated with them. But again, since you won't always see those ingredients listed out on the product packaging, it's up to you as a consumer to trust the FDA's regulation.

The Argument for Using Organic Tampons

Although standard tampons are safer today than the ones your grandmother likely used due to these new requirements, it doesn't guarantee they're entirely free of bad-for-you ingredients. That's because conventional tampons are still made from a blend of super-absorbent rayon and cotton that is still bleached with other ingredients, albeit with a chlorine-free bleaching process.

"Conventional tampons may contain a host of toxicants, such as the herbicide glyphosate that might be used on non-organic cotton plants, various types of bleaches, pesticides, and synthetic materials," says Felice Gersh, M.D, an ob-gyn and founder/director of the Integrative Medical Group of Irvine. "The numerous chemicals within tampons can become systemic, meaning they can circulate throughout the body, with the potential for harm," says Dr. Gersh.

And we're talking about one of the most delicate organs in the body, so many medical professionals advise you to be extra careful what products you're inserting in there. "The vagina is a very permeable and a highly absorptive organ," says Sandy Wang, R.N., director of nursing operations and senior lead family nurse practitioner of Pill Club. "Not being aware of the products you use can lead to potential toxins in your body, which can penetrate your bloodstream."

That's why Wang recommends going with menstrual products with just one ingredient: 100 percent organic cotton, so there's no wondering about what chemicals you're possibly allowing to seep into your body. (Up next: Should You Switch to Organic Condoms?)

Other Potential Health Benefits of Organic Tampons

There may be some additional perks that haven't yet been researched. For instance, certain patients with endometriosis have reported fewer symptoms of inflammation when using organic cotton (as opposed to traditional tampons made from synthetic blends of rayon or with cotton that is processed and treated with chemicals), explains Rachel Stone, R.N., of Pill Club.

She adds that since most organic tampons don't contain fragrance, it can help keep prevent irritation. This cocktail of unlabeled chemicals may be inflammatory to women with endometriosis, who already struggle with inflammation, but they can also disrupt the pH balance in the vagina for all women, Stone explains. (Related: Why Having Sex with a New Partner Can Mess with Your Vagina In More Ways Than One)

And while there's no scientific evidence yet that going organic can affect cramps or irritation, there is at least circumstantial evidence. "Some customers have reported that their cramps and skin irritations have reduced after using our period products for a while," says Yanghee Paik, CEO of Rael, an organic pad and tampon brand. Of course, it may also be the placebo effect—which is a very real thing.

Environmental Benefits of Organic Tampons

Although docs are split on the health risks, there are definitive environmental benefits to using 100 percent cotton products. "Cotton is a natural fiber, which makes is not only safe and healthy for skin contact, but also compostable, unlike synthetics," says Janet O'Regan, director of non-wovens marketing at Cotton Incorporated.

"It biodegrades in soil, whereas synthetic, petroleum-based fibers don't have that biodegradation cycle and persist in the environment, contributing to the accumulation of plastics on land and in lakes, rivers, and oceans," O'Regan adds.

Yes, you can actually compost your 100 percent organic cotton products in your backyard compost bin with the rest of your household waste, like apple cores, dust, and even cotton clothing, says Kathryn Kellogg, founder of the blog Going Zero Waste and author of the book 101 Ways To Go Zero Waste.

Tampons and their applicators, and pads can't be recycled for sanitary purposes, but it's safe to add all-cotton pads or tampons to your home compost pile. (Menstrual blood, released from the uterine lining, is not considered a biohazard because researchers do not believe that it can transmit pathogens in the same way as the blood that runs through your veins, according to research from the University of North Carolina at Asheville.)

Kellogg also recommends non-applicator organic cotton tampons and a reusable silicone applicator to reduce your impact even further, since most applicators, even biodegradable cardboard ones, can't be composted. (Using menstrual cups instead is also a great eco-friendly solution, adds Kellogg.)

But, Are Conventional Tampons Bad for You?

The problem with the whole organic tampon debate is that the medical community is quite divided. While there may be unnatural ingredients in menstrual products that concern some docs, many others feel that current science can't back any association between ingredients in tampons and any serious health conditions.

"The FDA's job is to regulate drugs and products and make sure that anything used in the public has enough evidence to support the products being safe," says Jessica Shepherd, M.D., an ob-gyn at Baylor, Scott & White Health in Dallas, Texas. The FDA wouldn't put its seal of approval on any kind of menstrual products that were dangerous to the general public, she adds. (And again, because tampons are classified as Class II medical devices, this means that they must pass strict clearance, including testing for harmful bacterial growth before they can be sold anywhere in the U.S.)

For instance, while research published last year found that non-organic cotton may contain trace amounts of the pesticide herbicide glyphosate, the link between tampon use and negative health effects on humans hasn't been shown, says Dr. Shepherd. In fact, according to the Competitive Enterprise Institute, there is likely more glyphosate present in our drinking water, which is regulated by the EPA, than there is in menstrual products, she adds.

When it comes to the concern of TSS (which has been labeled by the government as a precautionary risk on every conventional tampon box in the U.S. since 1982), any products that collect menstrual blood (and even potentially menstrual cups) could allow the TSS-causing bacteria to grow if left in for too long, according to the University of Washington Medicine. The rate of contracting TSS today is rare—about one in 100,000 women of reproductive age—but whether you're opting for organic or not, it's important that you don't leave your tampon in longer than eight hours—and use the right level of absorbency for your flow that day. (Related: Toxic Shock Syndrome Scares Inspire a New Bill for Tampon Transparency)

The Bottom Line On Organic Tampons

TLDR? Organic tampon manufacturers have put out warnings claiming that the ingredients used in conventional tampons can cause health problems, including period cramps, vaginal dryness, hormone disruption—and more seriously, birth defects, infertility, and even cancer, but docs on the other side say there is simply not enough scientific evidence at this time to substantiate those claims or connect any health condition to any one ingredient in tampons.

In other words, it's a personal choice for health, comfort, and environmental reasons. At the end of the day, it's your period, and with increased awareness of what's going into your menstrual products, you have the agency to decide what's right for your own body.

If you want to make the switch, there are tons of new organic tampons to choose from (with and without plastic applicators):

  1. LOLA Organic Cotton Tampons, $10 for 18,
  2. Cora Organic Cotton Tampons Variety Pack, $16 for 36,
  3. Rael 100% Certified Organic Non-Applicator Tampons, 6 for 18,
  4. o.b. Organic Tampons, Made with 100% Organic Cotton, $15 for 24 (3 pack),
  5. Tampax Pure 100% Organic Cotton Core Tampons, $7 for 16, 
  6. Seventh Generation Organic Cotton Tampons, $6 for 16,
  7. Natracare 2000 Organic All Cotton Non-Applicator Tampons, $14 for 20 Count (3 Pack),
  8. L. Organic Cotton Tampons, $7 for 30,