Do You Know What’s in Your Period Products?

The following essay was written by MPH student Kathleen Brody, a member of the Columbia Mailman School Gender, Adolescent Transitions, and Environment (GATE) Program team:

The range of products marketed to people with vulvas and vaginas is constantly expanding. This is despite regulation and the general public’s lack of awareness about what those products are actually made of. For a topic as taboo and stigmatized as menstrual health, perhaps it feels like there is no other option but to blindly accept the products that are put in front of us.

Earlier this semester, I came across the news that Thinx, a brand known for its reusable period underwear, had reached a settlement for a class-action lawsuit against the company. Thinx had marketed their product as “organic,” “sustainable, ” and “non-toxic. ” In reality, according to one report, it contained “PFAs, harmful chemicals linked to fertility issues, environmental pollution, and certain cancers.” Horrified, I did a deeper dive into the existing and current research about the state of ingredient disclosures in menstrual hygiene products. It was then that I came across a comprehensive review published in October 2022 by Chemistry & Engineering News magazine. This research added a great deal to my ever-expanding understanding of menstrual (in)equity, as part of my studies at the Mailman School of Public Health.

A couple of years ago, the term “period poverty” entered my professional lexicon. I had recently finished my bachelor’s degree and was working full-time with an international sexual and reproductive health agency. Period poverty refers to the challenges associated with being unable to afford menstrual products, like pads or tampons, or to the economic burden of purchasing such products for low-income people who menstruate. While the availability of menstrual products is key to addressing period poverty, I now know that this is just one of many barriers to ensuring true menstrual equity. This is thanks to my time working with the Gender, Adolescent Transitions, and Environment (GATE) Program directed by Dr. Marni Sommer.

While period poverty focuses mainly on economic barriers to menstrual products, menstrual equity takes into account the holistic needs of people who menstruate. This includes access to clean water, private facilities to tend to menstrual hygiene, and even puberty education and product information to better prepare young people for menstruation. You might be asking: What’s the connection between period product ingredients and menstrual equity?

The fact is that these products are chronically underregulated, and more awareness-raising is needed to inform people about the consequences of potential chemical absorption through the vulva and vagina. While the U.S. Food and Drug Administration regulates products like douches and wipes as cosmetics, products like pads, tampons, cups, and discs are deemed to be “medical devices.” Consequently, manufacturers are not required at the federal level to list their ingredients. In 2021, New York State enacted a law that mandates manufacturers of these products to list ingredients on their products’ packaging. While such steps will improve access to menstrual health information in the United States, most people still don’t know how various ingredients could affect their bodies.

The same could be said for many other products manufactured in the United States. We’ve seen how the historic lack of transparency between the government, companies, and the public contributed to disinformation and vaccine hesitancy during the COVID-19 pandemic. Yet in the case of menstrual products, companies have convinced us for decades that they are safe. The lack of transparency around what we put into our bodies can lead to blind acceptance.

Barriers to awareness of and lack of regulations around the safety of menstrual products is one of many manifestations of menstrual inequity and gender inequality, both in the United States and globally. As stated by Gloria Steinem in her satirical piece on menstruation, “If men could menstruate, the power justifications would go on and on.” In other words, if menstruation were considered a ‘men’s issue’ rather than a ‘women’s issue,’ exponentially greater resources would be dedicated to menstrual health. In this fictional parallel universe, surely the federal government would ensure that period products do not pose any risk to health.

Instead, as the general public remains generally disengaged from the topic of menstruation, managing menstrual health and hygiene remains a barrier for millions of people to the fulfillment of their human rights. According to Dr. Sommer and her colleagues, “for girls to have access to menstruation-related infrastructure and information would enable them to successfully advance their education and subsequent development.” As long as the menstrual and greater reproductive health of people with uteruses continues to be neglected and controlled, millions around the world will continue to endure the consequences of those barriers to health. The willingness of governments to allow menstrual hygiene products to be manufactured with toxic chemicals is a topical example of this negligence, but it is just one of many.

Kathleen Brody is a graduating MPH student in the Department of Population and Family Health, earning a Certificate in Sexuality, Sexual and Reproductive Health. She has supported research and communications at the GATE Program since September 2022.