Does it Really Matter?

Back in January of this year, Jen Gunter M.D., a San Francisco Bay Area OB-GYN was interviewed for Self Magazine.  In the article, Gunter goes after the claims made by the producers of many organic and natural feminine product.  She “stresses that there are no toxins, aka poisonous substances that can cause diseases or illnesses at low amounts, in tampons, and notes that concerns about phthalates in applicators are also unnecessary.”

Exercising Caution

"At low amounts"... the wording is interesting.  She does not say that there are no toxins; she states that there are none, that can cause diseases or illnesses at low amounts.  Are the tampons in question containing toxins, at low amounts?  This is not clarified here.  Then the article mentions phthalates.  They fairly state that the National Institutes of Health reports phthalates can emit from plastics when heated.  This is why everyone is so hell-bent on buying glass everything these days, glass water bottles for exercising and glass food storage containers, etc.  I suppose the question is, "How hot must the plastic be to activate this leaching effect?"  Since one of the recent concerns has been putting water in a plastic water bottle or even warm food in a plastic container, then perhaps putting this same material several times a day per month, in our bodies at 98.6 -104 F degrees, should be a concern.  Is storing these plastics in certain conditions (like a hot car) unwise?  I would expect warnings labels or directives regarding storage to come with these products.  A local government website in New York, discussed the potential dangers of babies chewing on pacifiers, rattles and teethers.  It stated that, “…when kids put toys, teethers, and other products that contain phthalates in their mouths, the chemical may leach from the product to the child”.  If this is a concern, why is it not a valid concern to have an object containing phthalates in a woman’s vagina?  

Regarding phthalates, Gunter pacifies us, "the concerns about phthalates in applicators are also unnecessary."  She jokes, it is not like they are being placed in the oven and baked.  So is 350 F degrees the critical temperature at which these plastics begin to release phthalates?  Also, what if dioxins build up in one’s body, over a period of time?  That could also pose a real issue?  Typically, for better or worse, the testing for these hazards, require conditions that are difficult to meet.  They are typically extensive and expensive.  Often they require human subjects and typically humans do not want to be a part of a study that may lead to cancer. Current New York Congresswoman, Carolyn Maloney has worked hard to introduce a bill assist women in knowing what is in their feminine products, so that they can make informed decisions.  The research results are inconclusive and the fact of the matter is there are no current studies that demonstrate the effects of long term use of these feminine products. Currently most of this is speculation on both sides.  It is us talking out of our...meow... 

I choose to exercise caution. 

Some Bum Calls

The FDA has not always made the best calls!  In course of history many times the FDA has left the important studies to be conducted by the producer of various products and required only short-term studies.    Regarding poor calls, shall we recall the approval of Quaaludes:

Image Courtesy of  Newsweek

Image Courtesy of Newsweek

It was recalled for symptoms of mania,seizures, vomiting, convulsions and ...oh...death.  It was initially tried in India to treat malaria.  That didn't work, so it was used as a sedative.  Perhaps for someone having sleep issues.  Well...it is currently a schedule 1 drug, like heroin or LSD!  We all make mistakes, but these mistakes have life altering consequences.  If these organizations that are put in place to protect us, are fallible, perhaps it is good for us to take more responsibility for our own bodies and the health of our families by exercising caution.  

Then there is the lack of effective labeling for bottles, cans and packages that effect consumption of products that promote obesity and heart disease in America.  Oh and please, lets not forget the history of the lack of regulation of the tobacco industry.  It is certainly not the only debacle the FDA has been involved in, but it is one well remembered.  Initially the tobacco industry had no labeling either.  In fact, people encouraged it.  No evidence yet...People even advertised cigarettes on children's/family shows, like the Flintstones. During the Flintstone’s first season on ABC, their sponsor was Winston cigarettes. 

flinstones winstons.jpg

As time passed, regulations became progressively stricter, from requiring vague notices like, “CAUTION: Cigarette smoking may be hazardous to your health”, to gradually more blunt and frightening notices like, “WARNING: Cigarettes cause cancer”.  It is great to have that support from the FDA, complete with regulations on labeling now, but it is too late for many who believed for so long that it was safe to enjoy smoking.  There are of course situations where looser FDA laws are beneficial to some, experimental drugs for instance that can save peoples immediate lives who otherwise may die.  I think transparency is the key here.  

Consider the Source

One motto that I have lived life by has been, “consider the source”.  I suggest that you take heed to that, including where I am concerned.  We are all different.  Two people can take the same information and find that it may apply differently to their lives, based on their unique value systems.  I for instance, may be more of a big business skeptic, than some people.  As a note, I don't feel that way; I feel I am a healthy skeptic, but I know there are certainly others that place a large amount of faith in their government and corporations.  I question the veracity of claims made by the government (and others), after all, like all organizations, they are comprised of people.  Again, people are fallible; mistakes happen.  Let's be honest, it's also not possible to live a full life and research absolutely every topic of concern/interest alone.  Researching and speaking to friends/others who are informed beings, that may even hold values different from our own, can give us a well rounded view of the issues at hand.

My Big Bro's Two Cents

I was speaking with my big brother (one of my sages) about this and he suggested that if one has the time, investigate who is the sponsor of the stories we read.  What do they have to gain from their position? Is a given story funded by someone who stands to benefit from the point of view supported?  He stressed that sometimes it is difficult to “follow the money”, but when someone is presenting a point that is completely analogous to the points presented by others, it is especially pertinent to take some time to consider the source.

Go Ahead and use them?

Regardless, when the FDA announces that something is or isn't safe that just doesn't seem right, I am cautious. I question the source.  In fact, even with the article from Self magazine.  I found it puzzling that the quotes from Dr. Gutner, did not not strongly point out that the results were unknown, because from what I understand, that is the case.  No long term study has been done.  Instead of stating her point of view, which I value and serving it up with a health dose of, "this is all just educated speculation, because there has never been a study done"; she instead seemed to attempt to dissuade consumers from questioning the safety of conventional non-organic feminine healthcare products: 

"You may have also seen or heard rumors that tampons contain harmful chemicals, like asbestos and dioxins, a byproduct of bleaching rayon that is linked to hormonal changes, but experts say that's just a myth—and you shouldn't toss your regular tampons to spring for an alternative type just yet."   These are fairly large claims to ignore and cast to the side as hog wash for a "just yet".

"Just yet...?!"  Which experts? The article also seemed to be promoting the mainstream menstrual products out on the market. The WHO (World Health Organization) put out bulletin," Dioxins and their effects on human health".  That bulletin states that, "Once dioxins enter the body, they last a long time because of their chemical stability and their ability to be absorbed by fat tissue, where they are then stored in the body. Their half-life in the body is estimated to be 7 to 11 years. In the environment, dioxins tend to accumulate in the food chain. The higher an animal is in the food chain, the higher the concentration of dioxins."  We use a significant amount of bleached cotton products over a period of 7-11 years, this could definitely be substantial.  

Phillip Tierno, Jr., M.D., the well-known microbiologist and Director of Clinical Microbiology and Diagnostic Immunology at Tisch Hospital, New York University Medical Center, consultant to the office of Attorney General of the New York State, member of the NYC Mayor’s Task force on Bioterrorism & the NYC Medical Reserve Corps.  among so many other research foci has done "extensive research on the microbial ecology of the vaginal vault, and the microbiology and ecology of Toxic Shock Syndrome, as well as the Microbiology of AIDS patients"  Back in 1998, he was quoted in Vegetarian Times, by Leonora Tanenbaum in an article called, "Red Alert", as saying the following: 

“The vagina is like a sieve...whatever is in there goes right into the blood circulation.”

...yea...

PHTALATES

Regarding phthalates, Gunter has stated phthalates are not a problem, but then she says, " But, if you’re concerned about phthalates in your tampon applicator, she recommends using a cardboard applicator (Tampax products, for instance) or a tampon with no applicator at all (like the O.B. brand).  I am not certain whether it was Gutner herself who suggests these brands or I suspect it was Self magazine doing a bit of product placement, but the article starts to feel like it has a purpose other than protecting women. 

As for claims that organic tampons are minimally processed, Gunter points out that all cotton used for tampons has to be processed to some degree so that it’s safe for use.  I do not think anyone contests that.  I believe the issue is what chemicals are used to create the process, for instance elemental chlorine free is different than totally chlorine free.  Women are beginning to request health and safety for their own bodies.

A little side Note: I did a little research on the doctor and then on Self magazine (now available only via internet).  The magazine is published by Conde Nast, who months prior had begun a new project called Conde Nast Spire:

Image courtesy of  Conde Nast

Image courtesy of Conde Nast

The above clip seems to be point to their publisher, using data on their readers to assist client companies in marketing through content.  So perhaps that is why OB tampons and Tampax products, have been mentioned:

"If you like the idea of using organic or all-natural tampons, Streicher says there's no harm in using them—they're just going to cost more than other varieties. But you can also save your money—a 16-pack of The Honest Company tampons costs $6.95, compared to $4.30 for the Tampax variety—and keep using regular tampons with no concerns."  However it seems they stated one of the most expensive natural brands for contrast.  I did not do price shopping, but on the on the Target website, I see Seventh Generation tampons advertised at $5.99 a box, which significantly bridges the gap, plus it is organic!  OK, I don't like to mention Walmart, but they have 7th Generation Organic tampons on their site for $4.41/20 count box.

No longer a fringe market focus group

Up until now, these natural products seemed to be servicing a fringe group that were relegated to purchase at the local food co-op or some large chain (whose name shall remain unwritten).  Their designs have been evolving over the years; they commenced their endeavors really in the 90’s, with designs not so convenient.  They were more in keeping with the market at that time, but the market quickly surpassed the natural feminine care producers designs and made the choice for the natural product more difficult for me.  The conventional ones were less bulky, the tampons did not leak and the pads had “wing technology”.  All of these additions were a real improvement.   Who wanted to be ruining the edges of their underwear (period undies or not) each month. 

Recently, there has been a floodgate (No pun intended…) of these products in the market and new producers are popping up everywhere.  They are surfacing in places other than one’s traditional health food store and from manufacturers other than the market mainstays (like Seventh Generation and Natracare Organic).  The feminine care market is saturated (ok…I will leave that one alone…) with organic and natural feminine care products, that can be purchased at local drugstores, food chains and online subscriptions. 

So what’s the difference.  The big debate seems to be, “Does it really matter?” Do you really need to use feminine products manufactured with organic cotton.  Isn’t natural cotton enough? Aren’t the FDA regulating these products?  These are the questions that people ask.

Ingredients

Many assume that these pads and tampons are all-cotton products anyhow.  This is not so.  There are many brands like Playtex, Kotex and Always that produce feminine products made with chemical additives, gels, rayon, bleached cotton, fragrances, powders, etc.  There are many women who experience allergic reactions to these products, not to mention that it can just get hot down there using products like Always.  One definite perk of cotton products is, “she” gets to breathe! 

The debate over cotton vs. rayon centers more around issues of Toxic Shock Syndrome (TSS).  Believe it or not, TSS from the 80's, still exists today.  It is thought to be occurring for a range of reasons.  Some of these reasons could occur with any tampon.  One is the absorbency of ones tampon.  It is important to chose a tampon that is suited for the amount of flow that a woman is having at a given time.  It is recommended in the Journal of Clinical Mircrobiology,  that "additionally, tampon absorbency should be reduced to the pre-2000 absorbency levels with capacity limits of no more than 15 g of fluid as an extra measure of safety."  A tampon should not remain dry in your canal absorbing the healthy vaginal environment and creating a more optimal environment for bacteria.  Even though tampon producers advertise that one can sleep 8 hours with a tampon in, most experts dissuade against it.  Women cannot always predict that they will sleep for only and 8-hour cycle, the risk is not worth it.  

It is believed that three of the major culpable ingredients regarding TSS, have been removed from tampons, while one still remains, rayon.  It seems it is best to stay clear of the rayon feminine products altogether.  Tierno states

"In my studies I have clearly shown that, albeit viscose rayon is the best of the bad four ingredients in tampons and the other three have been removed, this still remains, and toxic shock still occurs in this country, and deaths also occur in this country.”

In regards to the threat of TSS there is a debate over which has a greater adverse effect; the excess absorbency of a tampon or the material which the tampon is composed of (generally cotton vs. rayon).   Tierno says...

“it’s more the composition that matters. Even the regular size can cause toxic shock. And we’ve had slender regulars cause toxic shock when they’re made of viscose rayon. I know of no case, none, of people who use 100% cotton who had toxic shock syndrome.”

I feel on a hierarchy of concerns, regarding tampons,  we can say, cotton is a better option than rayon, but past that we are stuck with the additional debate over Organic Cotton products vs. Pure Cotton products.  Pure here sounds like organic, but it is not.  It just means it is cotton.  Cotton is one of the dirtiest crops.  It gets heavily sprayed with pesticides.  Yes these products do get “cleaned” from the pesticides, but like our food, the cleaning is not perfect.  The FDA has determined that the toxins are not at high enough levels to strike concern.  Dioxins and other chemicals store in the body.  It does seem that dioxins may leave the body in a matter of days, but they are still able to leave their marker and do some damage.   If you are using these regularly over 38-40 years, it seems it could very well present a problem.  Tierno states: 

"Sure, one tampon is trace, but consider the menstrual lifetime of a woman. They use approximately 12,000 tampons in a lifetime. That means 12,000 exposures of dioxin ... five, six, seven times a day. That's a lot of dioxin absorbed directly through the vagina. It goes directly into the blood."

The FDA considers tampons to be a Class II Medical device, like blood pressure cuffs, powered wheel chairs or pregnancy kits.   As one can imagine Class II Medical Devices are not required to provide ingredients lists like the regulations on cosmetics.  I mean would you expect to see the ingredients in a wheel chair?  Then again it is odd that something like a wheel chair that you use externally and a condom or tampon would be viewed similarly. These companies sometimes do list ingredients online or even on the box, but they are not required to list all of the ingredients.  I am having a difficult time understanding why a product that goes next to a orifice or actually in one, is not required to list ingredients.  I want to know what I’m eating… sorry…  Phillip Tierno says, “Women assume that the FDA or other bodies have looked at the matter, and, therefore, whatever product is on the market is safe, and that’s incorrect.”  He advocates 100% cotton tampons but says that if you are a very young menstruating girl it is best to not use them at all.  Interesting addition, Tierno states that "young women are more susceptible to toxic shock because they’re less likely to have the antibodies to fight it. And if you use tampons, never use them at night.”

the take-away

I feel the industry is uncertain.  Where food is concerned, however, if a product is heavily sprayed (like red apples), it is a no-brainer.  I think I will follow the same motto with my feminine products as I do with food...eat organic (sorry). 

Placing a known pesticide laden product (prior to production) inside my body seems to follow the similar rules to eating.  If I am able, I will buy organic. So here is my current order of preference; I have a feeling it is going to change in the next few months, as I research and review other products:

1. If I am in a position where it is convenient, I would first op for organic cotton pads (to let my body flow like it is meant to).  That could be store boxed pads or Glad rags.  

2. I would probably choose the menstrual cup (except I have just heard they are not Vegan, so I must research this), or organic cotton tampons next.  I am skeptical of putting silicon inside my body, but they are super easy.  I do not always want to wear a pad, so these are good alternatives.  

3. Menstrual undies are interesting, except I do not know what they are made of and how safe that is.  This will have to be another article!

4. I have my doubts about menstrual sea sponges (though I may review those at some point as well).  Reviews I have currently read for these seem quite good.  I have read women say they are well suited for women with a low cervix or uterine prolapse. 

7. My last non-conventional line of defense would be Pure Cotton products. 

So there you have it!

NOTE: I only looked at direct personal health.  Environmental health and the trickle down that is experienced personally from being mindful of the environment is also a relevant argument in favor of organic and alternative products.  I find many people who are transitioning to alternative products are initially, primarily concerned with the direct effect such decisions have on their personal health. So I began there.

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