Dubbed one of the Dirtiest: How safe is our cotton? | Enlighten

Uriia Land
Jun 10, 2016
5 min read

Updated: Dec 12, 2025

🩸 The Unseen Risks: Conventional Feminine Hygiene and Women's Health

Feminine hygiene products, particularly tampons, are widely used by menstruating individuals. However, the composition and manufacturing practices associated with conventional cotton products have raised significant health and environmental concerns.

The Issue with Conventional Cotton

Cotton is frequently characterized as one of the world's most environmentally impactful agricultural commodities due to its reliance on intensive pesticide use and genetic modification (Benbrook, 2012; Gwosdz et al., 2021).

Pesticide Residue: Non-organic, or conventional, cotton is often treated with synthetic insecticides, herbicides, and fungicides. Residues of these chemicals can remain in the final cotton product (Gwosdz et al., 2021). Given that the vaginal mucosa is highly permeable, there are concerns that these residues could facilitate systemic exposure to potentially toxic substances (Zota & Shamas, 2018).
Tampon Composition: Estimates suggest that a significant proportion of commercially available tampons, which are not made from certified organic cotton, may contain chemical residues and undisclosed ingredients (Cora, 2016).

Chemical Components and Potential Health Implications

The structure of a typical tampon often includes various materials that undergo extensive chemical processing:

Component	Description	Health and Environmental Concern
Conventional Cotton	Non-organic cotton.	Pesticide and herbicide residues; genetic modification.
Viscose Rayon	A synthetic cellulosic fiber derived from wood pulp.	Heavy chemical processing, including bleaching, which may involve organochlorine compounds like dioxins (Gwosdz et al., 2021).
Synthetic Fibers	Materials like polyethylene or polypropylene.	May cause localized irritation or microtrauma to the vaginal wall (O'Donnell, 2016).
Undisclosed Ingredients	Fragrances, binders, or other functional chemicals.	Lack of transparency and potential for allergic or adverse reactions (Zota & Shamas, 2018).

The bleaching process used for both cotton and rayon historically involved chlorine, which can result in trace amounts of dioxins. Although the industry has largely shifted to elemental chlorine-free (ECF) or totally chlorine-free (TCF) processes, the presence of even trace dioxins is concerning due to their classification as persistent environmental pollutants and known endocrine-disrupting properties (Gwosdz et al., 2021; Zota & Shamas, 2018). Some preliminary, non-peer-reviewed research (Cora, 2016) has suggested that irritation from synthetic fibers might potentially lead to localized inflammation, which is a known underlying factor in various gynecological conditions, though this connection requires more rigorous scientific validation.

Regulatory Oversight and Consumer Information

A primary concern is the lack of mandated ingredient disclosure by regulatory bodies, such as the U.S. Food and Drug Administration (FDA), for manufacturers of tampons and other menstrual products (FDA, 2021). The FDA generally classifies tampons as medical devices, which typically require different data submissions than consumer products, contributing to a gap in readily available information about chemical composition for consumers (Zota & Shamas, 2018).

Toxic Shock Syndrome (TSS)

The most widely recognized acute health risk associated with tampon use is Toxic Shock Syndrome (TSS).

Pathogenesis: TSS is a rare but life-threatening condition resulting from the systemic effects of potent toxins, primarily the Toxic Shock Syndrome Toxin-1 (TSST-1), produced by the bacterium Staphylococcus aureus (Schoenewald et al., 2020).
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A less common cause involves toxins produced by Group A Streptococcus bacteria (Mayo Clinic, 2016).

Mechanism: Tampons, particularly those with higher absorbency, may create an environment (e.g., localized warmth and air entrapment) conducive to the proliferation and toxin production of S. aureus in the vagina (O'Donnell, 2016).
Risk Mitigation: The risk of menstrually-associated TSS can be significantly reduced by adhering to recommended practices (MedlinePlus, 2016):
- Using the lowest absorbency tampon required for menstrual flow.
- Changing tampons frequently (every 4 to 8 hours).
- Considering the use of other feminine hygiene products (e.g., menstrual cups, pads) part of the time.

Given the potential for severe outcomes, including fatality in approximately 50% of cases if untreated, prompt diagnosis and management are crucial (MedlinePlus, 2016). Recurrence is also possible, emphasizing the need for comprehensive treatment (MedlinePlus, 2016).

References

Benbrook, C. M. (2012). Impacts of genetically engineered crops on pesticide use in the U.S. — the first sixteen years. Environmental Sciences Europe, 24(1), 24. https://doi.org/10.1186/2190-4715-24-24

Cora. (2016). Tampon Transparency: A Guide to the Hidden Ingredients in Feminine Care. (Self-published informational content).

FDA. (2021). Menstrual Tampons and Pads. U.S. Food and Drug Administration.

Gwosdz, A., Waniek, K. M., Fels-Klora, J., & Dautzenberg, K. (2021). Organic vs. conventional cotton: A comparison of sustainability aspects. Cleaner Production Letters, 1, 100004. https://doi.org/10.1016/j.cplett.2021.100004

Mayo Clinic. (2016). Toxic shock syndrome.

MedlinePlus. (2016). Toxic shock syndrome.

O'Donnell, M. J. (2016). Toxic shock syndrome: An analysis of pathogenesis, risk factors, and risk reduction. Journal of Nursing Interventions and Patient Care, 2(1), 1-5.

Schoenewald, C., Harmsen, D., & Schick, B. (2020). Toxic Shock Syndrome. In P. A. Klenk & A. T. B. Klenk (Eds.), Toxicology - New Aspects to Quality and Safety. IntechOpen.

Zota, A. R., & Shamas, S. W. (2018). Endocrine-disrupting chemicals and public health: A call to action. Environmental Health Perspectives, 126(11), 115001. https://doi.org/10.1289/EHP4889

Would you like to explore information on specific organic cotton certifications or alternative menstrual products like menstrual cups?

First Edition

Did you know that cotton is regarded as one of the world's dirtiest crops? You might wonder why.

90% of tampons made from conventional cotton contain materials and chemicals that could be harmful to women's health (Cora, 2016).

The typical tampon can be made with:

Conventional (non-organic) cotton, known as one of the world's dirtiest crops due to its heavy pesticide use and genetic modification.
Undisclosed ingredients
Viscose Rayon, which is synthetic, heavily chemically processed, and bleached.

Synthetic fibers left behind can cause irritation, potentially leading to endometriosis, chronic inflammation, and infertility (Cora, 2016).

Might the cotton products women use monthly be harmful to us?

Did you know?

Women generally use between 10,000 and 16,000 tampons over the course of their lives.

On average, they spend nearly $5,000 managing their periods during their lifetime.

The U.S. feminine hygiene market generates approximately $5.2 billion annually.

“The FDA does not mandate tampon manufacturers to study or disclose the ingredients in their products.”

How can you be sure about the safety of tampons or their ingredients when searching for information only yields results from the major brands that sell them?

This isn't typically a headline discussed over breakfast unless you're dealing with an unexpected visit, yet it's an important issue that needs attention.

“Moreover, more than half of the world’s population menstruates for approximately 40 years (Cora, 2016).”

One of the common risk factors of tampons is the risk of TSS (toxic Shock Syndrome).

Toxic Shock Syndrome has been known to be a risk factor of wearing tampons.

You can reduce the risks of TSS by:

Avoiding high absorbency tampons
Changing Tampons Frequently
Only using tampons occasionally during menstruation (Medline, 2016).

Toxic Shock Syndrome is a life-threatening, rare complication from certain types of bacterial infections. Often Toxic Shock Syndrome is a result from toxins produced by Staphylococcus aureus bacteria.

TSS can also be caused by toxins produced by group A streptococcus bacteria (MayoClinic, 2016). It is important to get diagnosed and follow treatment because Toxic Shock Syndrome can be deadly in up to 50% of cases. TSS can also return in some cases as well as in those who are not treated properly (Medline, 2016).

–A great company is CORA they are providing organic tampons to women in the U.S., and sustainable pads to girls in India.

Check out at CORA.LIFE

Use the Code: Uriia78

The world’s most thoughtfully designed way to manage your period. – Cora