Estrogenic activity in tampon products

Abstract Tampons are widely used menstrual products with prolonged mucosal contact, raising questions about their potential role in exposing females to endocrine-disrupting chemicals (EDCs). This study evaluated estrogenic activity in tampon extracts using a cell-based estrogen receptor reporter bioassay. Synthetic and organic tampons sourced from domestic and international markets were tested for estrogenic bioactivity. Of the 18 brands analyzed, estrogenic activity was detected in nearly half, independent of material type. Comparative chemical analysis of one estrogenic-active brand vs one nonactive brand via high-resolution mass spectrometry tentatively identified various plasticizers, surfactants, and fragrance agents, that were present in higher concentrations in the estrogenic-active brand. The list of chemicals included known EDCs, such as phthalates and alkylphenols, that may be responsible for the observed estrogenic activity. Notably, estrogenic activity varied by brand, suggesting formulation-dependent risk. Although the detected in vitro activity levels were low, the findings demonstrate that compounds capable of activating estrogen receptors can leach from tampons. These results highlight the importance of including endocrine bioactivity assays in tampon safety assessments and suggest that safer formulations are achievable. Further investigation is warranted to assess long-term health implications of low-level EDC exposure from menstrual products.