Tampons are one of the most popular period products in a growing market that also includes period underwear and menstrual cups. They’ve been around since the 1930s and are still a mainstay for many people today, used by up to 80% of people who menstruate.

But few studies have looked at the potential contaminants in tampons and whether they pose a health risk, and a new study, the first of its kind, is leaving many questioning the truth. Are tampons safe?

A recent study from the University of California, Berkeley found that many commercially available tampons, both organic and non-organic, may contain toxic metals such as lead and arsenic. Researchers looked at tampons sold in the United States and Europe.

“Some tampons had higher concentrations of some metals and lower concentrations of others,” said lead author Jenni A. Shearston, PhD. “None of the tampons we tested appeared to have low concentrations of all metals.”

Searston said she and her colleagues began researching tampons after noticing little information about their ingredients in the research literature.

“There has historically been a taboo around menstruation,” she says, “and that not only impacts our social lives, but it also impacts scientific research, which I think is one of the reasons why there isn’t much research on menstrual products.”

Dr. Mitchell Kramer, chairman of obstetrics and gynecology at Huntington Hospital Northwell Health, said the study is “groundbreaking” and shows tampon manufacturers need to do more testing of their products.

“It certainly needs further evaluation. … I think this could have a big impact going forward in terms of how tampons are made and the impact on users,” Kramer said.

However, it is unclear what health effects using tampons that contain these metals may have.

“It’s unclear whether these metals are absorbed through the vagina, which is a key exposure,” said Dr. Jennifer Lincoln, an obstetrician-gynecologist and author of Let’s Talk about Down There: An OB-GYN Answers All of your Burning Questions … Without Making You Feel Embarrassed for Asking.

Shearston, a postdoctoral researcher at UC Berkeley’s School of Public Health and School of Environmental Science, Policy and Management, added that one of the limitations of the study is that it’s not known whether metals even leach from tampons.

“We only tested the tampons to see if they had these metals in them,” she said. “We don’t know if they’ll come out.”

Here’s what you need to know about the study:

Tampons and toxic metals

The paper states:Environment InternationalIn a new study titled “Tampons: A Guide to the Effects of Metals on Men’s Health,” researchers looked at 30 different tampons from 14 different brands and measured the levels of metals in them. Every tampon tested had measurable levels of all 16 metals they tested, including toxic metals like lead and arsenic.

But the study doesn’t conclude that the tampons tested, or others on the market, are unsafe, and Searston hopes people don’t “panic” about the study.

“We need more information,” she said. “What I would encourage people to do is support more research, ask more questions about this, and try to prioritize research on menstrual products and periods.”

The metal content varies depending on the type, where you buy it, and whether it’s generic or brand name.

“These metals were found in varying amounts, with some more prevalent in organic tampons (such as arsenic) and others more prevalent in traditional tampons (such as lead),” Lincoln said. “The study was blinded, so we don’t know which brands were tested, which I know is frustrating.”

Lincoln, who was not involved in the study, said he’s a bit surprised that this is the first of its kind, but that the findings make sense.

“It’s not surprising that metals were found in organic tampons because they can be absorbed from the soil and pesticides are still used in organic farming,” she said.

Are tampons safe?

Yes, tampons are still safe to use, experts say.

“There’s no need to panic,” Kramer said. “It hasn’t been proven that these products are dangerous or that they’re causing serious illness in people. I don’t think so. I think the concentrations of these heavy metals are very low.”

Research news release “It’s unclear whether the metals detected in this study contribute to any adverse health effects,” she said. Shearston said she and her colleagues are currently investigating “whether metals can migrate out of tampons.”

“We do leaching experiments,” she said, “and we also test the same products, like tampons, for other chemicals.”

Lincoln also stressed that it was too early to say what the study’s findings might mean for consumers looking for the safest tampons.

“This study shows that the average amount of lead found in tampons is actually very low, much lower than the amounts of concern in food and water,” she said. “This doesn’t negate the findings, but it’s an important consideration when people are deciding whether to continue using tampons.”

Katherine Roberts, deputy health editor at Consumer Reports, Covered Organic Tamponspoints out that the study highlights the need for more research on tampons.

“This isn’t a lesson that’s immediately actionable for individual consumers,” Roberts said. “The big lesson from this is that we need to do more research. In particular, studying how using tampons that are contaminated with heavy metals affects physiology would be very helpful.”

Are non-toxic, organic tampons safer?

All of the tampons tested contained some level of the toxic metal, even those that were claimed to be non-toxic and organic. In fact, these tampons contained more arsenic than traditional tampons.

“I hope this study shows people that organic doesn’t necessarily mean better, especially when it comes to menstrual products,” Lincoln says.

For example, an organic label on a tampon doesn’t mean as much as it does on food.

“Tampons labeled as organic don’t have a whole lot of information on them,” Roberts says. “It can mean a variety of different things.”

Lincoln added that people should choose menstrual products based on what’s best for them.

“This study shouldn’t be a reason for us all to immediately throw away tampons, but it’s important for people to decide what feels right for them,” she said. “It’s important to recognise that which period product to use is a personal choice – not everyone feels comfortable in pads, cups or period underwear, and for those people, tampons are their go-to.”

Using tampons safely

For tampon users who are concerned about metal exposure, Kramer recommends using tampons less frequently and relying on other menstrual products.

“You might want to alternate between tampons and sanitary napkins during your period, rather than leaving a tampon in 24 hours a day,” she says. “There are a few things you can try to reduce some of your exposure.”

There are other things consumers should consider when choosing a tampon to avoid unknown ingredients.

“Unfortunately, buying a particular brand or looking at a particular label doesn’t necessarily translate to avoiding (heavy metals),” Roberts said.

Roberts says you can buy unscented tampons, choose tampons with fewer ingredients, and avoid tampons made with plastic materials like polyester, polypropylene, and polyethylene.

“Flavours are a big black box, regulatory-wise,” Roberts says. “You can add flavours, but you don’t have to disclose what’s in them.”

Still, Cramer hopes people don’t panic about the findings.

“Tampons have been around for ages. I’ve never seen anyone come in with heavy metal poisoning. That’s completely different from the toxic shock syndrome issue,” he says. “That was a bacteria that had nothing to do with heavy metals.”

Alternatives to tampons

If you want to try other types of menstrual products, consider these Alternatives to tampons:

Menstrual cup

One popular brand is the DivaCup, a cup that is inserted into the vagina to collect menstrual fluid.

Menstrual disc

These products use a rimmed bag, similar to a cup, to collect menstrual fluid.

Period underwear

These are similar to regular underwear but contain additional material to absorb menstrual fluid.

Reusable Pads

These are cloth pads that you place inside your underwear to absorb liquids, but unlike regular disposable pads, they can also be washed and reused.