Don't Believe the Hype About Tampons and Cancer

A recent video on TikTok sparked panic among some tampon users. In this video, a TikTok user speculates that titanium dioxide, which is present in many tampon brands on the market, could be to blame for ovarian cysts and cancer.

The video was created in response to another TikTok user who shared her story of ending up in the ER with an ovarian cyst after using a new brand of tampons that contained titanium dioxide.

Both videos went viral, which caused some people to question whether tampons are safe to use. Several TikTok commenters stated they would be switching to reusable pads, menstrual cups or period underwear to reduce their exposure to this chemical. But is this necessary?

What is titanium dioxide?

Titanium dioxide is a naturally occurring mineral that is mined and added to a wide variety of products, including sunscreen, makeup and skincare items. It is also a food additive. This powder is often used in the bleaching process for certain products so they appear whiter and brighter.

And, yes, some tampon brands use this ingredient in the thread of a tampon, said Jessica Auffant, M.D., an OB-GYN at Orlando Health Physician Associates in Florida.

Titanium dioxide is classified by the International Agency for Research on Cancer (IARC) as a Group 2B carcinogen, meaning it may be carcinogenic to humans. This is due to some studies on rats that found a "rise in pulmonary inflammation, oxidative stress and distal organ involvement" upon inhalation, with toxic effects on the body.

However, the animals used in the studies inhaled high doses, so it's not surprising that adverse effects were reported.

"When substances such as titanium oxide are inhaled or ingested in higher amounts than intended, there is always a risk to be toxic," Auffant explained. "But in normal usage, we will not have complications expected such as cancer."

Furthermore, no studies clearly link titanium dioxide to cancer in humans. Many studies have reported inconclusive results because there is not sufficient data to understand the risk to human exposure. This has led researchers to conclude it's not necessary to avoid all products containing the ingredient.

Do tampons pose a health risk?

Even though many everyday products contain titanium dioxide, most of the attention has fallen on tampons, due to the viral videos circulating on TikTok.

The concern has been blown out of proportion, explained Sarah Yamaguchi, M.D., a board-certified gynecologist at DTLA Gynecology in Los Angeles. "Tampons that use titanium dioxide use them at very low levels and it has not been clearly linked to cancer yet, so it does seem to be social media hysteria."

Auffant agreed that these videos are misleading.

"It is important to remember that viral videos can be made by anyone," she said. "They do not have to have any evidence to back their claim, so I would be hesitant to believe these videos without having solid research backing them up."

If you are changing your tampon within eight hours and taking it out during sex, you should have no concerns, Yamaguchi said. Auffant recommended that you use the least absorbency needed and change it every three to four hours, depending on your menstrual flow.

What about toxic shock syndrome?

Another concern some tampon users have is toxic shock syndrome (TSS), a rare bacterial infection that can occur when a tampon is left in for too long. Leaving a tampon in for more than eight hours increases the risk that harmful bacteria will grow and release toxins into the body. This occurrence can be life-threatening if not treated in time.

TSS affects about 1 to 3 in 100,000 women ages 19 to 44, according to the National Organization for Rare Disorders (NORD). However, it's important to note that TSS can be caused by more than just tampons and can affect menstruating and nonmenstruating people of all ages.

The incidence of TSS related to tampon use has dropped significantly over the years, so the risk remains extremely low, especially if you follow proper guidance. The U.S. Food and Drug Administration (FDA) offers the following safety tips:

• Follow the directions on the label.
• Wash your hands before and after using a tampon.
• Use tampons only when you're on your period.
• Change your tampon every four to eight hours.
• Use the lowest absorbency needed.
• Contact your healthcare provider immediately if you experience pain, fever or other unusual symptoms.

"I recommend using the smallest tampon needed to absorb. For example, use regular tampons when [flow is] moderate and only wear the heavy-flow tampons on days that you are bleeding heavy," Auffant advised.

If you have any adverse effects shortly after using a tampon brand, discontinue its use immediately and talk to your doctor.

How to protect yourself

Tampons are generally safe to use, but if you experience an unusual reaction after using them, it's possible you are allergic to one of the ingredients. Some people are sensitive to fragrances, dyes and certain materials. If that's the case, stop using them and seek an alternative.

Yamaguchi suggested you switch to a different brand or opt for an environmentally friendly option such as period underwear or a menstrual cup. Some women find these options more comfortable, too.

"As far as protecting yourself from misinformation online, don't get your information from TikTok or any other medium where bad information is known to flourish," Yamaguchi said.

If you ever have any concerns or questions, always see a healthcare professional first.