Titanium dioxide isn't making tampons into toxic death sticks
Please stop with the TikTok fear mongering
Please don’t panic about titanium dioxide in tampon strings.
Yes, I know there are scary videos circulating on TikTok, but this is chemophobia. And it’s also awful fear mongering as I have received panicked messages from women worried their tampons caused their pre-cancer of the cervix.
Titanium dioxide, or TiO2, is a naturally occurring mineral. I’ve emphasized that because it’s interesting how the term natural is only used when it suits a specific agenda. Titanium dioxide is a white powder and a common ingredient in many products. If something is white, it often has titanium dioxide. It's used in sunscreen, toothpaste, some food, and it is used to whiten the string of tampons.
For example, here’s the ingredient list for Tampax Peal
Some particles of TiO2 are nanoparticles, meaning they are much smaller than the width of a human hair. When particles are this tiny they can interact differently, so it’s possible that nanoparticles of titanium dioxide could have different health risks than larger particles.
There is no data showing titanium dioxide in food or in other products is unsafe, but some recent rat studies showed ingesting massive amounts (more than we could ever get from food or tampons) every day for 90 days might theoretically cause some bowel concerns. This data seems to be why it was banned in the European Union. It is important to note that as reported by Scientific American, the EU panel didn’t identify any actual health concern to prompt the ban.
Health Canada recently reviewed all the data about titanium dioxide in food and concluded the following:
no evidence of cancer or other adverse effects in mice and rats exposed to high concentrations of food-grade TiO2 (long-term or lifetime study)
no changes to DNA in various animal studies
no adverse effects on reproduction, development, immune, gastrointestinal or nervous systems, or general health when rats were exposed from pre-conception to adulthood
Some of the fear mongering about tampons seems to be because the International Agency for Research on Cancer (IARC) classifies titanium dioxide as a Group 2B carcinogen, meaning “possibly carcinogenic to humans”. But there’s an important caveat here…by inhalation. This was from studies where rats were inhaling high doses. This isn’t happening from your tampon string.
What other evidence do we have that titanium dioxide is safe, besides everything reviewed by Health Canada? And while the Health Canada review was for food, we’re exposed to far more titanium dioxide via food than we could ever be via tampons.
Titanium dioxide doesn’t dissolve in water, meaning the nanoparticles aren’t going to dissolve from the tampon string and get into the blood that might be pooling in the vagina and then get absorbed by the body. Meaning, you don’t have to worry that the blood soaked tampon string is leaking titanium dioxide nanoparticles into your vagina. When products like titanium dioxide are put on fabric, the point is to have them stay put on that fabric through the miracle of chemistry. Fabrics with titanium dioxide have been studied by washing them repeatedly, and it seems very little titanium dioxide is released, even after multiple washings. But no one is washing a tampon (meaning the string isn’t exposed to detergents and high level friction and repeated rinsing). And of course no one is washing them repeatedly and reusing them.
People are also swishing titanium dioxide toothpastes in their mouth twice a day (hopefully) and toothpaste isn’t causing cancers or reproductive toxicity. During brushing there is also friction and a lot of blood vessels under the tongue, things that make absorption much easier, so theoretically a far higher risk environment than the vagina.
Titanium dioxide nanoparticles in sunscreen are also not linked with cancer or any other negative health outcome. It seems they stay on the surface. Titanium nanoparticles are on the surface of some medical-grade titanium implants that are placed inside the body, and there’s no indication those are associated with cancers.
And finally, tampons themselves are not linked with cancer, endometriosis, or other serious health conditions with the exception of the rare toxic shock syndrome.
There is no evidence that titanium dioxide on tampon strings can cause any harm.
References
Release of Titanium Dioxide from Textiles during Washing. L. Windler, C. Lorenz, N. von Goetz, K. Hungerbühler, M. Amberg, M. Heuberger, and B. Nowack. Environ. Sci. Technol. 2012, 46, 15, 8181–8188
Titanium dioxide in our everyday life; is it safe?Matej Skocaj, Metka Filipic, Jana Petkovic, and Sasa Novak.Radiol Oncol. 2011 Dec; 45(4): 227–247.
Health Canada report on Titanium Dioxide https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/titanium-dioxide-food-additive-science-report.html
Are Skittles Toxic from Titanium Dioxide? Sam Jones, July 29, 2022 Scientific American https://www.scientificamerican.com/article/are-skittles-toxic-from-titanium-dioxide/
Toxicity of orally administered food-grade titanium dioxide nanoparticles. Hyoung-Yun Han, Mi-Jin Yang, Cheolho Yoon et. al. J Appl Toxicol. 2021 Jul;41(7):1127-1147.
Tampax ingredients https://tampax.com/en-us/about/ingredients/what-tampons-are-made-of/
Nanoparticles and sunscreen, are they harmful? Cancer Council Australia https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/about-sunscreen/nanoparticles-and-sunscreen
Good god, where will it end? In chem class we learned peanut butter was carcinogenic I'm massive doses.
Hi dr. Jen! I was wondering if you could make a post on why someone would have moderate to many white blood cells in wet mount but negative for the common pathogens? What are the potential reasons that would not require treatment?