Tampon Safety and Regulations

Concerns about materials and tips for proper use

There have been a number of widespread concerns about the materials used in tampons and their manufacturing process. The U.S. Food and Drug Administration's (FDA) Center for Devices and Radiological Health has been regulating and providing consumer information about the safety and efficacy of medical devices produced and sold in the United States, including tampons. In general, tampons are very safe, but it's imperative that they are used properly.

Unwrapped tampons on blue background
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Tampons Safety Concerns

There are several widespread concerns about tampons themselves, and the FDA has addressed them by providing information to the public and setting regulations for how tampons can be made.


There are warnings that rayon fibers used in tampons cause toxic shock syndrome (TSS), a serious blood infection. The materials used in tampons don't cause TSS, but high-absorbency tampons are associated with an increased risk (more below).


There are concerns that dioxin, a pollutant found in the environment, could be present in the cotton or rayon used in tampons, potentially causing endometriosis. Major U.S. tampon manufacturers tested their products for dioxin levels using an analytical method provided by the FDA. The results showed that dioxin levels ranged from non-detectable to one part in 3 trillion, and the FDA has determined that dioxin at this extremely low level does not pose a health risk.


Bleaching is required to purify wood pulp and retrieve the cellulose fibers that make rayon. There have been consumer concerns raised about the use of chlorine in this process. Use of chlorine can lead to a dioxin byproduct, so tampons sold in the United States are required to use a chlorine-free bleaching process.


There have been claims that that asbestos is used in tampons to increase manufacturers' profits, causing excessive bleeding. According to the FDA, tampons are made of cotton and rayon, or a combination of these materials. Asbestos is not approved for use in making tampons, and factories that manufacture tampons are subject to inspection to ensure that required manufacturing standards are being met.

Using Tampons Safely

If you are going to use tampons, you should know that they are safe when used properly. But, some side effects, as well as serious complications, can occur as a result of tampon use.

There are a few things to keep in mind to prevent problems.

  • Wash your hands before insertion. This will help prevent the transfer of bacteria from your hands to the tampon.
  • Change your tampon every four to eight hours. Often, because tampons are not always obvious when you use the toilet, you can forget to change them. However, they need to be changed about every four hours and should not be left in for longer than 8 hours. Bacteria can grow on a tampon that is left in for too long, increasing the risk of vaginal or bladder infections, as well as toxic shock syndrome (TSS).
  • Change your tampons after you have a bowel movement. Bacteria-laden feces can contaminate the string that hangs out of the tampon, exposing you to potential vaginal or urinary tract infections.
  • Don't use a more absorbent tampon than you need. If some days of your period are light, an excessively absorbent tampon can increase your risk of vaginal dryness because it can absorb the normal protective lubrication of the vagina. And even more importantly, tampons that are too absorbent have been shown to increase the risk of TSS. Tampon sizes are standardized across brands in the United States and labeled as regular, super, super plus, or junior to describe the range of tampon absorbency.
  • Don't use a tampon when you don't have your period. If you are not sure if you might get your period, it is best to use a pad or a pantyliner. Leaving a tampon in when you don't have your period causes vaginal dryness and increases the risk of TSS.

Toxic Shock Syndrome Symptoms

Toxic shock syndrome (TSS) is caused by an infection of either Staphylococcus aureus or Streptococcus pyogenes bacteria. These bacteria already live on the surface of your skin, and they protect your skin from other infections. However, they can invade the body's bloodstream, causing a life-threatening infection.

Toxic shock syndrome is rare, but it's important to know about it. TSS is more common among young women and women who have decreased immune function. But leaving a tampon in for too long is considered one of the most significant risk factors for TSS, even for otherwise healthy women who have used tampons before.

Be aware of TSS symptoms, including:

  • Fever
  • Vomiting
  • Lightheadedness
  • Rash

The condition can advance rapidly and may even result in death. The FDA requires all tampon manufacturers to provide packaging information on all tampons sold in the United States describing the symptoms of TSS and how to reduce your risk, so a handy reminder of this information is likely as close as your bathroom cabinet.

A Word From Verywell

Tampons are a convenient option for many women. They tend not to cause an odor, don't show under tight clothes, and are practical when swimming or participating in other sports. The regulations regarding tampon materials and production provide reassurance that the tampons sold in stores in the United States are safe to use. If you are still concerned, consider buying an organic option.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food & Drug Administration. The Facts on Tampons—and How to Use Them Safely.

  2. Vostral S. Toxic shock syndrome, tampons and laboratory standard-setting. CMAJ. 2017 May 23;189(20):E726-E728. doi:10.1503/cmaj.161479

  3. U.S. Food & Drug Administration. Menstrual Tampons and Pads: Information for Premarket Notification Submissions (510(k)s) - Guidance for Industry and FDA Staff.

  4. Jacquemond I, Muggeo A, Lamblin G, et al. Complex ecological interactions of Staphylococcus aureus in tampons during menstruation. Sci Rep. 2018;8(1):9942. doi:10.1038/s41598-018-28116-3

  5. Vostral S. Toxic shock syndrome, tampons and laboratory standard-settingCMAJ. 2017;189(20):E726‐E728. doi:10.1503/cmaj.161479

  6. Genetic and Rare Diseases Information Center (GARD). Staphylococcal toxic shock syndrome.

By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women's health issues.