Sawbones: Tampons
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Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion.
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I'm your co-host, Justin McElroy.
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I'll be starting off this Sawbones like I do every Sawbones with an energy drink review.
Today we got C4 Performance Energy Popsicle Hawaiian Pineapple Flavor.
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Just yet.
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they've perverted it.
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Pepper is for.
Okay.
Can I, should I start this episode with sort of a group apology?
Or do you want to do, should we save it for the end?
We'll save it for the end.
You can save it for the end.
It's easier, yeah.
So you may have heard recently in the news, very recently in the news, like, I think, well, I think that the study was actually published a couple weeks ago, but I think that it has
not even a couple, like a week ago, but just in the last few days, it's like permeated culture.
And so, like me, you may have first heard about it on TikTok and said, what?
Is that real?
And then found the study and realized that, yes, it is real.
There are metals in our tampons.
Now, Sydney, there's metals in lots of things.
This is true, Justin.
And that is a fair point to bring up that a lot of times when a study like this gains traction in popular culture,
there's a headline from it that's gaining the traction, and it's the nuance gets lost very quickly.
Yes.
Right.
And
something that researchers are looking at going, hmm, we need to study this more.
Popular opinion is going to either, it's just going to be one or the other.
Like, oh, this is terrible or, oh, this is nothing.
Right.
When the answer is usually, we don't know if it's either or both or none of those things.
It's pretty common if you're like, especially if you have science reporters who, I mean, obviously.
I mean, one hopes understand science, but may not be experts in their field.
There's always a, you know, a risk when you're synthesizing data for that kind of thing that you are, you know, you're making the best assumptions you can about it, but you may miss the forest for the trees.
I also feel like this is the kind of thing that is going to, as experts are interviewed about it, is going to lead a lot of reporters
to maybe ask the unadvisable question, will you still use tampons?
Which would be a wild question to ask a human in polite society.
Yeah.
Typically.
so metal and tampons though we were talking we got I diverted you we're saying that there is a and that that is I guess what you probably assumed when you first saw the tick tock that there is it's not uncommon for people to to mention well okay vaccines are a pretty good example of right there's things in vaccines that sound scary and you can use it for fear mongering when you understand them well it's not it's not really scary right exactly this
not that
guessing from your conversations I think that there is some,
I'm not going to, I don't even want to say cause for concern, but I do think this is something we should be paying attention to.
Sometimes it's just like, this is not something you need to really worry about or will impact you or that you can impact.
And that's the end of that.
This is something I do think is worth paying attention to.
I certainly, I never, no, I don't want to say never.
Sometimes you should panic.
Don't panic over this.
I'm not, I do not think everyone should panic.
So this is not fear-mongering, but I do think we should be paying attention.
So there was a study that was published in Environment International, and I'm going to talk, we're going to talk a little bit about the history of tampons first, like modern history of tampons.
But I want to talk about this study because I think I don't want to save that for the end.
I know that's what you want to hear.
So Environment International published a study called Tampons as a Source of Exposure to Metaloids.
OIDS was in parentheses.
So metal and oids, metalloids, both.
And researchers looked at the amount of heavy metals, including some that are toxic, in 30 different tampon brands.
This included a bunch of different brands that are popular throughout the U.S.,
EU, mainly France, I believe, and the UK.
And they also
looked at both store brand and name brand.
tampons and they looked at organic and non-organic tampons.
Okay.
And the way that they did this is they, if you're interested in how do you look at, how how do you figure out if there's metals in a tampon?
Huh?
I put a magnet up to it.
Yeah, that's what they did, honey.
They held magnets to boxes of tampons in the supermarket aisle and saw which ones stuck.
Wow.
Easy.
That's not true.
Oh, that's not true at all.
Did you really think that's what they did?
No, I didn't when I said it, but you played it so cool.
I was like, dang, Jamie.
Did it again?
So yeah, you got me twice, I guess.
No, they took little bits of tampons.
It's great, which by the way, I just, I, uh, I was reading news articles about the study and they all link to the study.
So I was able to go directly to the study and read it.
Um, it's all freely available
from the journal Environment International.
So if you want to go find tampons as a source of exposure to metalloids, you can.
And you can read the entire thing for yourself.
And you can also find there's like a very helpful picture of like a
tampon that has been taken apart into all of its base components.
And so it's like...
Is that where you see the metal rod inside of it?
How did we miss this?
How did we miss this?
No, but it has like a diagram of a tampon.
And it's like, here is the non-woven outer covering.
And here is B, the withdrawal string and C, the inner absorbent core, which has been sort of shredded and poofed out to a big mass of cotton.
I will say this.
The applicator and the wrapper.
There may be some percentage of our nation's scientific minds that need a diagram of how a tampon is put together.
Would we like to revisit Sally Ride and the hundred tampons?
So anyway, they took bits of different parts of the tampon, right?
So like the outer covering that some of them have, which is sort of like a woven material, the inner like poofy cotton stuff that absorbs.
Seriously, you may want to explain.
the parts of a tampon.
Okay.
So a tampon, if you've never seen one, which maybe you haven't, generally looks like, I mean, they're described as bullet-shaped.
And that often is kind of what they look like, little,
I mean, larger than that, pieces of, of usually cotton, something absorbent.
Right.
They might have like, and when I talk about like the outer woven covering, it's like to hold the cotton.
And so when you look at the tampon, you might not even.
It's not like you're seeing the covering.
It's just kind of the netting, mesh netting sort of substance-like like that is around the outer cotton part okay
and then it has a string hanging off of it right so the cotton absorbs the the minstrel product yeah product exactly it uh the netting sort of holds that all together yeah so that it's all one thing yeah that you can and and then it's got the string so you can pull it back out the string is of course like the sky hope from batman uh that's what you use for exfiltration yes that's how you get them out in a pinch exactly exactly it's just how you get them out and they can come with or without an applicator.
And an applicator can be cardboard or it can be plastic.
They made plastic ones that are like rounded at the tip because then they're easier to insert is the idea.
But then obviously there's a lot of concern about the environmental impact of all these plastic applicators.
You can also find like more environmentally friendly ones that are paper, edible,
cardboard.
I've never seen that you can.
No, I've never seen edible.
And there's also tampons that don't have applicators.
So you just get the little cotton thing
and use your finger as the applicator.
Okay, can I ask a really dumb question?
Okay.
Okay, because this is something that I didn't understand earlier, and that's about where I'm at now.
Some are small, like you're saying, and then some are larger, like glow stick-shaped.
What is the deal?
What's going on there?
What's the tubes?
What's up with the tubes?
And then there's a smaller thing.
Oh, well, you're talking about the applicators?
I don't know.
Like, I've seen the small things, and then there's like bigger bigger things.
Like, sometimes it's like a bigger...
So it depends on if the applicator is like an expandable one or not.
Oh, okay.
There are some really small tampons, and it's because they've turned the applicator into a
telescoping expandable thing that you pull out and then push the plunger in to
you know force the cotton out of the applicator and into the vagina and then there are other ones that are just already sort of extended which is the longer tampons that you see.
And then there are ones that don't use any applicator, which are quite small if you look at them packaged, like they can be very little.
They have those a lot.
If you go to like a
gas station bathroom, convenience store bathroom, and there sometimes are tampons you can buy in a machine.
Or if they're really nice, they're free, but they usually have to buy them.
They're usually the applicator list ones because they take up so much less space.
Okay.
Okay.
All right.
No more diversions.
I'm sorry.
Yes.
And
if you see different sizes in terms of like
super regular, ultra, super plus, that, they're talking about the amount of flow.
That has nothing to do with the size of a vaginal cavity.
That is just the flow.
Why not always just use super?
Well,
it's a larger piece of cotton.
So
I would say that they might not be as comfortable to insert.
And if if you don't need it, why are you putting a larger piece of like using a bigger bandage than you need?
Right.
It's just extra pieces.
Just use the size you need.
Yeah, that's it.
But it has nothing to do with that.
I think there's been a misconception that it has something to do with the size of a vagina, and it hasn't, that is not what the different sizes are for.
I knew that part.
Okay.
So they looked at 30 different tampon brands and they took these bits of the tampon, the outer part, the cotton part, the applicator, whatever.
They acid-digested them, broke them down
with some sort of microwave device.
Not a microwave, I'm assuming.
They didn't microwave tampons, but they used a microwave device.
And then they used like mass
spectrometry to measure the amounts of different
metals within
these components.
And they measured arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, manganese, mercury, nickel, lead, selenium, strontium, vanadium, and zinc.
The testing was done by the senior author on the paper, Catherine Schilling, who is a laboratory expert in metals at Columbia University Mailman School of Public Health.
And surprise, there are metals in the tampons.
That's what they found.
They found measurable, these are in the, you could like, there's an abstract.
So if you're not familiar with studies, which we've done an episode before on how to read studies,
if you want to check them out,
it can be difficult to interpret them sometimes if you're not an expert in various scientific fields.
But there is always an abstract, which is just like a little summary.
And so you can usually read the abstract to get like a basic idea of what happened here.
So they found measurable concentrations of all 16 metals assessed.
We detected concentrations of several toxic metals, including elevated mean concentrations of lead, cadmium, and arsenic.
It differed by region, so US versus EU versus UK, organic versus non-organic, and store versus name brand.
All of these things were different in terms of what level of what metal they found.
No category consistently had lower concentrations of all or most metals.
So there was no like absolute winner, so to speak.
I don't want to use the word safest because then that implies that there's danger in the others, right?
So I don't want to use that.
I think you would be
least least metals.
Yes, there was no routinely less metallic
brand.
And most here, here's what's interesting.
So while in like non-organic tampons, lead was higher, the organic ones had more arsenic.
So there was no like routinely again don't want to use the word safe routinely lower category okay we can't talk about safe unless we know there's a harm and i want to stress that i do not know that there is a harm from anything they found in this study and they say the same thing in their discussion we don't know what this means We know that there is no safe exposure level to lead.
So like different things, metals that we find in the environment, we have like acceptable levels of exposure, right?
That are okay.
We know it's okay.
We know we can be exposed to X amount of this and you're not going to be harmed by it.
There is no level like that for lead.
We're not supposed to be exposed to lead in the environment.
So if there's lead in the tampons,
that's not great because
all lead is bad.
We kind of just say we shouldn't have any lead in anything.
Because lead is stored in bones.
It can replace calcium.
It can be retained in the body for decades and it is associated with neurological, renal, cardiovascular, immunological.
So many different.
It can result in neurobehavioral impact in adults and children, children even in low levels decreased cognitive function so like lead is bad for humans generally speaking arsenic is a known carcinogen meaning cancer causing substance it's associated with heart disease and respiratory neurological again all of these different things
cadmium has effects on the kidneys um and the heart and
uh all three government bodies this is all from the study by the way all of these things these facts i'm giving you all three government bodies
where they found these tampons, the places where they purchased the study.
So the EU, the U.S., and U.K., regulations around tampons are not extensive and do not require regular product testing.
Okay, so I got to ask a question because it's occupying my mind.
And you may have no insight into this, in which case, that's fine.
But
I feel like history will look back on this maybe, possibly, and be like, wow, we're really lucky that we found the metal in the tampons.
I can't believe
why did they look at tampons
for metal?
What made them think like we should check?
And then all of a sudden, tampons they found had not just some metal, but lots of different kinds of metals.
What on earth made them think to check tampons for metal?
Well,
so
tell you what, that kind of gets us into the history of tampons.
Okay, good.
So I think this is a good lead-in to the rest of what I wanted to talk about in this episode.
All right, perfect.
Let me just finish off with this study
to go into this.
We don't know the implications of this.
The concern here
is that there's metal in tampons.
This is that the metal is in the tampons.
And
we know that specifically the lining of the vagina is good at absorbing things.
So like we have done studies on administering medication sometimes through the vagina as a way of absorbing a medication regularly do we do that we don't normally yes there are there are cases where we can administer a medication vaginally there are some cases we do that but generally speaking the reason they've they've done that and what they found is that the way you absorb it it's directly into the bloodstream and it's much faster it's really good at that and it doesn't pass through the liver so when you most things like you ingest through your mouth
They have like first pass metabolism through the liver where your liver will detoxify them.
Right.
Because remember, that's why you don't need to detoxify yourself because you are doing it for you in your liver and kidneys.
Unless the toxins are getting in through your vagina, in which case you maybe should invest in some charcoal foot pads.
There you go.
But we know that the vagina is very good at absorbing things.
And so
while we have certain levels for these different substances in food and drink, and we have certain levels in these substances for textiles.
So like zinc, for instance, is in textiles frequently.
Vaginal safety levels for
It's different.
The amount you're going to absorb through your skin is different than through the vagina.
And, and so, this is a, we don't know what the health consequences are.
We do know that
while it is brief
contact, hopefully, with the tampon itself, right?
I mean, we are advised generally those of us who use tampons to not use them for more than eight hours
because of other risks associated with tampons.
A typical menstruator, they did this math, will use around 7,400 tampons or possibly more in their life if you are someone who uses them.
So that's a lot of contact with tampons.
Yeah.
No one has ever checked for this stuff before.
No one had ever studied it.
And we do limit these, like other products are tested for these metals
that you put on your skin and in your body, but not this product that you put put in your body.
So
I just want to say for right now,
no one and the authors of the study and many of the doctors who were interviewed to comment on this and doctors from various areas of specialty surrounding either like reproductive health or OBGYNs or, you know, toxicologists.
Nobody right now is saying, stop the tampons.
I mean, I'm sure somebody is, but the experts are not saying, stop the tampons.
What everyone is saying is, oh, we probably shouldn't have metal in the tampons,
even if this doesn't necessarily mean it's having some horrible impact on our health right now.
Nobody's proven that.
No one has proven that the metal in the tampon can be absorbed enough in levels through the vaginal walls that you will have health impacts.
Well, I'm just saying,
I don't want everyone to run to the doctor and go, I've used tampons for 10 years.
Test me for lead.
No one is suggesting that we need to do that right now.
Someone is probably suggesting that we need to do that right now.
The experts are not suggesting that you need to do that right now.
So let's talk about how did we get here.
Okay.
But first, we've got to go to the billing department.
Well, let's go.
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Okay.
So we have done a whole history of menstruation on this show before, kind of like how we've treated, you know,
bleeding in general from the the vagina throughout history, our like sort of perceptions of it, what it's meant to us culturally and from religious perspectives and all that.
There's a whole episode on it.
It's very old.
It's from like 2014.
Wow.
That's how long ago.
Decade ago that we did that episode.
And I will say right now, like in that, so I'm not going to rehash that history since we've talked about it before.
I will say that if you decide to go back and listen to that episode, there's a lot of gross stuff that we've done through the years, as you can imagine, to try to, you know, stem the flow of menstrual blood.
I also would like to say right now that in that episode, I equate
people who have periods with women quite frequently.
So I would like to apologize for that and note that if you choose to listen to it, that is, that is in the episode.
And that was
a less educated version of myself.
The word tampon is probably from the Middle French for plug.
French was my guess.
Yeah.
Tampon.
For a plug.
Specifically, this would have often referred to the plug as like the stopper on a bottle or like at the end of the muzzle of your rifle.
Yeah.
Tampon.
Temple.
That's where that comes from.
Originally, it's interesting.
So up until, I mean, really,
the 1900s, when we see what we think of today as tampons invented,
something that we called a tampon was not, one, had nothing to do with menstruation, had nothing to do with collecting menstrual blood.
And two, was really more used as a device to keep stuff out.
It was mainly something that was used for contraception,
what they called a tampon.
And
occasionally, kind of like a pessary,
meaning like a medicated device that you would insert in the vagina for some other sort of illness or infection or to treat some sort of problem.
So you would soak it in something and then insert it into the vagina to treat something.
So, and this could range from like, you might soak it in honey, like a linen, piece of linen soaked in honey, and you would insert it and that would be a tampon to treat some sort of problem.
There were, there was a period where goose fat was recommended.
Specifically for contraception for a while, rock salt.
Oh, no.
I know, which is terrible.
I mean, it must have been very uncomfortable.
This was specifically for contraception because
rock salt, which, and I mean, they wouldn't have known this at the time, but it is indeed spermicidal.
Okay, well, that's a pretty good job.
We have many better ways to
prevent pregnancy.
They're not hard to kill.
But we have a goofy little worm.
Well, that's what I was going to say.
Like, we have way better ways now.
Please do not use rock salt as contraception.
Please don't do this.
Please do not do this.
This would be bad.
There are stories in all these time periods about like maybe
things that would be like tampons of the time being used for men's ease, but we actually don't know if any of them are true.
They may all be apocryphal.
So if you hear about things like blood moss, a specific kind of moss that supposedly was used as like an early tampon, we don't actually know if that's true.
We don't know.
There is a mention that Hippocrates specifically mentioned how to like create a tampon with like some lint and a stick or something.
There is no evidence that that had anything to do.
I mean, like, probably he did do that, but it had nothing to do with menstruation.
So there's been this conflation, like this retroactive conflation of every time a tampon is mentioned, it must have had something to do with a period.
That probably wasn't true.
Okay.
I mean, it's certainly possible.
I have to think that there were people who at the time were not able to write history,
were not able to put down, you know, in word what we could read today,
who came up with the idea of inserting different things into the vagina as a way to stop the flow of menstrual blood.
But that was not widespread or well known.
I just think it's weird that there were all these years, or not well documented at least.
There were all these years that, as far as we know, tampons were being used, something like a tampon, but not associated with menstruation at all.
I think that's a very interesting point.
Well, part of that, I wonder if part of it is like, well, I don't know.
I'm not smart enough to try to guess why.
I know that
it was much more a like
the idea that we would be out and about during menstruation, I think, is relatively
more of a new concept, you know what I mean, rather than just like staying in your boudoir.
That was part of it.
And depending on what culture or religious tradition you were in, you may very specifically specifically have been sort of put in a very specific place to stay while you had your period.
That's where Shay's lounges come from.
Actually, a lot of people don't know that.
Papa's on chairs, is what I was thinking.
None of this is true.
But I mean, the other part of it is just that, generally speaking, again, not always, but generally speaking, the people who were writing the history were not people who menstruated generally.
Not exclusively, but generally.
The standard use of like cotton or some sort of absorbent material for tampons came around in the 19th century.
But again, this was for contraception.
But these things that we were calling tampons in the 19th century, these cotton things used for contraception, probably did look like what we think of as tampons today.
So probably if you saw that, you would say, oh, yeah, that's a tampon.
There is a treatise called Illustrations and Proofs of the Principle of Population from 1822.
A lot of peas in there.
I don't know.
And Francis Place wrote this advocating that
are you telling me it's Place's illustration and proofs of the principle of population?
Yep.
Basically, saying instead of a sponge, which was commonly used for contraception, we should use a tampon.
And you could make it with lint, flax, cotton, wool, anything soft and absorbent, and you would insert it like you would a sponge, and it would, you know,
soak stuff up.
So,
so
the Mincis.
No pregnancy occurred.
No, no.
This is all again for contraception at this point.
Nobody is talking about periods.
Oh, okay.
Gotcha.
Dig it.
This was from The Lancet, by the way.
This was published in the journal The Lancet.
Wow.
During the 1800s, there were other devices similar to tampons that were created.
But again, a lot of this
was to control, even when we started to use them for things other than contraception, because primarily this is to prevent pregnancy, they were used for non-menstrual vaginal discharge.
So it's, you will find like a vaginal tampon tube mentioned in 1879, but it is not for periods.
It is for other like infections or whatever that might cause some sort of discharge.
And you would saturate the cotton with some sort of chemical or something you were hoping would be a medication.
Okay.
It was 1879.
So
it was.
No, probably not honey.
1879, probably not honey.
No, I mean, that was when we were like...
Vladimir.
Mercury.
You know, I mean, something corrosive and dangerous.
They put the mercury on there like, hey, this is really absorbent.
We've got to stick with this.
Anything metal, guys.
Metal.
That's the secret.
Metal.
And like, a lot of these things were not,
you wouldn't use them outside of a hospital.
So when I'm talking about like the tampons that they used for these other cases outside of contraception, these are things that would be inserted in a hospital by like a doctor or a nurse or a midwife.
Like the nurses may be sewing them and making them themselves and then administering them in the hospital.
And
you would, again, soak them in some kind of antiseptic or something like that to treat some sort of infection or whatever.
It isn't until the 1920s that supposedly the idea that, hey, these things that we're putting in there for all these other reasons might be good at managing menstrual flow wasn't even mentioned until the 1920s.
But there wasn't like there's this story of
John Williamson, who was an employee at Kimberly Clark,
the company that made a bunch of different products.
He poked holes in a condom and stuffed it with a pad, with a menstrual pad, and then said i think this should be a new thing now he he was well known as an office prankster so he could have been joshing everybody we don't know
but that was not picked up uh nobody wanted to do anything about that we didn't do anything about it wait so wait hold on wait
this guy this guy this anecdote this paragraph you brought me this dude is just like he goes to the boss's office he's like i've been in hand pods they're like out and on his way out he's like hey everybody tell history tell history that i tried to do this you gotta wonder what how people even find out about this right like what is the i feel like he went back i feel like he was telling his grandkids this and it's all a lie this is you run into these you do run into these like this may be true maybe not but like when i research people you always find like these paragraphs are like um okay pal you are just sure like uh the the cat that emitted beeto emitted like bajillion other things like wow okay i this just seems like it's from your story but all right
um in 1931, Earl Haas, a physician in Colorado, made a cardboard applicator tampon.
So the idea was, we're going to take this tampon that we know it exists.
Sorry, I don't mean to cast dispersions on the Beano guy.
He may not have done that.
He may well have done that.
I don't know.
But anyway, he made the tampon inside a cardboard applicator.
The tampon is kind of what you'd think of, cotton with a string, like what you'd think of as a tampon.
And it was because he'd been inspired by a friend who said she used a sponge.
And he was like, well, instead of a sponge, why don't we use a tampon?
And I made an applicator for it.
And that's cool.
And why would he have made an applicator?
And why would this have mattered?
It was still very
improper at the time for a person to touch their own vagina or to admit that they may do so.
A tampon without an applicator necessitates that you use your finger to insert it.
So just the buying of it would be an admission that you are going to touch your own genitals.
The applicator was a way of allowing people to purchase a product
without having to publicly sort of not, it's not like it's a confession, but by buying it, you're confessing that I'm going to go home and touch my genitals.
Can I ask sort of a dumb question for all us wiener folks over here?
Is the applicator like a necessary or a convenience or is it just like pointless?
Or what's the stance on applicators now that we don't necessarily have that same hang-up?
So they are convenient.
They're definitely a convenience.
They're not necessary.
You can insert a tampon just fine without an applicator.
Comfort level has a lot to do with it.
And then there are regional preferences.
You find inside the U.S., applicator use is much more common.
Outside the U.S., you'll find a lot more people who use applicator-less tampons.
So part of it's regional.
And then again, part of it is just the comfort level of knowing, like,
I mean, there are still great swaths of the population where because of cultural or religious ideology, they may feel very uncomfortable inserting their finger into their own vagina to, which is what you have to do to place a tampon without an applicator.
And if that is something that does create a lot of discomfort for you, you just don't want to do, or if you're nervous or unsure, the applicator makes it easier.
Okay.
Thank you.
The tampon, though, what's interesting is Earl Haas made it and made the, he made kind of what we think of today as a tampon and he made the applicator.
And then he sold his patent almost immediately.
Like he made it in 31.
And then by 33, he has sold it to a woman named Gertrude Tendrick who said, I want to do this.
I'm going to take this product and everybody's going to love it.
I don't know why Earl Haas had no interest in it other than, I mean, he just didn't want to be the tampon guy.
But he sold it to Gertrude Tendrick and she made tampax.
Wow.
Okay.
Yeah.
It's from the word tampon and vaginal packs, which vaginal packs were what you often would call anything that you put inside the vagina at the time to stop menstruation.
So tampax.
Oh, and
even despite the fact that there were a lot of people who were initially, you know, sort of, oh my goodness, no, clutching their pearls at the invention of the tampon, tampons.
Pearls actually wouldn't be invented for many years later.
That's not true.
What?
Oh, you mean the tampon pearl, tampax pearls?
Yeah, it's good that you know, Brand or a line of tampons there.
I buy your tampons.
What are you talking about?
I'm just hanging into a corner like I'm some Neanderthal.
Like, I buy, I buy tampons.
Everybody
there, so in the first seven years of Tampa's time on the market, their use increased five-fold.
Uh, their factories were used to produce dressings and bandages during World War II.
That didn't stop people from using tampons, and even more so
because during World War II, so many people who used tampons were suddenly needed in the the workforce that
it became really beneficial to have something that you didn't have to change as frequently.
And then sometimes people in the wars are using the tampons to stop up bullet holes.
So you tell me it's a virtuous cycle.
I think everybody's loving these things.
There was another tampon, the non-applicator kind, was invented by the German gynecologist Judith Esser Mittog.
And these are often called OB tampons.
Do you know why they're called OB tampons?
This is how I was always,
by the way, I only ever ever knew them as OB.
There were applicator tampons and OB.
I would assume, I mean,
the only connection in my head is obstetrics.
Nope.
It's the German, which I don't speak German.
It's on bind,
which means no pad, like
OB.
That's why they're called that, in case you're curious.
Anyway, and so they start, and then they sold that to, she sold that to Johnson and Johnson.
And so OB tampon is another huge name.
And like in a lot of regions where you mainly use applicator tampons, you may not be as familiar with it.
You may be more of like Tampax, Playtex, like you know those sorts of names.
OB is a huge tampon brand all of its own.
But it was hard because there was a lot, it took, it took time to get society to accept the use of a tampon.
There was still this sort of stigma against like, well, but are you...
Are you are you touching yourself?
Are pads common at this time?
Pads.
Pads are
the colour.
Yeah.
And we've talked about, and this is in the other episode, that like pads back then didn't have adhesive on them often.
So you would wear like a little belt to keep your pad in place.
Yeah.
And the, but the, the advantage of this is that it was, it was easier than a tan, than a pad with a belt.
Um, it was easier than a pad with a belt.
You could, you would have more control over your life if you use these.
Um, and there, but there was still this sort of stigma.
You sound like it was back and forth.
You sound like the spokesperson for when they were initially invented.
Like, hey, bass, I just want to tell you about these.
It's a lot easier than a pad with a belt, and it will stop the bleeding.
So here's the point.
Yeah.
Tampons are becoming more popular and we're kind of in the US focused right now.
They made these scented tampons for a while and these were irritating and could cause they're irritating and they're irritating.
They're irritating.
I just think
I am somebody who has trouble with like allergic reaction to scents.
Just thinking about a scented tampon makes
everything hurt.
We try to get rid of everything scented in the house and I've tried to be really diligent about it.
You don't realize how much stuff is scented because every once in a while you'll get like a replacement or something from Instacart or something like that.
It's like, whoa, like, because we try really hard to be diligent about it because
trouble with smell.
I do, I do.
And I could not, so that, so in the 70s, because of all this, Congress said we need to regulate tampons.
And we're the perfect people to we're gonna we're gonna um make them medical devices so they are no longer regulated they were no longer at that point regulated as cosmetics which they had been before but then they fell under the medical device regulations so they have to go undergo more extensive testing however they did not have to disclose a list of ingredients now which cosmetics did isn't that interesting um
they uh and that's like
that's different than like your shampoo has to have its ingredients in it right tampons don't because it's a medical device So were the metals on there before?
Well, so here's the thing.
The metals have probably always been in there honey we weren't testing even as they as we started doing this more rigorous testing of them because they were medical devices and like by the way one product sort of fell through the gaps there there was a tampon called rely
uh that was super absorbent and so you could leave it inside much longer was the idea this is where a lot of the fear from toxic shock syndrome comes from so if you leave a tampon inside your vagina for too long the thought is that it creates a perfect breeding ground for a certain kind of bacteria, and then you can get a shock reaction that can be fatal, which is why they tell you don't leave your tampon in for longer than eight hours.
This Rely brand is really where that fear sort of got kicked off because they didn't do all the testing on it because it was approved right before this new act was passed.
And so, a lot of people started using these longer-acting tampons.
And we saw
over a hundred cases of menstruation-related toxic shock syndrome.
So, and 38 of those were fatal.
So, like, very serious.
So, after that,
they did start to look at tampons a little more closely because of the toxic shock.
So, they started to look at like specifically ingredients like polyester, polyacrylate, rayon.
They started
looking at like synthetic fibers versus like cotton.
And so, they did, they did do some research in the 80s on what we should make tampons out of and what would prevent toxic toxic shock syndrome.
But that really still had nothing to do with what else is in there.
Nobody was looking to see, are there metals in there?
Nobody was checking that out.
So they did a lot of focus on like how long can you wear them, absorbency, that sort of stuff, ways that amplify bacterial growth and ways where we can reduce bacterial growth inside a tampon.
There was a concern in the 90s about dioxin, which is a carcinogen.
And that had to do with like a chlorine bleaching method that was used in the processing of the tampons.
And so like a lot of companies started switching away from that to reduce the amount of dioxin that is in tampons.
So we'd looked at this before as well.
So like my point is, we have looked at other things in tampons through the years.
It wasn't until the authors of this study sat down and said, you know, a lot of plants contain metals.
And the reason is that they're leaching it from the soil that they're growing in well if we make tampons out of plant fibers
do tampons contain metal look at that this is where this idea came from you answered my question yes
and so they sat down and looked to see
are there metals and tampons and there are and it turns out folks there are a wild amount so much that well and so the where is the metal coming from probably some of it is from the plant fibers themselves, from the soil, because our soils have these things in them.
And so then the plants get them too, then the tampons do.
Some of it may come from the processing.
And that was one thing that it's really interesting if you read the whole study.
The amount of zinc that they found made them wonder if processing is part of it.
Because it seemed like
it was more than you would expect from just like leaching from the soil.
And so the thought is that maybe there's something in the processing that is putting more zinc into the tampons.
It is more zinc
or it is below the threshold that we allow for textiles.
But then the fear is, again,
you wear a shirt on your arms.
You don't put it inside your vagina and the vagina is different.
That's a really helpful tip for everybody there.
So don't freak out.
We don't know what this means.
We don't have, I mean, the next step is...
Don't freak out.
We don't know what this means.
The next step is, if there's metal in the tampon, is it getting from the tampon to the inside of your body?
We don't know.
We're going to have to find models, probably in animals, where we can see in a standard tampon with this much metal, how much of it gets absorbed from the tampon into the lining of your vagina.
We don't know.
And then, are those levels enough to cause any of the detrimental health effects of these chemicals?
We don't know.
Nobody tested anybody wearing a tampon to see if they have a higher lead level, right?
Nobody did that yet.
But those would be the next steps to figure out: is this something that worries you?
Just to be clear, is there, so is there, because I think a lot, even people who aren't tampon users are aware of toxic shock syndrome.
Is there no connection between this and toxic shock syndrome?
No, this has nothing to do with that.
This would be a whole other, a whole other issue.
If it is, if it is indeed an issue, it's a whole separate issue.
I would say that if you look at like in the 90s, the dioxin issue,
or even if you look at like some of the substances that they removed in response to the toxic shock concern, a lot of this, I mean, there was the toxic shock syndrome that spurred that in the 80s.
In the 90s, they didn't necessarily see cases of cancer and then say, oh, it's from dioxin and tampons remove the dioxin.
They said, this is a potential danger.
Let's just get it out of there.
So I would say that there is a question I would ask, which is, even if this is just possible, even if this hasn't caused any harm whatsoever, but it is a potential harm.
Can we make efforts to get the metal out of the tampons?
Can we just get the metal out of the metamorphosam?
Could we get the metal out of the tampons?
I mean, like, that's, that would would be
a question.
What if we could skip the research onto what the effect of the metal is on vaginas and vagina hamburgers?
Maybe we just don't anymore do the metal and the tampons.
But it's, but this is, but, like, like a lot of things that have to do with people with vaginas and people who menstruate,
the, the freedom to move about in the world for those of us who do has been limited throughout history in various ways, more severely for different groups.
And so, to just blanket say stop using tampons would be a really dangerous, reckless statement to make, right, without more evidence.
Um, because they do provide a freedom of movement that previous menstrual products had not.
Now, a lot of people I know right now are screaming about the menstrual cup.
And I will say that, like, the menstrual cup has existed.
It predates the tampon.
It's a small, usually silicone or some other sort of similar material that you can insert into your vagina and it collects the menstrual blood that way and does not, as far as I know, contain metal.
It's silicone.
I don't, I did not study it, though, for metal.
I'm going to run it through the metalizer,
the metal, metalizer 3000 just to double check.
So there are alternatives that are long-lasting and limit some of the other risks as well.
But that's not for everyone.
And so right now, no one is saying, nobody who understands this is saying throw your tampons away.
But I would pay attention to this.
More studies are coming.
Yep.
I am certain, and we'll know more.
And I think to advocate that we regulate companies to not put metals in our tampons is an absolutely fair thing to advocate for.
Absolutely.
Hey, folks, thank you so much for listening.
You want to come see us?
You can if you want.
We're going to be doing some shows.
It's a rarity to get sawbones out on the road, but we're going to be there
July 18th in Detroit before my brother and me and July 20th in Cleveland, Ohio.
You can get tickets at bit.ly forward slash McElroy Tours,
and we hope to see you there.
Thanks to taxpayers for the use of their song of medicines.
This is the intro and outro of our program.
And thanks to you for listening.
We really appreciate it.
And hey, if you came out to see Escape to Margaritaville,
weekends.
Thank you.
We saw it, met a lot of folks.
Thank you.
Really appreciate it.
That's going to do it for us for this week.
Until next time, my name is Justin McElroy.
I'm Sidney McElroy.
And as always, don't drill a hole in your head.
All right.
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