Period underwear has gone mainstream in recent years, appealing to eco-conscious millennials looking to save money and protect the planet.
Their convenience factor has also made them popular with teenagers and pre-adolescent girls looking for a less invasive alternative to tampons.
But there is evidence that makes up as much as two-thirds of menstrual underwear contain toxic “forever chemicals” that have been linked to everything from kidney cancer to miscarriage and even infertility.
Thinx, the most popular menstrual underwear brand in the US, has settled a three-year, $4 million class-action lawsuit after Nicole Dickens, who used to use the products, accused the company of forever having chemicals in her underwear.
Exactly how the toxic chemicals got into the underwear is not known, but it is thought that the liquid-repellent outer layer most likely contains PFAS. The perpetual chemicals can enter the bloodstream through pores in the skin. Once in the blood, they can travel throughout the body and remain there for many years. PFAS are associated with numerous health risks, including reduced fertility and a higher risk of miscarriage and kidney cancer
Independent third-party testing of Thinx underwear reportedly shows detectable levels of per- and polyfluoroalkyl substances known as PFAS.
They are a class of about 12,000 man-made chemicals that repel grease, water, stains and heat.
All PFAS contain carbon-fluorine bonds, some of the strongest known to man. They are also called “forever chemicals” because they take thousands of years to break down in the environment and in the body.
Dr. Shruthi Mahalingaiah, an environmental health researcher at Harvard TH Chan School of Public Health, told DailyMail.com: “[PFAS] is not broken down or metabolized in the body.
“They are excreted in breast milk, menstrual blood, transfer to the fetus during pregnancy and blood loss. A very small amount can be excreted in faeces and urine.”
DR. Mahalingaiah bought some period underwear for her daughter, but was shocked to learn of its potential PFAS content, as it was marketed as a natural, organic product.
There has been speculation as to exactly how and at what point in the manufacturing process the toxic chemicals get into the underwear.
The stain and water repellent layer added to the fabric is suspected to contain PFAS.
In the settlement, Thinx agreed to ensure that PFAS is not “intentionally added”.
Consumer activist Mamavation’s website found that 65 percent of menstrual underwear tested had detectable levels of fluoride in the outer or inner crotch layer.
Mamavation sent 17 pairs of underwear from 14 brands to an Environmental Protection Agency-certified lab to calculate fluoride levels in the fabric above 10 ppm.
Eleven of the pairs contained detectable fluorine.
Dr. Ken Spaeth, head of occupational and environmental medicine at Northwell Health, told DailyMail.com that the presence of PFAS is “typically a manufacturing issue”.
He said: “PFAS has some utility in environments where the idea is to create a barrier to keep moisture out, so that could be the problem.”
The health risks of PFAS are far-reaching but not yet fully understood. Links have been made to high blood pressure, some cancers and even infertility.
Period underwear has gone mainstream in recent years, appealing to eco-conscious millennials looking to save money and the planet (file image)
The specific way in which PFAS chemicals harm human health is unclear, but the fact that they affect a number of organ systems in the body is well accepted.
Dr. Spaeth said: “We don’t know the exact mechanisms, we only know what the consequences of the contamination are.
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“The ability of these chemicals to disrupt signaling is part of their endocrine disrupting activities.
“And it appears to be directly harmful to the cells of the liver and some other organ systems.”
“The carcinogenic signaling pathways appear to be related to a number of different cytotoxic inflammatory pathways and possible gene damage.”
He added: “The full mechanism of injury is not fully understood, but their ability to injure is nevertheless recognized with certainty.”
PFAS in period underwear is of particular concern, said Dr. Spaeth.
He added: “Because it is underwear, the genitals are particularly susceptible to absorption. The skin in and around the vagina become potential absorption areas.
“Given some of the preliminary figures associated with the concentrations found in some of these products, they would suggest that they are quite high, so the potential for significant uptake should be considered.”
Dr. Spaeth said the evidence on the effect of PFAS on fertility is “mixed”.
He said: “There is certainly evidence of that [infertility] can be a problem… These chemicals are endocrine disruptors.
“One of the ways they disrupt the endocrine system has to do with the normal pathways and normal activities of hormone signaling, including estrogen and some of the other hormones that are critical to women’s reproductive health.” So that potential is definitely there, but it’s not clear exactly to what extent it will affect fertility in particular.”
PFAS can also be dangerous at some stages of pregnancy, including for the developing fetus.
A study published in June found that middle-aged women with the highest levels of PFAS in their blood were 71 percent more likely to develop high blood pressure than other women their age with lower levels of the chemical.
The study states that PFAS may be an “underestimated factor in cardiovascular disease risk in women.”
A 2020 study found that participants with the highest levels of PFAS in their blood were more than twice as likely to develop kidney cancer as those with the lowest levels.
Humans already have measurable levels of PFAS chemicals in us, ingested through breathing, eating or drinking contaminated water.
PFAS can also enter the body through the skin because the particles are so small. Dr. Spaeth said, “Once they’re in the body … they can travel in the bloodstream and potentially get anywhere in the body.”
The authors of a 2016 review said that half of the studies they examined showed that exposure to PFAS takes the time it takes women to get pregnant.
A 2020 study in Minnesota also found that removing PFAS-contaminated water supplies resulted in fewer premature births and fewer low birth weight babies, as well as higher fertility rates.
In Sweden, researchers found that women with double the amount of PFAS in their blood were 50 percent more likely to miscarry than other participants.
Dr Spaeth said: “This is additional exposure to a chemical that is already in our bodies from multiple sources. We all already walk around with measurable amounts of these PFAS chemicals inside us. In addition, the risk of health effects can only increase . In situations where additional exposures can be identified, this is certainly a concern.”
Exposure to PFAS has “real potential consequences,” he said, as hormone-disrupting chemicals have a variety of health effects, including things like reproductive cycles.
Dr. Spaeth added, “At the very least, these types of chemicals should not be used in a way that exposes individuals without warning.”
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
