If a tampon shortage in the USA wasn’t enough, there’s now a terrifying TikTok about the effects of titanium dioxide in tampons with an emotional story that hits home for menstruators. It tells the story of a woman who—after using a specific “organic” tampon brand—developed cysts and then uterine cancer. She discovered the tampons she was using lists titanium dioxide as an ingredient, which she blames for her health issues. It's a scary and emotional story. Is titanium dioxide safe in tampons or could it cause health issues? Let’s unpack this TikTok and follow the evidence.
One of our founding values at joni is radical transparency. We disclose every ingredient we use in our products to inform and educate so you can make the best decision for your body. Full disclosure: our ingredient list is simple and does not contain titanium dioxide or any other chemicals or fragrances. In fact, joni tampons are 100% organic cotton. And that’s it.
What is Titanium Dioxide (and should you be worried)?
Is Titanium Dioxide Safe in Tampons? Titanium dioxide is used in all kinds of products as a whitener, including toothpaste, sunscreen, and yes, period care. While the EFSA in the United States declared titanium dioxide unsafe as a food additive in 2021, the FDA has ruled it safe for use as a colorant.
joni co-founder, Jayesh Vekariya—in addition to holding an MBA—has a master’s in pharmacology with a research interest in endocrine hormones and reproductive health with more than nine years of experience within the pharmaceutical industry. To say this guy likes his scientific studies is an understatement. In a previous blog post, Jayesh debunked the myth that non-organic pads can cause cancer since study after study has not proven this. Yet Jayesh clarifies that simply because a brand uses materials that have been pre-assessed for health safety does not mean how they’re being used does not cause problems. For instance, certain plastics and artificial adhesives have been shown to increase the risk of vulva-vaginal infections and contact dermatitis.
So when asked if titanium dioxide in tampons can cause cancer, Jayesh says, “I don’t know because it simply hasn’t been studied for this application. When titanium dioxide is used, we assume it isn’t in large quantities. But we don’t know anything about how much is safe in tampons or if it accumulates in the body. There’s no evidence of cancer due to titanium dioxide in tampons but that may be because there simply aren’t any studies in this regard.”
In an interview with Popsugar, ob-gyn Jen Gunter, MD said that within her 30 years of experience, there has never been a case where cancer, endometriosis, or other serious health conditions have been linked to tampons themselves—except toxic shock syndrome, which is rare.
Jayesh adds that we have to be careful to not make assumptions without evidence-based facts. Cancer is a complex phenomenon that can be correlated with many factors. And yet, without any studies, we cannot rule out the possibility that titanium dioxide is not safe. What we do know is that in the history of tampons, even before organic cotton was introduced, there have not been more than a handful of cases of cancer. In each of those cases, the cancer was found to be correlational but not causational. In other words, over the billions of tampons used, a handful of cases have found that tampons contributed to cancer but did not cause cancer.
“We have to remember that even with the big corporate brands, they exist because they want to solve a problem while making money in the process. They have teams of scientists and gynecologists. They don’t set out to do harm. If they’re using titanium dioxide, it’s because related studies have shown it doesn’t pose a threat. It’s important to question ingredients and read the studies for a balanced view to understand any risk. And it’s equally important to question the motivations behind trending conspiracies that prey on emotions (and boost social virality),” adds Jayesh.
Does Organic Mean Safe?
When it comes to tampons and other period care, what does organic mean? The product in question in the TikTok video is one that is labeled as organic and yet it contains titanium dioxide. How can this be?
In Canada and the USA, organic claims must be verifiable but only a percentage of the product needs to be organic, and that percentage must be displayed. But if you are truly looking for organic, look for certifications on the packaging. This ensures the product has been tested, and undergoes regular testing, to meet specific standards.
OEKO-TEX, for example, is a popular certification for textiles that tests for potentially harmful substances, from raw materials through to the finished product—and re-testing occurs every three years. USDA Organic certification may only be displayed on products that are 100% organic. At joni, we’re also proud to have ECO-CERT certified, which also oversees responsible production, recyclable packaging, and the responsible use of resources.
Keep in mind that products labeled as “natural” don't mean anything and are a form of greenwashing. And just as titanium dioxide has not been tested for use with tampons, certified organic tampons have not been tested for any negative or positive medical results.
So are organic tampons better? We recommend looking at the whole picture by looking for certifications and asking what those certifications entail. For us, choosing organic is a proactive choice.
The Choice is Always Yours
It’s important to note that even with organic tampons and pads, irritation, inflammation, and infections can occur from not changing them regularly or from chaffing. Non-organic period care may also have fragrances or use bleach that can cause irritation, so it’s important to find the product that works for you individually and use it as directed. Organic doesn’t necessarily mean better and non-organic doesn’t equal danger. The choice is yours.