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- The Curse. That time of the month. Although
American women don't retreat to menstrual huts, as they once did in some
societies, many are squeamish talking about their periods. But since reports
of tampons tainted by chemicals started surfacing, many have begun insisting
on some frank talk about the health and safety of feminine hygiene products
- and seeking out alternative brands.
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- Ruth B's periods had always been a nightmarish
ordeal. The rural Wisconsin woman suffered from severe cramps and pelvic
pain, eventually being diagnosed with endometriosis, a disabling menstrual-related
condition that is a leading cause of infertility.
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- "It feels like there's a hot poker
inside you, jabbing you in the gut," Ruth says of the disease in which
the uterine lining somehow escapes the uterus and becomes implanted on
other pelvic organs. "Sometimes I end up in a fetal position, writhing
in pain."
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- Although rarely discussed in her day,
endometriosis was the devilish disease that put Marilyn Monroe in the hospital
and caused her pain throughout her life. In "Goddess," biographer
Anthony Summers quoted Marilyn's first husband saying, "Norma Jean
had so much trouble during her menstrual periods, the pain would just about
knock her out."
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- Instead of suffering in silence, though,
Ruth - who asked that her full name be withheld for fear of reprisal by
the chemical industry - became an activist, seeking to help herself and
her fellow sufferers. She learned that the causes of endometriosis, which
afflicts anywhere from 6 million to 9 million American women, remain puzzling
to researchers.
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- But new studies have begun to link the
disease - as well as a variety of other reproductive ailments - to environmental
toxins, specifically dioxin. Dioxin is a byproduct of many chemical, manufacturing
and incineration processes.
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- Researching endometriosis on the Internet,
the Wisconsin woman read that one route of exposure to dioxin, in addition
to widespread sources in food, air and water, could be tampons and sanitary
napkins - products she'd used for 15 years. The chlorine used to bleach
the wood pulp and rayon fibers can leave behind traces of the chemical.
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- Ruth says she then launched her own Web
page "to try to get the word out to women that dioxin is a problem
and that there is dioxin in tampons and that more testing is required to
make them safe."
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- NOT ALONE
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- During this time, Ruth also found that
she is not alone: A growing number of women were beginning to fear that
they may have been putting themselves at risk if they used major brands
of tampons. However, many more weren't - and still aren't - aware of the
issue, activists say, and neither are many physicians.
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- 'There is very little regulation of sanitary
products - manufacturers are not even required to inform consumers of the
ingredients used in the products, for example.'
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- - MARY LOU BALLWEG author, "The
Endometriosis Sourcebook"
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- Not satisfied with the manufacturers'
claims that their products contained negligible amounts of dioxin, Ruth
had her own Playtex tampons tested independently. The tests showed they
did indeed contain measurable levels of the chemical - at a personal cost
of about $1,000. But few women are willing to go to the trouble and expense
of testing the products they buy, Ruth says.
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- Others agree. "Most women assume
these products are sterile (they are not) and that government regulations
protect them," writes Mary Lou Ballweg in an anthology of articles
that comprise "The Endometriosis Sourcebook" (Contemporary Books,
1995). "Unfortunately," Ballweg states, "there is very little
regulation of sanitary products - manufacturers are not even required to
inform consumers of the ingredients used in the products, for example."
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- During the last few years, several activist
groups have taken on the issue, and a number of articles, including one
in New York's The Village Voice, "Pulling the Plug on the Sanitary
Protection Industry," charged some companies of deliberately ignoring
the health risks. In 1997, Rep. Carolyn Maloney took up the cudgel for
the cause, introducing The Tampon Safety and Research Act. The bill, which
called on the U.S. National Institutes of Health to fund independent studies
looking into the health effects of tampon usage over time, never made it
out of committee that session, but was re-introduced in the 106th Congress
in 1999.
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- In response to these charges, the major
manufacturers (Tambrands, Playtex and Johnson & Johnson) counter that
their products are perfectly safe.
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- The FDA, which regulates these products
as medical devices, agrees. "There used to be negligible amounts of
dioxin in tampons and other products," says Sharon Snyder of the FDA's
Public Affairs office. "But now there is none at all."
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- In response to consumer questions (and
a rampant e-mail claiming tampons contain asbestos - which appears to all
parties to be a hoax), the FDA issued a December 21, 1998 memo, stating
"Chlorine is no longer used in bleaching the pulp used in making tampons.
This is universal across the tampon industry."
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- ONLY 'TRACE AMOUNTS'
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- John McKeegan, a public relations officer
at Johnson & Johnson, which makes "o.b." tampons, says the
company has reduced the dioxin in its tampons to "non-detectable"
levels. "There are trace amounts of dioxins in many, many things,"
he says. "They're formed when there's fire. It's found in paper. But
it is always in minute, trace amounts."
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- However, questions about pulp bleaching
continue to surface. On Jan. 26, Congresswoman Maloney wrote the FDA, charging
that there is no evidence upon which to base their statements that tampons
are dioxin-free. The new bleaching processes, known as "elemental
chlorine free" and "elemental free" (chlorine dioxide),
still create and release dioxin, she wrote.
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- Maloney also sent around a "Dear
Colleague" letter, saying that FDA's statements were misleading. "Exposure
to this chemical has been linked to cancer, immune system suppression,
pelvic inflammatory disease and infertility, and has also been linked with
increased risks for endometriosis," she wrote. "Men, women and
children are exposed to dioxin through the air and the water. It makes
no sense for women to have an additional exposure through tampon use."
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- The dioxin exposure from tampons and
feminine hygiene products are thought to be relatively small compared to
other sources, most agree. But what are the potential risks for women?
That is difficult to know, say scientists who have looked at the issue,
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- because there have been no relevant clinical
trials.
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- Arnold Schecter, a professor of environmental
sciences at the University of Texas School of Public Health at Houston
and a specialist on dioxin's health effects, feels there should be studies
to analyze how much of the dioxin in these products could be taken up by
a woman's body. In initial tests of a dozen major brands on the U.S. market
today, he found detectable levels of the chemical in all the feminine products,
even the so-called "natural" ones.
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- Peter deFur, a physiologist consultant
and part-time researcher with the Center for Environmental Studies at Virginia
Commonwealth University in Richmond, Va., says he doesn't accept the FDA's
position that the dioxin level in the products is too low to measure. His
review of FDA data showed that there was a measurable amount of dioxin.
And it would stand to reason, deFur says, that if the internal lining of
organs - which includes a sensitive area such as the endometrium - is exposed
to dioxin, there would be a "near 100 percent absorption of the chemical.
It crosses membranes, it is taken up, transported and stored."
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- Are these products Earth-friendly?
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- Dr. Philip Tierno, a researcher at New
York University Medical Center who studied the absorbent chemical in tampons
responsible for toxic shock syndrome, is also concerned. "The vagina
is a very absorbent place. No amount of this chemical is safe."
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- Fortunately, Tierno says, "with
attention to the issue, we may be lucky that levels of dioxins are finally
going down.
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- "What's also encouraging,"
says Tierno, is that "women are getting smarter. They alternate the
tampons with pads and go with pads in the night."
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- But Rep. Maloney isn't content to leave
safety to the manufacturers. "Let's just do some studies," she
says. These should be independent - not industry-paid, she adds; "otherwise,
it's like having the tobacco industry do their own tests to prove cigarettes
are safe."
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- In the meantime, dozens of alternative
feminine products have started springing up - everything from "sea
sponges" and tampons bleached with hydrogen peroxide, a non-chlorine
alternative, to organic and pesticide-free cotton pads. One company now
sells reusable menstrual cups, which boast added environmental benefits:
less raw material manufacture, no paper, no chlorine discharged into the
air and water, and no garbage.
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- But until the male-dominated Congress
is willing to hear the issue, says Maloney, there's no chance any of these
products can be proven safe. "One thing that has gotten women talking
about this," says Therese Schlachter, one of Maloney's aides, with
a touch of irony in her voice, "is e-mail and the Internet. They can
talk about their menstrual problems anonymously."
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- Francesca Lyman is an environmental and
travel journalist and editor of the recently released "Inside the
Dzanga Sangha Rainforest."
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