If you haven’t already tried some of the modernized menstrual care products on the market, it may officially be time. Harvard University‘s school of public health suggests younger menstruators are embracing market disrupters like absorbent period underwear and menstrual cups—though tampons, as well as pads, are still most popular when looking across age demographics.

If your go-to is a tampon, you may be aware of growing concern that’s not only due to environmental issues and the possibility of toxic shock syndrome (which the National Library of Medicine describes as “an acute-onset illness … classically associated with high absorbency tampon use”), but also because of a health risk a new study is illuminating: Exposure to toxic metals.

Get The Healthy by Reader’s Digest newsletter

Set to be published in August 2024 in the scientific journal Environment International, the study was led by a team of nine environmental scientists and epidemiology researchers at University of California at Berkeley, New York’s Columbia University, and University of Michigan. The researchers report they tested 30 tampons across 14 brands and 18 product lines for the presence of metals and metalloids. Though they don’t mention specific brand names, the team says they “generally selected products that were listed as top sellers on a major online retailer, as well as ‘store-brand’ products from several large chain retailers in the US.”

The researchers evaluated the presence of arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, mercury, manganese, nickel, lead, selenium, strontium, vanadium and zinc.

They discovered that all of these metals are “present in quantifiable concentrations” in tampons.

Several are also toxic: Arsenic, cadmium, chromium, lead and vanadium. According to the researchers, “all tampon samples” contained detectable levels of these toxic metals, with “elevated mean concentrations” of arsenic, cadmium and lead in particular.

The researchers speculated that metals could be introduced to tampons in several ways: The raw materials that make up tampons, such as cotton, rayon or viscose could be contaminated during production; tampons could be contaminated with metals from water used during manufacturing; metals could be added intentionally as microbial agents or to aid in lubrication when inserted. For example, they note that cadmium and zinc, which were detected in the highest concentrations, “are used for odor control, lubrication and as antimicrobial agents.”

The researchers noted that there is “no safe exposure level” to lead, with the Agency for Toxic Substances and Disease Registry reporting that lead exposure can cause brain damage, impaired kidney function, digestive problems, heart disease, depression, impotence and more. Perhaps most alarming, they speak to the particular danger of this as it relates to the female reproductive system and exposure to the vagina, saying the chemicals “could be absorbed by the vagina’s highly absorptive tissue, resulting in systemic exposure.”

Further, they add: “Menstruators may use more than 7,400 tampons (4 tampons/day  4 days/cycle  12 cycles/year  39 years of cycles) over their reproductive years, with each tampon being retained in the vagina for several hours.”

They suggest the type of tampon you use could make a difference in the nature of your exposure. The researchers found that non-organic tampons had higher concentrations of lead. With that said, organic tampons had higher concentrations of arsenic. The World Health Organization has stated that prolonged exposure to arsenic has been associated with bladder cancer, among other types, while the Centers for Disease Control and Prevention notes that some types of lead are likewise “probably carcinogenic to humans.”

If tampons are what feel most comfortable to you during your period, trying a similar inserted product such as a menstrual cup could be a safer, healthier alternative.