New research finds that Black Americans and people with less formal education are more likely to use scented and scent-altering menstrual and intimate care products than other groups. Ingredients used in these products have been linked to allergies, asthma, cancer, endocrine disruption, and poor pregnancy outcomes. 

The study was led by researchers at Columbia University Mailman School of Public Health with collaborators from the Silent Spring Institute, Department of Urban and Environmental Health and Public Health at Occidental College, and Black Women for Wellness. The findings appear in the journal Frontiers in Reproductive Health.

Socioeconomic factors determine attitudes about menstruation and individuals’ use of intimate care products, the authors say. Expectations around odor control disproportionately fall on Black women, who face stereotypes and discrimination related to beauty and hygiene.

“Use of scented menstrual and intimate care products is concerning since they are marketed for odor control and perpetuate stigma around menstruation. They may also contain ingredients linked with cancer, endocrine disruption, and other adverse health effects. Our research suggests that populations marginalized by racial and/or socioeconomic inequities may be disproportionately impacted by environmental health risks from these products,” says study first author Ami Zota, ScD, associate professor of environmental health sciences at Columbia University Mailman School of Public Health.

“Our research shows how social identity can shape a person’s preference for certain types of menstrual products, which can then influence their chemical exposures. Understanding these dynamics is important for developing strategies to reduce toxic exposures from intimate care products and ultimately reduce health inequities,” says Elissia Franklin, PhD, postdoctoral research associate at the Silent Spring Institute and a co-author of the study.

The researchers combined and analyzed data from two surveys of adults who menstruate: the Taking Stock Study and the Fibroids Observational Research on Genes and the Environments study, which recruited participants in California and Washington D.C., respectively. Participants were asked about their use of menstrual and intimate care products, such as tampons, sanitary pads, and menstrual cups, as well as intimate care products such as douches, vulvar sprays, wipes, and powders. Respondents reported on how often they use these products and the factors that influence their decision-making. They also volunteered information about their educational background and identities. 

White participants were nearly twice as likely to use unscented tampons, three times as likely to use menstrual cups, almost half as likely to use wipes, and one-quarter as likely to use douches than Black participants. Use of unscented menstrual products was more common among those with at least a bachelor’s degree, whereas use of scented menstrual and intimate care products was generally more common among those with a high school diploma or less. Young people ages 18-24 reported greater use of menstrual cups. No non-binary respondents reported use of scented menstrual products.

The new findings follow another study by Zota from earlier this year that sheds light on racialized beauty norms that motivate the use of chemical hair straighteners and skin lighteners linked to poor health outcomes. An expert on the health risks of certain chemicals used in cosmetics and how their use is tied to racist attitudes and policies around personal appearance,  Zota testified before the Washington State Senate in April as they debated on the Toxic-Free Cosmetics Act. The bill passed and was signed into law soon after Zota’s testimony, becoming the strictest regulation of its kind in the country. She also provided testimony for a similar law passed in California in 2020. 

Additional co-authors of the new study include Emily Weaver and Eva Siegel at Columbia Mailman; Robin E. Dodson at Silent Spring Institute; Bhavna Shamasunder at Occidental College; and Astrid Williams at Black Women for Wellness.

The study was supported by the Eunice Kennedy Shriver National Institutes of Child Health and Development (R21HD096248), National Institute of Environmental Health Sciences (ES009089), National Center for Advancing Translational Sciences (TR001876, TR001877), California Breast Cancer Research Program (B28TP5728, 23UB-6511).