Tampon prices

The average price for a box of tampons is $4.63. But you can knock about $2 off the price by opting for supermarkets’ store brands, the cheapest of the 11 brands in our survey.

We calculated the cost of buying 16 tampons (tampons typically come in boxes of 16 or 20). At $2.40, Select (a Countdown store brand) was the least expensive. The company dropped its prices with much fanfare in July, bringing them closer to what it sells tampons for in Australia. Pams (a New World and Pak’nSave store brand) was next at $2.56.

These tampons are made from rayon (or viscose) – like the big name brands. They also have a polyethylene and polyester overwrap.

If you want cotton or organic cotton, which is more expensive to produce, you’ll pay more. The cheapest organic product in our survey, Organic Initiative, cost $5.44.

Online subscriptions

Online subscription services, which deliver to your door, were among the priciest ways to buy.

Of the 6 online companies we looked at, Cotton Pony and Luna were the most expensive. They both offer a pick-and-mix package where customers can choose from a selection of pads, liners and tampons. Brands offered are the main ones you’d find at supermarkets.

Cotton Pony charges $19.95 a month for a choice of 20 pads, tampons or liners. That’s about $1 a pop, compared with 15¢ for a Select tampon. That’s before shipping too, which costs up to $5.50 a month.

Luna costs $20 a month for a mix of 15 to 18 tampons, pads and liners. Buy the same products in its New Moon pack from the supermarket and you’d pay about $5.60.

Both Cotton Pony and Luna state chocolate, tea and a gift are also included in their packs but quantity and brand information isn’t published on their websites.

A subscription with Organic Initiative also worked out more expensive than buying the same brand at the supermarket.

Change To Green was the only brand where it was cheaper to buy from its online store. With no added shipping costs, it was the best subscription deal, at $5.75 a month.

What about menstrual cups?

Menstrual cups have been promoted as a cheaper and safer alternative to tampons. The reusable cups cost between $25 and $75 and some manufacturers say the products will last up to 10 years.

There’s little research on menstrual cups. But a 2018 French study, published in Applied and Environmental Microbiology, suggests they could raise the risk of toxic shock syndrome (TSS). TSS is a rare but potentially fatal condition, associated with tampon use.

The study looked at the growth of staphylococcus aureus, and the TSS-causing toxin this bacterium produces, in a range of menstrual products. All 15 products tested, including 4 menstrual cups, saw growth of the toxin. However, bacteria growth was slightly higher in menstrual cups.

The researchers suggest this was due to the higher volume of air introduced into the vagina by the cups and advised using a small cup size to limit this effect. They also suggested having 2 cups so that one could be sterilised after each use, rather than simply rinsed until the end of your cycle.

There are unanswered questions about whether the materials menstrual cups are made from – which vary depending on brand – affect bacteria growth.

Dr Siouxsie Wiles, a microbiologist at the University of Auckland, is crowdfunding for a research project to investigate menstrual cups.

“One thing that appalled me as I was reading around the topic is that it appears menstrual cups have hardly been studied at all,” Dr Wiles said.

She’d like to see a combination of lab-based studies and user research to answer questions such as how many bacteria stick to cups, what influences this and how often users need to sterilise the cups.

Should you buy organic?

Three companies, BON, Necesse and Natracare, claim cotton or organic cotton tampons reduce the risk of TSS. But the weight of evidence doesn’t support this.

A 1994 report indicated the toxin that causes TSS was less likely to grow on cotton tampons. However, other studies have indicated all tampons, including organic cotton, can provide an environment for the toxin-producing bacterium to grow.

The 2018 French study concluded there was no reason to think organic cotton tampons would be “intrinsically safer”.

Associate professor Deborah Bateson, from the University of Sydney Faculty of Medicine and Health, said evidence did not show today’s rayon or other types of tampons were less safe than organic cotton ones. “The main thing is [that] you have hygienic practices and follow the instructions about changing them and not leaving them in for too long.”

Dr Bateson said using tampons safely was the most important factor – washing your hands before use, using the lowest absorbency possible for your needs and changing them every 4 hours (or a maximum of 8 hours overnight).

After we contacted it, Necesse removed statements on its website claiming cotton tampons reduced the risk of TSS.

Nasty chemicals

Several companies pitch their tampons as being free from nasty chemicals.

Organic Initiative said the way other tampons were produced created dioxin, “a substance linked to health issues such as cancer, endometriosis and immune system compromise”.

BON similarly claims “generic tampons make use of herbicides [and] pesticides” and use chlorine in their production, drawing a link between dioxin and cancer.

Natracare tells customers that “even low levels of dioxin are cause for concern … Just a few parts per trillion in body fat can have serious health effects”.

While dioxin is a known carcinogen, studies in the early 2000s concluded that exposure to dioxins through tampons was thousands of times less than exposure through food.

In 2005, the United States Food and Drug Administration studied tampons and found dioxins and furans (another group of contaminants linked to cancer) in most tampons were below detection limits.

Dr Bateson said there was a lack of robust research about the potential long-term effects of substances in tampons.

“What we do know is that today’s type of tampons have been used by many millions of women around the world and haven’t raised any significant safety signals.”

However, she recommended women avoid sanitary products with added fragrances, which can cause irritation.

Waste disposal

Change To Green, Natracare, Necesse and Organic Initiative promote their products as better for the environment because they’re compostable. However, the Waste Management Institute doesn’t recommend putting used tampons in your home compost, or in green waste collections, because of the contamination risk.

Tampons, organic or not, usually end up at the landfill, whether they're put in your rubbish or flushed down the toilet and processed at a wastewater treatment plant. If the tampons have a polyethylene and polyester overwrap, there’s a risk they’ll release micro-plastics as they break down. All the rayon tampons we looked at and BON organic cotton tampons had this overwrap.