A growing body of research has identified "forever chemicals" called PFAS in menstrual products, raising concerns about exposure during pregnancy and early development. These persistent chemicals, found in tampons, pads, and period underwear, can accumulate in the body over years and may interfere with critical developmental processes in unborn babies.

What Are PFAS and Why Should You Care?

PFAS stands for perfluoroalkyl substances, a family of chemicals widely used in non-stick cookware, water-resistant clothing, food packaging, and cosmetics. They earned the nickname "forever chemicals" because they resist breakdown in the environment and in the human body, potentially remaining for decades. One particularly concerning PFAS, perfluorodecanoic acid (PFDA), has been shown to disrupt facial development in unborn babies, increasing the risk of small eyes, jaw problems, and other facial abnormalities by around 10 percent, according to research from the University of Colorado Anschutz Medical Campus.

The concern extends beyond cookware and clothing. Studies have found PFAS in a significant number of menstrual products, including some labeled as organic or natural. This exposure pathway is particularly important because menstrual products come into direct contact with sensitive tissue and are used repeatedly throughout a person's reproductive years.

How Do PFAS Affect Fetal Development?

The mechanism by which PFAS harms developing babies is now better understood. PFDA interferes with retinoic acid, also known as vitamin A, which is essential for shaping a baby's face during early pregnancy. The chemical blocks an enzyme called CYP26A1, which normally keeps retinoic acid under control, and reduces its production. This creates what experts call a "double hit" to the body's defenses.

"PFDA delivers a double hit to the body. It blocks a key enzyme that clears excess retinoic acid, then suppresses the genes that produce that same enzyme, meaning the body loses two lines of defence at once," said Valentina Milanova, a gynaecological expert and founder of Daye.

Valentina Milanova, Gynaecological Expert and Founder of Daye

Retinoic acid controls hundreds of genes involved in forming the baby's face, eyes, and nervous system. Too much of it is just as harmful as too little. The highest-risk window for exposure is between weeks four and ten of pregnancy, when the face, jaw, and eyes are actively forming. Because a developing baby cannot regulate retinoic acid on its own, it relies entirely on the mother's body to maintain proper levels.

Where Are PFAS Found in Everyday Products?

PFAS chemicals are pervasive in modern life. Beyond menstrual products, they appear in a wide range of household items and consumer goods:

• Kitchen and Cookware: Non-stick pans and cooking surfaces that use PFAS-based coatings to prevent food from sticking
• Textiles and Furniture: Water- and stain-resistant clothing, carpets, and upholstered furniture treated with PFAS-based repellents
• Food Packaging: Grease-resistant paper used in takeout containers, pizza boxes, and food wrapping materials
• Cosmetics and Personal Care: Waterproof cosmetics and some menstrual products, including tampons, pads, and period underwear
• Other Household Items: Ski wax and various water-resistant products

These chemicals can escape from products, build up in household dust, and create low-level exposure through breathing or swallowing, particularly for children. PFDA has a biological half-life of around 12 years, meaning exposure can accumulate long before pregnancy even begins.

Steps to Reduce PFAS Exposure During Pregnancy and Beyond

• Choose Fresh Foods: Eat fresh food instead of processed items, which often come in PFAS-treated packaging that can leach chemicals into the food
• Avoid Plastic Storage: Replace plastic food storage containers with glass alternatives, and never microwave food in plastic, which increases chemical leaching
• Filter Your Water: Use a water filter to reduce PFAS contamination in tap water, which can accumulate in the body over time
• Wash Produce Thoroughly: Rinse fruits and vegetables to remove pesticide residues and reduce overall chemical exposure
• Limit New Household Items: Minimize purchases of new furniture, carpets, and textiles that may be treated with PFAS-based water and stain repellents
• Reduce Cleaning Product Use: Minimize exposure to cleaning products and disinfectants that may contain PFAS chemicals

Dr. Deborah Lee, a sexual and reproductive health specialist at Dr Fox Online Pharmacy, emphasized the importance of these practical steps. "What women eat and drink in pregnancy affects the growth and development of their baby," she explained. "Exposure to enzyme-disrupting chemicals such as PFDA can even affect fertility before conception".

What Does This Mean for Menstrual Product Users?

The presence of PFAS in menstrual products is particularly concerning because these products are used repeatedly throughout a person's reproductive years and come into direct contact with sensitive tissue. The fact that PFAS has been detected in products labeled as organic or natural suggests that current labeling standards may not adequately address chemical contamination.

Experts stress that while smoking, alcohol, and certain medications remain far more harmful than PFAS exposure, avoiding these forever chemicals is an important additional precaution, especially for people planning pregnancy or currently pregnant. Following guidance from the Royal College of Obstetricians and Gynaecologists, women are encouraged to take folic acid, avoid unnecessary chemicals, and be cautious with household products during pregnancy.

The research into PFAS and fetal development could help regulators and manufacturers identify the most dangerous chemicals, develop safer alternatives, and reduce exposure for high-risk groups. This could make everyday products, including menstrual care items, safer for families and children in the years to come.