Are CBD tampons safe to use?

For mavens of wellness culture, CBD oil is the latest must-have, fix-all product. You can now buy cannabidoil (CBD) gummy bears, face masks, coffee and tea, standalone oils, and much more online, alongside vague, health-related words like “zen”, “soothing”, and “refreshing”. You can also buy CBD-infused tampons, which mean to help with period pain.

CBD products are perfectly legal in the UK, but with the lack of regulation around them, many wonder, quite reasonably, whether or not they are safe to use.

CBD is the non-psychoactive chemical component of the cannabis (marijuana) plant, and has been declared safe for use in its pure state by the World Health Organisation (WHO).¹ It is not a controlled substance in the UK, which means that the government does not regulate its possession, supply, or use. The only compliance procedure currently in place is for food businesses, who should apply to the Food Standards Authority (FSA) for authorisation of their CBD extracts and isolates.²

There are rules, however, for how CBD products can be sold. No medicinal claims — that they can treat or prevent disease — may be made about CBD products nor can they be sold as licensed medicines. So where does that leave tampons that seek to soothe period pain?

How do tampons fit in to all of this?

“A CBD tampon would not be considered a medical device. And because you don’t ingest it, it won’t have to go through the FSA,” says Dr Julie Moltke, a doctor who prescribes medical cannabis at Clinic Horsted in Denmark. This means that a CBD tampon would not be held to the same standards as a medical device before it is allowed to be sold, nor would it need to be authorised by the FSA.

“CBD is considered well-tolerated and quite safe, and there is no potential for addiction. It is very safe to use”

Even if you were to create a CBD product with the specific aim of treating a medical problem, say, period pain, you would not need to register it as a medical device — but you also wouldn’t be allowed to claim that your product has any medicinal benefits nor present it as a medicine.

“To administer CBD, you don’t have to register [your product] as a medical device,” says Dr Mikael Sodergren, Consultant Hepatobiliary & Pancreatic Surgeon at Imperial College London and Research Director at EMMAC Life Sciences, where he leads the pre-clinical and clinical medical cannabis research activities. “If you wanted to administer a cannabis-based medicine that has THC, then you would be in the realm of medicine.” Tetrahydrocannabinol (THC) is the active component of the cannabis plant with psychoactive properties that gets you “high”.

“It’s all quite confusing for those not in this field,” says Dr Sodergren. “CBD is unregulated at the moment, however cannabis-based medicines are completely regulated and if you want to prescribe one of those, then they need to have gone through checks, they have to be produced in a certain way, they have to have a certificate, and they have to go through pre-clinical trials.”

Are CBD tampons safe?

Aside from the quality and safety of the tampon itself, CBD is generally considered safe for use. “CBD is considered well-tolerated and quite safe, and there is no potential for addiction. It is very safe to use,” says Dr Moltke. However, both Dr Moltke and Dr Sodergren note that more research and evidence are needed into the health impacts of CBD.

Valentina Milanova, CEO and Founder of CBD-infused tampon company Daye, sought guidance from the US Food and Drug Administration (FDA) when developing her product, due to the lack of safety guidance available in the UK. In the US, tampons are considered to be medical devices. “We could have launched without [any approval],” she says.

There are no industry-wide standards to ensure tampon safety — leaving it to brands to self-regulate and be transparent about their manufacturing processes

When developing Daye’s tampons, Valentina considered two levels of safety: first, whether or not the tampons cause side effects, and second, whether they are being manufactured safely. Daye has undertaken preclinical and additional validation testing to investigate the safety and usability of their tampons, finding no significant difference in adverse effects compared to competitor tampons and a self-reported effectiveness for menstrual pain relief in an initial test of 126 people.³

Like CBD, tampons are largely unregulated in the UK. There is a code of practice for tampon manufacturers and distributors that is published by the Absorbent Hygiene Product Manufacturers Association (AHPMA), but adherence to this code is voluntary.

This means that there are no industry-wide standards to ensure tampon safety — leaving it to brands to self-regulate and be transparent about their manufacturing processes.

Can CBD tampons help with period pain?

Where it comes to the potential of CBD, “we’re really at the beginning of the research journey,” says Dr Sodergren. “We’ve got some data, but we are just really scratching the surface. We’re not even sure we understand all the signalling pathways. So we’ve got a lot of work to do to get the clinical evidence up to scratch.”

When asked whether CBD can help specifically with period pain, Dr Sodergren says: “I certainly can’t say that it will, because I’ve seen no evidence to suggest that, but I can’t certainly say that it won’t. For CBD alone, we have very little robust data to confirm a beneficial effect on pelvic menstrual pain. But, we have very little data overall.”

“CBD can help decrease pain because it interacts with an enzyme, anandamide, which is basically our internal THC. By increasing anandamide, we get this reduced pain sensation”

“It definitely has the potential to help women,” says Dr Moltke. “We do have a lot of endocannabinoid receptors in and around our sexual organs, and even inflammation and pain are regulated by the endocannabinoid system, so it is definitely likely.”

Our endocannabinoid system is a complex cell-signalling system that plays important roles in central nervous system development, learning and memory,⁴ pain regulation,⁵ and more. Endocannabinoids are made naturally by your body, whereas cannabinoids are components of cannabis that you ingest. Both interact with the endocannabinoid system.

“CBD can help decrease pain because it interacts with an enzyme, anandamide, which is basically our internal THC. And what CBD does is increase the level of this hormone in the body, and then it increases the activation of the endocannabinoid system. By increasing anandamide, we get this reduced pain sensation,” says Dr Moltke.

More research is required to properly understand the potential of CBD and how it interacts with the endocannabinoid system, however. “CBD works with a lot of different receptors, it’s really a bit of a loose cannon,” says Dr Moltke. “We are still discovering new pathways which is why it’s so exciting.”

What to look out for when buying CBD products

Without industry-wide regulation, it’s tricky to gauge the quality of CBD products available for sale.

For Dr Sodergren, safety should be front-of-mind when considering new CBD products. “I think that you have to be careful, as long as you know that there is absolutely no evidence that it will help, then the primary concern is whether it’s safe,” he says.

Approaching a brand directly for answers and doing some research on their processes can help you get the information you need. If they have done any clinical trials, or are choosing to self-regulate, this information should all be on their website.

“One thing to keep in mind is whether the product has been tested for cannabinoid content, and for purity,” says Valentina. “We also test to make sure that there’s no microbial contamination, heavy metals, or pesticides. This is important, because there are no standards in growing hemp.”

Another thing consumers can do is to check on a brand’s website whether they do third-party quality testing, adds Dr Moltke. “For now, we still haven’t got quality control so it’s good to look up whether the brand is following these kinds of guidelines. Hopefully, we will get a more tightly-regulated market, which means you will get a higher quality for consumers.”

Featured image is a hand dangling a loose tampon by its string, against a dulled, green background of cannabis leaves. The hand and tampon are in black and white

Page updated June 2020