- Tuli Kamati
A recent study conducted by researchers at the University of the Free State (UFS) found that sanitary pads and pantyliners sold in South Africa contained endocrine-disrupting chemicals, including phthalates, parabens and bisphenols. Every sanitary pad and liner tested contained at least two of these chemicals, raising concerns about long-term exposure and reproductive health risks.
We often say when South Africa sneezes, we catch a cold across the region. So the findings understandably sparked anxiety across Southern Africa, with reports from Eswatini describing women feeling “angry and powerless” after learning that products they had trusted for years may contain substances linked to hormonal imbalance, infertility, endometriosis and certain cancers. It’s the fibroid and hair relaxer conversation once again or even one about the Depo-Provera contraceptive injection. Online conversations quickly shifted toward panic: which pads are safe? Should everyone switch to organic products or menstrual cups?
As a clinician working in reproductive health research, I understand why these questions matter. Menstrual products come into repeated contact with highly absorptive tissue over many years. The study itself highlights concerns around cumulative exposure over time. This is important research, especially in a region where menstrual health remains underfunded and under-researched. But I also think we need to ask a more difficult question: what is the ethical responsibility of researchers and public health communicators when findings generate fear in contexts where people have limited ability to act on the information?
In the Southern African context, menstrual health does not exist in a vacuum. It exists alongside unemployment, water insecurity, period poverty and unequal access to healthcare. For many menstruating people, especially young women and girls, sanitary pads are already difficult to afford. The idea that they should now immediately transition to “safer” alternatives such as organic products, reusable pads or menstrual cups ignores the realities of everyday life. Reusable products require reliable ability to cover upfront cost, education and comfort with insertion. Organic products are significantly more expensive, if they are even available at all. In other words, awareness does not automatically create agency.
This is where public health communication becomes complicated. Information is necessary. Communities deserve transparency in accessible and inclusive language. The study rightly identities regulatory gaps in South Africa, including the absence of standards regulating these chemicals in menstrual products and the lack of mandatory ingredient disclosure by manufacturers. These are important findings that should push the government, regulators and manufacturers toward accountability. But when research is translated into public messaging without equal attention to structural realities, the burden quietly shifts onto individuals.
Women are told to choose better in systems where meaningful choices barely exist. That is not reproductive justice.
The issue here is larger than individual consumer behaviour. Menstrual health is a public health issue. It requires regulation, transparency and state accountability. If endocrine-disrupting chemicals are present in products used monthly by millions of people, then governments and regulatory bodies should be leading the response, not leaving consumers to navigate fear alone.
It’s not all dreary though; the conversation emerging out of South Africa indicates that some institutions appear to be responding. The Congress of South African Trade Unions (COSATU) noted that the National Consumer Commission had launched an investigation into major sanitary product brands, and some women’s groups are committed to reviewing regulatory frameworks governing menstrual products.
Hopefully, Namibia does not wait for South Africa but takes its own initiative. This matters because research should not end at publication. It should move toward policy, oversight and implementation. Namibia still has significant gaps in research translation and regulatory enforcement and often follows South Africa’s lead. Too often, important findings circulate publicly without clear pathways for action. This creates a cycle where communities become increasingly aware of risks while remaining structurally unable to avoid them.
As researchers and healthcare professionals, we must think carefully about how we communicate emerging science in unequal societies. Ethical public health messaging should inform people without isolating them in panic. It should acknowledge risk while also acknowledging reality. People should know what products they use, but they should also not be made to feel personally responsible for systemic failures they did not create.
Awareness matters. But without access, affordability, regulation and infrastructure, awareness alone can become another burden women are expected to carry.
Tuli Kamati is a clinician and reproductive justice activist. Follow her on Instagram @tuli_kamati.
