Chemical ingredients in cosmetics, foods, and pharmaceuticals have been scrutinized for their potentially detrimental health effects. Products formulated for vulvovaginal use, whether cosmetics or medical devices, are no exception. Although most of the potentially toxic chemicals are found in products at low levels, there are concerns about total exposure across a lifetime of daily use. These concerns relate to personal health effects such as endocrine disruption, cancer, fertility, and fetal development, and to environmental effects on water quality, bioaccumulation in the food chain, and similar consequences1. Conscientious consumers want to know how their choices affect not only them, but their families and the world around them.
Parabens are preservatives thought to be non-persisting in the body that have been shown in animal studies to have endocrine-disrupting effects; cell culture studies have also suggested the ability to promote growth of cancer cells. In animal studies, the doses given are many times what a human would be exposed to in daily life, so understanding the relevance to human health is difficult. Some studies have correlated human urine paraben levels with health conditions including infertility2, but others have shown no correlation between urine paraben level and blood endocrine disruption1. In spite of the conflicting study results, overall, parabens present some cause for concern for certain populations – those who wish to reproduce in the future (not just those trying to conceive immediately), those with personal or family history of hormone-sensitive cancers or other conditions, pregnant and lactating women, and children. However, one must keep in mind the alternatives to parabens. Products on the shelf must have preservatives to avoid illness and even death due to microbial contamination.
Alternatives include polyquaterniums – shown to increase susceptibility to sexually transmitted infections when used in vaginal products – and chlorhexidine, which thoroughly disrupts the vaginal microbiome. These alternatives are actually worse for vaginal products than parabens.
Healthcare providers can recommend their patients look for products using benzoates and sorbates (or their acids) as preservatives. These are the safest alternatives, though none is completely without effect on the body.
Petrochemicals are any chemical derived from petroleum. In vulvovaginal products, petrochemicals like polyethylene glycol (PEG) are often the base of the gel. From the perspective of vaginal health, it is the hyperosmolality of the final product derived from PEG and other glycols that is the issue3,4 – not the source of the glycol. Plant-based gels like hydroxyethylcellulose form gels at much lower osmolality. Overall, avoiding petrochemicals will make it easier to find an iso-osmotic vaginal gel product. Beyond osmolality, there is nothing inherently bad about the source of a chemical – your body can’t tell the difference between the same molecule derived from petroleum vs. plants. Rather, it is the residual contaminants from manufacturing processes remaining in final products that present health concerns. These are too many to list, but often include compounds known to be carcinogenic, teratogenic, or otherwise toxic5. Even plant-derived compounds can contain toxins if not processed properly (aloe being a prime example6 – look for “decolorized” aloe, or leaf fillet, which avoids the “aloe latex”).
Government and industry panels determine maximum levels of contaminants for manufactured products to be considered safe. But consumers with particular sensitivities or others who need products to be “clean” beyond these levels are faced with the choice to accept potential risks or simply avoid using products, as it can be impossible even for companies to know the exact characteristics of all their ingredients.
Finding a company that is transparent and committed to using natural ingredients whenever possible can reduce the lifetime burden of toxic chemicals.
Keep in mind that everything that touches our bodies introduces multiple effects; in an ideal product, the good effects far outweigh the detrimental. Parabens and petrochemicals should be avoided when possible due to both personal and environmental health effects, but it is probably not possible to completely avoid them. Over a lifetime, consistently finding products that use natural ingredients and safer preservatives will pay off both for better health and a cleaner environment.
- Nowak K, Ratajczak–Wrona W, Górska M, Jabłońska E. Parabens and their effects on the endocrine system. Mol Cell Endocrinol. 2018;474:238-251. doi:10.1016/j.mce.2018.03.014
- Smarr MM, Sundaram R, Honda M, Kannan K, Louis GMB. Urinary Concentrations of Parabens and Other Antimicrobial Chemicals and Their Association with Couples’ Fecundity. Environ Health Perspect. 2017;125(4):730-736. doi:10.1289/EHP189
- Dezzutti CS, Brown ER, Moncla B, et al. Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity. PloS One. 2012;7(11):e48328. doi:10.1371/journal.pone.0048328
- Ayehunie S, Wang YY, Landry T, Bogojevic S, Cone RA. Hyperosmolal vaginal lubricants markedly reduce epithelial barrier properties in a three-dimensional vaginal epithelium model. Toxicol Rep. 2018;5:134-140. doi:10.1016/j.toxrep.2017.12.011
- Black RE, Hurley FJ, Havery DC. Occurrence of 1,4-dioxane in cosmetic raw materials and finished cosmetic products. J AOAC Int. 2001;84(3):666-670.
- Avila H, Rivero J, Herrera F, Fraile G. Cytotoxicity of a low molecular weight fraction from Aloe vera (Aloe barbadensis Miller) gel. Toxicon Off J Int Soc Toxinology. 1997;35(9):1423-1430. doi:10.1016/s0041-0101(97)00020-2