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• A new study suggests your body shape may reveal heart disease risk more accurately than BMI.
• Researchers found people with larger waists relative to their height were more likely to develop calcium buildup in their heart arteries — even if their BMI was in a healthy range.
• The findings could change how doctors screen for heart risk and provide patients with a simple at-home way to monitor their health.

Your body shape might better predict your risk of heart disease than your body mass index (BMI), according to a new study.

If you want a simple way to check your heart health, measure your waist and divide that number by your height. A waist-to-height ratio (WHtR) of 0.5 or higher could signal an increased risk of heart disease.

New research, recently published in The Lancet Regional Health, found that WHtR was more closely linked to heart disease risk than both BMI and waist circumference alone. 

“I think we’ve been shifting away from BMI being the only idea that matters to waist-to-height ratio being better when it comes to cardiovascular outcomes, especially related to metabolic and atherosclerotic conditions,” said Marcio Sommer Bittencourt, MD, PhD, associate professor of cardiology at University of Pittsburgh and senior author of the research

Notably, the findings held true even among people with a BMI below 30, the threshold for clinical obesity.

In other words: people who were in the normal or overweight BMI range were still identified as having a risk for future heart disease based on their WHtR.

“For those with a BMI between 25 to 29.9 but also for those with normal BMI, waist-to-height ratio was a very important marker. Waist-to-height ratio identified individuals at higher risk for actual sclerosis development after five years even after adjustment for all classic cardiovascular risk factors,” said Thiago Bosco Mendes, MD, instructor of medicine at University of Pittsburgh and first author of the research.

Although the measurement is simple, it’s not yet a routine part of standard health screenings. WHtR could become a valuable tool for physicians to spot people at higher risk of heart disease — especially those whose BMI doesn’t reflect their true risk.

It’s also easy to do at home for anyone who wants to keep tabs on their health without stepping on a scale.

Higher waist-to-height ratio raises heart disease risk

The researchers followed 2,721 adults in São Paulo, Brazil, to examine how body measurements predicted heart disease risk in comparison to BMI.

Participants were about 48 years old on average, and nearly two-thirds were female. The sample was racially diverse, but predominantly white (57%), and included participants of mixed race, Black, and Asian backgrounds.

To be included in the study, participants had to have no coronary artery calcium (CAC) buildup, as confirmed by a heart scan. CAC is a risk indicator for heart disease, with higher values indicating a more severe condition.

Alongside this initial heart scan, researchers performed three body measurements at baseline: BMI, waist circumference, and WHtR. 

After a five-year follow-up, researchers once again measured CAC. Approximately 15% of participants exhibited signs of CAC buildup, and it was found to be more prevalent among those with larger waists.

Although all three measures — BMI, waist circumference, and WHtR — were associated with heart disease risk in an unadjusted analysis, only WHtR remained an independent predictor after accounting for traditional risk factors, such as high blood pressure, elevated cholesterol levels, and diabetes.

In patients with a WHtR of 0.5 or greater, about 18% had CAC buildup, compared to only 10% those with a WHtR of less than 0.5. For every moderate increase in waist size compared to height, the risk of developing calcium in the heart arteries went up by about 18%.

“This study helps us to see what we have always suspected, which is that those people who have greater metabolic dysfunction, in this case marked by a waist-to-height ratio, are more likely to develop cholesterol plaque,” said Yu-Ming Ni, MD, board certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California. Ni wasn’t involved in the research.

The risk posed by a larger WHtR wasn’t fully explained by other common metabolic issues, such as high blood pressure and blood sugar, suggesting that abdominal fat may be harmful to heart health in other ways.

That’s likely because WHtR shows the presence of visceral fat, which is stored in the abdominal cavity and is associated with an increased risk of cancer, heart disease, and diabetes.

“We know that those who have more visceral fat have more inflammation, and that’s a risk factor for atherosclerosis as well,” Mendes said.

What body measurements say about your health

Doctors have long relied on BMI, an estimate of body fat based on height and weight, to diagnose obesity, and as an indicator of risk for everything from heart disease to cancer.

It’s a straightforward calculation that has played a disproportionately significant role in healthcare and medical research. However, the question of whether BMI is an accurate predictor of health has been increasingly raised by patients and doctors alike.

Other measurements, such as waist circumference, waist-to-hip ratio, and WHtR, may be better predictors of certain health outcomes than BMI alone; however, they are not used nearly as frequently.

 “Waist circumference measurement can be a little bit harder to do uniformly across clinic settings,” Ni said, “but it is something that I think the average person could use as a gauge of their personal health.”

Bittencourt emphasized that for some people — particularly those in the healthy or overweight BMI range — body measurements may offer a more accurate picture and better predict risk, especially among people who might otherwise be considered healthy.

Understanding your WHtR measurement may offer additional insight into your health in ways that BMI and weight alone do not. Still, for general wellness, BMI is generally a reliable indicator.

“Recommendations in terms of diet, exercise, reducing caloric intake, and preference for non-ultra-processed food are not changed by our findings,” Bittencourt said. “Whatever you can do to reduce your abdominal size, your WHtR, or your weight are still recommended.”

How to measure your waist-to-height ratio

If you want to check your WHtR at home. Here’s a simple step-by-step guide on how to do it.

1. Grab a tape measure — It should be long enough to measure your height.
2. Measure your height — Stand tall without shoes and note it in inches or centimeters.
3. Measure your waist —  Wrap a tape measure around your bare belly at the level of your belly button, between your ribcage and hips. Breathe out naturally before reading the number.
4. Do the math — Divide your waist measurement by your height (use the same units for both).
5. Example — If your waist is 34 inches and your height is 68 inches: 34 ÷ 68 = 0.5.
6. A simple rule of thumb — Your waist measurement should remain less than half your height.

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• Researchers report that intermittent fasting of less than 24 hours does not appear to diminish a person’s mental performance during the periods where they are not eating.
• They say the human body has adapted to fasting intervals by burning fat as an energy source.
• Past research has shown that short-term fasting can help individuals lose weight, improve insulin sensitivity, and reduce inflammation.

Intermittent fasting does not appear to diminish a person’s mental sharpness during periods when they are not eating, according to a new study.

Researchers report in their online-first paper, published in Psychological Bulletin, that short-term fasting of less than 24 hours does not affect the mental performance of adults.

“People often worry that if they fast they won’t be able to concentrate at work or study effectively,” said David Moreau, PhD, a neuroscientist at the University of Auckland in New Zealand and the senior author of the paper, in a statement.

“Our results show that, for most adults, short-term fasting is unlikely to have a major impact on mental sharpness,” he added.

Researchers noted that children and adolescents did show some erosion of mental capabilities while fasting. That reinforced the importance of having a proper breakfast before school.

In addition, the researchers noted that adults who fast tend to perform worse in tests later in the day. They suggested the lack of food may amplify natural dips in circadian rhythm.  

“Humans evolved with periods of food scarcity, so it makes sense our cognitive systems can function well without constant refueling,” Moreau said. “That said, children and teenagers appear more vulnerable, which fits with what we know about their high energy demands.”

Short-term fasting unlikely to impact mental performance

Experts who weren’t involved in the study say the research re-emphasizes the benefits of intermittent fasting.

“The important message is fasting is not going to cause a problem with your mental performance,” said Mir Ali, MD, a general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California.

“This may reassure a lot of people,” he added.

However, Debra Safer, MD, a professor of psychiatry and behavioral sciences at Stanford University in California, pointed out that the study only dealt with short-term fasting of less than 24 hours.

“The study included research investigations primarily examining short term effects of fasting (average 12 hours fasts on cognitive performance),” Safer told Healthline. “Assurance for people who want to fast would require having research available under conditions more similar to those who want to fast as a regular practice.”

“This would include testing the effects of fasting for longer durations of time, research that included participants who were not necessarily in a healthy weight range, testing with participants who may also have co-occurring medical and psychological disorders, particularly including those with eating disorders (or at risk for eating disorders),” Safer continued.

Human body draws from other energy sources during fasting

The meta-analysis comprised 63 studies from around the world, involving more than 3,400 individuals.

Most participants regularly fasted for between 8 hours and 24 hours, with a median fasting period of 12 hours.

The researchers concluded that fasting “neither enhances nor impairs mental performance.” They did note three factors that can influence mental acuity.

• fasting duration
• context of the cognitive test
• individual characteristics (i.e., age and body composition)

In particular, researchers noted that people tend to score lower on mental tests near the end of their fasting period.

“These findings suggest that although most adults need not worry about temporary fasting affecting their mental sharpness, implementation across specific populations and situations may require more careful consideration,” the researchers wrote.

Researchers said that glycogen, the primary stored form of glucose, serves as the main energy source for individuals who eat regularly throughout the day.

They said glycogen levels may decrease while a person is fasting, but the body finds other energy sources, such as ketone bodies, that are produced from fat tissue.

“This metabolic flexibility likely supported survival during periods of food scarcity, particularly before the advent of effective food preservation methods,” the researchers wrote.

The researchers stated that this prehistoric adaptation in the body continues to serve humans well.

“Comparative biological evidence and evolutionary theories suggest that humans developed enhanced fat storage capacity as an adaptive response to resource fluctuations,” the researchers explained.

“This energy reserve not only supported daily metabolic demands but also enabled the prolonged development and expansion of the human brain, which requires substantial energy input,” they added.

“[The study] does seem to provide reassurance that the human body is very adaptable and people – in general — can maintain cognitive performance for periods of fasting similar to what is usually observed when people have short-term perturbations in their sleep,” Safer said.

“However, some factors are important to watch out for, like how long the fasting interval is, the context one within which one is performing a cognitive task, and individual characteristics such as younger age,” she added.

Benefits of intermittent fasting

Intermittent fasting is described as a dietary pattern that switches between periods of eating and periods of fasting.

Most intermittent fasting plans don’t focus on what a person eats. The emphasis is on when they eat.

There are several popular fasting methods. They include:

• 16/8: This involves an 8-hour eating period and a 16-hour fasting period. Some people do this by skipping breakfast, while others reverse the approach by skipping dinner or eating it early.
• 5:2: This method involves eating only 500 to 600 calories on two nonconsecutive days of the week and then eating as usual the other 5 days.
• Eat Stop Eat: This plan involves fasting for 24 hours once or twice a week.

Fasting can work because of how the body reacts to an extended period of time without food. For example:

• Fasting causes an increase in human growth hormones, which in turn induces fat loss and muscle growth.
• Fasting can also improve insulin sensitivity and decrease insulin levels, making stored fat more accessible.
• In addition, fasting can initiate the process of cellular repair. This repair can include autophagy, in which cells digest and remove old and dysfunctional proteins that build up inside them.

“Fasting basically switches the body into the mode of fat burning,” Ali explained to Healthline.

Intermittent fasting can help with weight loss. One of the main reasons is that fasting results in fewer calories being consumed per day.

Research has shown that improvements in insulin sensitivity during fasting can help prevent and manage type 2 diabetes.

Some studies have indicated that fasting can reduce inflammation in the body, a key driver of chronic disease.

“Fasting is effective for a lot of people for a lot of reasons,” Ali said.

How to practice intermittent fasting

There are some side effects to intermittent fasting.

The most obvious is hunger. There are others, however. They include:

• blood sugar regulation
• low blood pressure
• interference with daily medication schedules
• loss of muscle mass

Additionally, intermittent fasting may not be the best choice for a person with a history of eating disorders or someone who is pregnant or nursing.

On the plus side, there is some flexibility with intermittent fasting schedules.

You can drink water, coffee, tea, and other liquids while fasting. You can also adhere to a daily exercise schedule.

It’s important to consume nutrient-dense foods while following an intermittent fasting plan, as well as to engage in regular exercise and ensure you get adequate sleep.

Ali recommends that people start slowly when implementing a fasting regimen. He says initially fasting for 6 to 8 hours is a good place to start. Then, a person can graduate to 8- to 10-hour fasts and eventually to the more optimal 12- to 14-hour fasts.

Ali recommended that the final meal of the day, such as dinner, contain a high amount of protein and vegetables. He suggested a lower amount of carbohydrates because those substances can burn off more quickly and induce hunger pangs.

• Researchers say people with insomnia who use melatonin supplements for more than a year have a higher cardiovascular disease risk than people with insomnia who don’t use the sleep aid.
• Experts say the research raises some important questions, but they note that the study does not directly link melatonin to the cause of the heart disease risks.
• They add that melatonin is intended for short-term use, and there are ways for a person to obtain good quality sleep without taking medication.

Researchers are reporting that long-term use of melatonin supplements may increase the risk of heart failure.

In their study, the researchers said that people who used melatonin for more than a year were more likely to be diagnosed with heart failure, require hospitalization for that condition, or die from any cause.

Their research is being presented later this week at the American Heart Association’s Scientific Sessions 2025 meeting in New Orleans.

The preliminary study has not yet been published in a peer-reviewed scientific journal.

Researchers acknowledged their study doesn’t establish a cause-and-effect relationship between melatonin supplements and heart failure risks.

However, they noted that the results raise safety concerns about the long-term use of melatonin and, therefore, may warrant further research on these supplements to assess their cardiovascular safety.

Researchers also noted that many melatonin supplements are sold over-the-counter without a prescription. They said these products are not regulated, and people can use them without the guidance of a healthcare professional.

“Melatonin supplements may not be as harmless as commonly assumed. If our study is confirmed, this could affect how doctors counsel patients about sleep aids,” Ekenedilichukwu Nnadi, MD, the lead author of the study and the chief resident in internal medicine at SUNY Downstate/Kings County Primary Care in Brooklyn, NY, said in a news release.

Experts who weren’t involved in the study said the research raises some serious questions, although they add it’s important to note the study does not directly link melatonin to cardiovascular disease risk.

“The study raises some important and unexpected concerns,” said Rigved Tadwalkar, MD, a consultative cardiologist and director of the Digital Transformation Pacific Heart Institute in Santa Monica, CA. “It’s interesting because melatonin has been thought of as being heart-protective.”

“The results are quite striking,” added Cheng-Han Chen, MD, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA. “That being said, an association (with risks) is different than a causation.”

Melatonin and heart health risks

Melatonin is a hormone produced in the body by the pineal gland. It helps regulate the body’s sleep-wake cycle. Melatonin levels increase during darkness and decrease during daylight hours.

Melatonin supplements are chemically identical synthetic versions of the hormone. They are often used to treat insomnia, a condition characterized by difficulty falling asleep, staying asleep, or waking up too early.

It’s estimated that about one-third of people in the United States don’t get the recommended 7 hours of sleep per night. About 10% of Americans have chronic insomnia, in which they have sleep difficulties at least three times a week over a 3-month period.

Past research has indicated that melatonin can be beneficial in helping people sleep as well as assist in correcting jet lag, improving eye health, and offering pain relief to individuals with migraine.

However, researchers in the new study said data have been lacking on melatonin’s long-term cardiovascular safety. That prompted them to examine whether melatonin use might increase the risk of heart failure, specifically in chronic insomnia patients.

Their study was done over the course of 5 years. The researchers utilized the TriNetX Global Research Network, a large international database established in 2013.

The researchers looked at the electronic health records in the database of more than 130,000 people. The average age of the subjects was 55 years. More than 60% were women.

They divided participants into two groups: People with insomnia who had used melatonin supplements for at least a year and participants with insomnia who had no record of utilizing these supplements.

There were about 65,000 people in each of the groups.

None of the people studied had been previously diagnosed with heart failure or had been prescribed sleep medications other than melatonin.

The researchers reported that the subjects who used melatonin for more than a year had a 90% higher chance of incident heart failure over 5 years compared to people who didn’t use the sleep aid.

Participants taking melatonin were also nearly 3.5 times as likely to be hospitalized for heart failure when compared to those who didn’t use melatonin supplements.

In addition, people in the melatonin group were nearly twice as likely to die from any cause when compared to the non-melatonin group.

Tadwalkar noted that one reason for these figures may be that people with chronic sleep issues may face health risks associated with that condition, regardless of whether they take melatonin.

“This might be a guilt-by-association type of situation,” he told Healthline.

Chen said melatonin was designed as a short-term treatment. He said people who need to take the sleep aid for more than a year could have other serious underlying issues.

“They probably should go see a sleep specialist and try to figure out what’s going on,” he told Healthline.

Benefits of quality sleep

Experts say that getting the recommended 7 or more hours of sleep per night offers numerous health benefits.

Sleep is listed as one of the key components of the American Heart Association (AHA)’s Life’s Essential 8 healthy habits.

According to the Centers for Disease Control and Prevention (CDC), quality sleep can enhance overall health in several ways. These include:

• stronger immune system
• healthy weight maintenance
• improved heart health and metabolism
• reduced risk of chronic conditions (i.e., type 2 diabetes)
• improved memory and cognition
• reduced stress and improved mood

On the other hand, a lack of consistent quality sleep can lead to health risks, including high blood pressure, stroke, heart attack, and heart disease.

Chen and Tadwalkar both said the health risks from poor sleep probably outweigh the potential risks from melatonin use.

“Poor sleep can put a lot of stress on the heart,” noted Chen.

“Inadequate sleep is a major cardiovascular risk,” added Tadwalkar. “Chronic insomnia is a huge red flag.”

Tips to help you sleep better

There are several things you can do to achieve quality sleep without medication. Among them:

• getting bright light exposure during the day
• reducing blue light exposure at night
• avoiding caffeine late in the day
• avoiding alcohol late in the day
• avoiding late meals
• exercising during the day but not at night
• having a comfortable bed and pillow
• going to bed and waking up at the same time every day

Tadwalkar added that cognitive behavioral therapy (CBT) has also been shown to be beneficial by addressing thoughts, behaviors, and habits associated with poor sleep.

Both experts encouraged going to bed in a dark, cool, quiet room and avoiding caffeine, alcohol, and electronic screens in the evenings.

“Sleep hygiene practices are so important,” Tadwalkar said.

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• Men may need nearly twice as much weekly exercise as women to achieve the same heart health benefits.
• A study of over 85,000 people found that females achieved greater reductions in cardiovascular disease risk and mortality with less physical activity.
• The findings highlight a persistent “gender gap” in both exercise habits and outcomes, suggesting a need for more targeted public health guidelines.

Men may need about twice as much weekly physical activity as women to achieve comparable cardiovascular benefits, a new study suggests.

The research, published October 27 in Nature Cardiovascular Research, highlights notable sex-based differences in how exercise affects heart health — and points to a possible need for more tailored public health strategies that account for those differences.

Guidelines from the Centers for Disease Control and Prevention (CDC) and the American Heart Association (AHA) recommend at least 150 minutes of moderate to vigorous physical activity each week. Females who met or exceeded that threshold had a greater reduction in risk compared to males who did the same.

However, the study also identified a “gender gap” in both adherence to exercise guidelines and overall fitness capacity. In other words, even though females appear to gain greater heart health benefits from exercise, they’re less likely than males to meet the recommended activity levels; males also generally have higher physical fitness.

The authors say their work is essential for tailoring physical activity guidelines and closing this gap.

Other experts say that while the findings are significant, the goal for now is to continue focusing on the majority of people, both males and females, who do not meet minimum physical activity recommendations.

According to the CDC, fewer than half of U.S. adults (47%) meet these minimum guidelines.

“This study finds consistent results with many previous studies and meta-analyses where physical activity has cardiovascular benefits for both sexes, but the estimated cardiovascular risk reduction from meeting moderate-to-vigorous intensity aerobic physical activity recommendations is a bit higher in women compared to men,” said Bethany Barone Gibbs, PhD, professor and chair of epidemiology and biostatistics at West Virginia University School of Public Health and volunteer expert for the American Heart Association (AHA). Gibbs wasn’t involved in the study.

“Though the modeled gradient of benefit is steeper for women than men, I think the more important message is the overall benefit from being active that both sexes achieve,” she told Healthline.

Men need twice as much exercise as women

The large observational study utilized data from over 85,000 participants in the UK Biobank to investigate the impact of physical activity on cardiovascular health in both males and females.

Specifically, the researchers investigated the impact of exercise on the risk of coronary heart disease (CHD), also known as atherosclerosis. This type of cardiovascular disease involves a hardening of the arteries due to plaque buildup.

The goal was to determine whether the authors’ “one-size-fits-all” exercise recommendations adequately reflect sex-based differences.

Most participants — about 80,000 — did not have CHD, while a smaller subgroup of roughly 5,000 did. Among participants without CHD, researchers assessed the risk of developing the disease; among those with existing CHD, they examined mortality. Participants provided activity data via wrist-worn fitness trackers. 

Females who hit the minimum physical activity recommendations had a 22% lower risk of CHD compared to just 17% for males. There was also a dose-response relationship: more additional exercise yielded greater benefits, but the gap between females and males widened.

At about 250 minutes of weekly physical activity, females saw a 30% reduction in CHD risk. To achieve a similar benefit, males needed to log more than twice as much exercise — 530 minutes per week.

In the subgroup with CHD, physical activity was linked to lower overall risk of death, but discrepancies in mortality risk also varied by sex.

Active females had a 70% lower risk of death, compared with just a 19% reduction in males.

To achieve the same mortality reduction, males required 1.7 times more exercise than females, approximately 85 minutes per week, compared with 51 minutes for females.

It isn’t entirely clear why females appear to gain stronger heart-health benefits from physical activity than males, but the authors suggest several possible explanations. One involves estrogen, which circulates at much higher levels in females.

This hormone has a wide range of effects on the cardiovascular system and is generally considered protective for the heart. The dip in estrogen that females experience during menopause is a contributing factor to the increased risk of heart disease during that time.

Setting sex-based differences aside, the study also underscores the simple fact that too many people are not getting even the minimum exercise every week. Those without CHD who met physical activity guidelines were in line with the U.S. average, about 48%. However, less than one-third of people with CHD hit this threshold.

Still, current research indicates that males, on average, engage in more exercise than females.

Globally, the number of females who do not get enough physical activity is approximately 5% higher than that of males.

In the United States, the difference between males and females meeting physical activity guidelines is approximately 43% and 33%, respectively, according to the Journal of the American College of Cardiology.

Addressing the physical activity ‘gender gap’

“Until we get more concrete evidence, best practice is to stick clinically with the evidence-based guidelines that recommend at least 150 minutes per week of aerobic activity for health benefits and 300 minutes [or more] for even greater benefits for both sexes,” said Barone Gibbs.

Currently the AHA does not make any specific recommendations for physical activity based on sex.

Denice Ichinoe, DO, an assistant professor in the Department of Family and Community Medicine at the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, said that while her concern is also reaching those who simply don’t exercise enough, women may face barriers to achieving their physical activity goals. Ichinoe wasn’t involved in the study.

“There are a lot of key contributing factors to it. A lot of times, it’s either time constraints with work or even caregiving responsibilities, which fall into the traditional social norms and cultural aspects of women,” she told Healthline.

Finding time to exercise can be especially challenging for mothers, particularly those who are postpartum.

“I always try and recommend doing at-home exercises to start with. That may mean having your partner or a family member, or even asking for outside help for a caregiver to assist,” Ichinoe said.

And for those who aren’t getting enough physical activity, Ichinoe and Barone Gibbs offer the following tips:

• Start small — Multiple short walks or bouts of activity add up over the day.
• Broaden your thinking about “exercise” — Raking, gardening, cleaning, and more are all ways to get active.
• Bike or walk instead of driving short distances.
• Find enjoyable activities you can do every day (or at least a couple times per week)
• Progress gradually. Consistency is key.

“Any way that we can help increase that base level of physical activity and maintain it is going to be helpful. Even small steps that we can take to get both men and women motivated to start undertaking a little bit more exercise, that’s going to be extremely helpful, however we can do it,” Ichinoe said.

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• Some TikTok and social media users have posted images and videos of dark, spotted patches inside unused pads, sparking concerns around potential mold contamination.
• Health experts say this discoloration is more likely due to harmless materials or storage conditions rather than mold.
• Research has shown very low microbial levels in unused menstrual products, with no findings linked to health risks.
• Manufacturing standards and proper storage help keep pads safe, but you should discontinue use if there is visible damage or mold growth.

There’s a wave of concern sweeping social media: users are holding up brand-new, sealed menstrual pads and spotting dark, splotchy areas that look alarmingly like mold. 

In a viral TikTok video, an unused sanitary pad was held up to the light and appeared to show fungal growth inside.

But are these dark spots actually dangerous contamination or simply harmless absorbent materials? 

Some say the discoloration is fibers that soak up blood, while others have raised concerns about manufacturing and hygiene. 

We looked at existing reesearch on this topic and asked medical experts about the possible causes of these dark spots, the risks associated with mold in sanitary pads, and what you can do to ensure the safety of your period products.

Do period products really contain mold? 

Experts can’t say for certain what these dark spots found in some period products could be.

“While it’s difficult to confirm exactly what’s inside the product, the material appears to have dark discoloration that could be consistent with mold,” said Monica Williams, MD, physician and co-founder of Scarlet by RedDrop, a puberty care brand for tweens and teens.

“This could be the result of mishandling, exposure to moisture, or expiration, rather than a reflection of standard manufacturing quality,” Williams told Healthline.

Typically, menstrual pads are manufactured in clean, controlled environments. They’re also sealed to prevent contamination.

“However, if a product is stored in a damp location, exposed to heat or humidity, or damaged in transit, organic materials could degrade or develop growth over time,” Williams said.

Importantly, she said, if this were to happen, the issue would likely be isolated and environmental, and not inherent to pads in general or to any one brand. 

Deborah Lee, a general practitioner in the United Kingdom and specialist in sexual and reproductive healthcare and menopause at Dr. Fox Online Pharmacy, said the dark spots some social media users are reporting in their period products may be linked to the materials from which they’re made.

“When you hold an unused period pad up to the light, it can look dark and splotchy in places because of the superabsorbent polymers (SAP) that make up the inner absorbent layer,” she told Healthline. 

SAP, a common material used in sanitary pads to absorb moisture, is a 3D hydrophilic material that can absorb and retain liquids. “[SAP] absorbs blue light and reflects yellow light, meaning the pad may naturally appear to contain darker areas when held up to the light,” Lee explained.

While one 2018 study examined unused tampons for microbial presence, there is very limited equivalent research on unused pads. A 2021 study of sanitary pads in Nigeria, stored under various conditions, found contamination emerging after 24 hours when the packages were left open, unsealed, or improperly stored.

Additionally, a 2023 study of various brands of pads also found bacterial and fungal isolates in some market-sold samples.

Although data on hygiene in sanitary pads is limited, current evidence suggests that the overall risk remains low, especially for properly sealed products.

What’s in your sanitary pad? 

It might help put your mind at ease to know how period products are manufactured. 

Manufacturers select raw materials for period products with established safety profiles and documented supplier specifications. For some products, manufacturers prepare technical files and safety data to support regulatory review. However, not all menstrual products are subject to the same premarket requirements.

Production typically occurs on automated lines that assemble the product layers (top cover, absorbent core, acquisition or distribution layers, and backsheet) and then fold and seal them in individual wrappers or packs.

Factories that supply regulated medical devices or device components typically follow quality control systems and hygienic practices designed to minimize contamination.

Finished goods are typically stored in dry, climate-controlled warehouses and tested by manufacturers for performance measures such as absorbency and structural integrity.

In short, manufacturers generally design processes to limit contamination and verify basic product performance; however, regulatory requirements and labeling for menstrual products vary by product and location.

Are there harmless components within pads, such as adhesives, dyes, or recycled fibers, that could appear like dark spots or discoloration when light shines through them?

According to Williams, the answer is yes.

“Plausible explanations for what people sometimes perceive as mold would include absorbent pulp fibers, adhesive strips or release paper, and backing or outer film irregularities,” Williams said. 

“Many non-hazardous components can appear unusual when examined under atypical conditions, such as being held up to an intense bright light, and can be mistaken for contamination, when in fact they are part of the product design or material construction,” she noted. 

Health risks of mold 

If mold were present in a menstrual product, you might wonder about the health risks associated with its use. 

Potential health risks would generally be limited to skin irritation, contact dermatitis, or allergic reactions.

According to the Centers for Disease Control and Prevention (CDC), exposure to mold on everyday household items can trigger these reactions, particularly in individuals with sensitive immune systems.

People with weakened immune systems may be at a higher risk of more serious infections from environmental molds, although this is rare.

The Food and Drug Administration (FDA) states that properly manufactured and sealed menstrual products are designed to minimize microbial growth, thereby reducing the likelihood of exposure to harmful mold.

Lee explained that the vaginal region has its own microbiome containing live bacteria and fungi, such as Candida albicans. Exposure to other bacteria may lead to imbalances in the vaginal microbiome.

“Your immune system and the presence of other bacteria keep this under control. It’s only when something happens to upset this balance, and the yeast starts to reproduce, that you start to get symptoms such as soreness, discharge, and itching.” 

You can minimize your risk of exposure to outside bacteria by changing your pad regularly. Lee recommended changing your pad every 4–8 hours, and more often if your flow is heavy.

Checking the safety, hygiene of period products 

If you’re concerned about the safety and hygiene of your period products, Williams offered some guidelines:

• Use a reputable brand and make sure there’s a visible lot/production code, which is a good sign the manufacturer tracks batches for quality.
• Make sure the products are sealed and individually wrapped and in dry conditions.
• Look at the packaging to ensure transparency of materials and ingredients used.
• Store products in a cool, dry place in your home; avoid damp bathrooms or any environments with steam build-up.

While most unused period products are unlikely to contain mold, if you find mold in your pads, you should stop using the product immediately and contact the manufacturer.