Uterine fibroids
Non-cancerous uterine growths that can cause heavy bleeding, pain and fertility complications. Black women are two to three times more likely to have them.
Read the fibroids guide →Health Hub
The Puure Health Hub
Educate. Navigate. Choose better.
Evidence-based women’s health education on hormones, reproductive conditions, every stage of life and the products you wear closest to your body.
Educational information, not medical advice.
Find your starting point
Where are you in your journey?
Not sure where to start? See the questions to ask at every age.
Your underwear is the garment closest to your body, and one of the least scrutinized.
Most of us wear underwear for many hours a day, in direct contact with some of the most absorbent skin on the body. In its conventional form, that fabric can carry residues from pesticides, synthetic dyes, finishing resins, elastic plasticizers and water-repellent coatings.
In the United States, a clothing label must list fiber content, country of origin and care instructions. It is not required to disclose the chemicals used to grow, dye or finish the fabric. For most garments, that part of the supply chain is invisible to the person wearing it.
Did you know?
More than 8,000 chemicals are used in conventional textile production worldwide, and many have never been tested for long-term health effects.
Why the intimate area is different.
Skin is permeable. Chemicals in contact with it can cross the outer layer and enter the bloodstream, and how much crosses depends heavily on where on the body the contact happens.
In controlled studies comparing vulvar skin with forearm skin, absorption of the test compounds was significantly higher on the vulva in both pre- and post-menopausal women (Oriba, Bucks & Maibach, 1996). One clinical review puts permeability at up to seven times that of forearm skin (University of Iowa review).
1×Forearm skinThe standard baseline in dermal absorption research
Up to 7×Vulvar skinHigher permeability reported in clinical reviews
What the research does and doesn’t show
These studies measured topical medications, such as hydrocortisone, applied directly to skin. How much of a specific textile chemical transfers from fabric to skin is less well studied. We share the absorption research because it explains why reducing unnecessary exposure in this area is a sensible precaution, not because it proves harm from any one garment.
Eight chemical groups worth knowing.
Each is used somewhere in conventional textile production: in farming, dyeing, finishing, elastic or cleaning. Select one to see where it shows up, what the research says and where to read more.
Read the full chemical guide →The reproductive health conditions researchers are studying.
Endocrine-disrupting chemicals are not the sole cause of any of these conditions. Genetics, age and many other factors play a role. Each guide explains symptoms, diagnosis, treatment options and what to ask your provider.
Endometriosis
Tissue similar to the uterine lining grows outside the uterus. ACOG’s 2026 guidance supports diagnosis without surgery, yet people still wait 4 to 11 years on average.
Read the endometriosis guide →PCOS
A hormonal and metabolic condition that can cause irregular periods, acne and extra hair growth. Up to 70% of people with PCOS remain undiagnosed worldwide.
Read the PCOS guide →Your journey, stage by stage.
Every stage of a woman’s life comes with its own questions. Use these sections to find what to expect, what the evidence says and what to ask your provider.
Trying to conceive
A preconception checkup is your chance to get ahead of anything that could affect a pregnancy, from chronic conditions to medications.
- Start folic acid early. Take a vitamin with 400 mcg of folic acid every day, starting at least one month before pregnancy and continuing through the first 12 weeks, to help prevent neural tube defects. Nearly half of U.S. pregnancies are unplanned, which is why it is often advised even before you start trying.
- Manage conditions first. Treating conditions such as diabetes or high blood pressure before pregnancy improves the chances of a healthy pregnancy.
- Tell your provider about symptoms. Fibroids, endometriosis and PCOS can affect fertility.
Ask your provider
- When should I stop my birth control?
- Are my current medications and supplements safe in pregnancy?
- Do I need a different folic acid dose?
- When should I get a fertility evaluation, given my age?
Pregnancy
Prenatal care starts early and continues throughout. Environmental chemicals are one part of a much bigger picture, and many small choices add up.
- Exposure is common, usually low. Health Canada found phthalate traces in over 95% of pregnant women’s samples, and researchers described the exposure as widespread but low.
- The evidence is developing. A review links prenatal phthalate exposure to altered thyroid and sex hormone levels in mothers and children, and urges steps to reduce exposure.
- Every swap counts. Diet is a major source of exposure to certain phthalates, so fresh food and less plastic packaging help. What you wear against your skin all day is one of the easiest exposures to choose for yourself, which makes certified organic cotton a simple place to start.
No one can avoid these chemicals completely, and that is okay. The goal is to make the easy choices that add up, without adding worry.
Ask your provider
- Which medications and supplements are safe for me?
- Are there exposures at home or work I should avoid?
- Which symptoms need a same-day call?
- How could fibroids, PCOS or endometriosis affect my pregnancy?
Sources: CBC on Health Canada’s study · Frontiers in Public Health, 2020 · Maternal and Child Health Journal
Postpartum
The weeks after birth matter for your health too. ACOG recommends contact with your provider within the first 3 weeks, followed by a comprehensive visit no later than 12 weeks after birth, instead of a single six-week check.
- What the visit should cover: mood and emotional well-being, infant care and feeding, sexuality and contraception, sleep and fatigue, physical recovery, chronic conditions and long-term health.
- Screening for postpartum depression and anxiety is part of the comprehensive visit.
- If you had high blood pressure in pregnancy, ACOG advises a blood pressure check within 7 to 10 days of birth.
- Comfort counts. Many people choose soft, breathable cotton during recovery.
Ask your provider
- When is my first check-in, and how will my recovery be checked?
- Can we screen my mood at each visit?
- Which birth control options fit with my feeding plans?
- What bleeding, pain or swelling is normal, and what is not?
If you ever have thoughts of harming yourself or your baby, call or text 988 in the U.S. or go to the nearest emergency room.
Hormone health
“Hormone balance” isn’t a diagnosis. Irregular periods, fatigue, mood changes, acne or excess hair growth and poor sleep can have many causes, including PCOS, thyroid conditions and perimenopause. The goal is to find out what is behind your symptoms.
- Chemicals and hormones. The Endocrine Society’s scientific statement found strong evidence that endocrine-disrupting chemicals, including BPA, phthalates and pesticides, affect female reproduction and hormone-sensitive cancers, especially when exposure happens during development.
- Track before you go. Cycle dates, flow, pain, sleep and mood give your provider something concrete to work with.
Ask your provider
- What could be behind my symptoms?
- Which tests make sense, and why?
- Are my cycle length and flow typical for my age?
- Could this be PCOS, a thyroid issue or perimenopause?
Sources: Endocrine Society, EDC-2 executive summary · International PCOS guideline, 2023
Read more on the blog: The Period Audit
Menopause
Menopause is diagnosed after 12 months without a period. The average age in the U.S. is 51. The years leading up to it, called perimenopause, can last 2 to 8 years, and periods may become heavier, lighter, closer together or farther apart.
- You can still get pregnant during perimenopause.
- Symptoms vary. Hot flashes, sleep problems, vaginal dryness and mood changes are common, and some people have few symptoms.
- Treatments range widely, from lifestyle changes to hormone therapy and non-hormonal options. The Menopause Society keeps a directory of certified practitioners.
- If your periods stop before 40, ask about premature ovarian insufficiency. About 1% of people who reach menopause do so before 40.
Ask your provider
- Are my symptoms perimenopause?
- Which treatments fit my health history, hormonal or non-hormonal?
- How do I protect my bones and heart?
- Is vaginal dryness or discomfort treatable?
Source: Mayo Clinic, menopause overview
Read more on the blog: Girl, It’s Not You. It’s Perimenopause.
Questions to ask at every age.
These are general guidelines for people at average risk. Your history may call for earlier or more frequent screening, so use this as a starting point for a conversation, not a schedule.
| Your 20s | Your 30s | Your 40s | 50 and beyond |
|---|---|---|---|
|
Checkpoints Cervical cancer screening starts at 21, with a Pap test every 3 years from 21 to 29. |
Checkpoints From 30 to 65, options include HPV testing every 5 years, a Pap test every 3 years, or both together every 5 years. |
Checkpoints Mammograms every 2 years from age 40 (USPSTF). ACOG advises every 1 to 2 years from 40, and no later than 50. Perimenopause often begins. |
Checkpoints Mammograms every 2 years through age 74. Cervical screening may stop after 65 if past screening was adequate. Menopause averages 51. |
|
Ask Are my periods normal for me? Which birth control fits my goals? Do my symptoms suggest PCOS or endometriosis? |
Ask Which cervical screening option is right for me? If I want children, what should I do now? How might fibroids or endometriosis affect my plans? |
Ask When should I start mammograms, given my family history? Could my symptoms be perimenopause? Is my bleeding pattern normal? |
Ask Which menopause treatments fit me? How do I protect my bones and heart? Do I still need cervical screening? |
At any age
Heavy or painful periods, pelvic pain, bleeding between periods and any bleeding after menopause are worth checking, not enduring. Cervical screening applies to anyone with a cervix.
Sources: USPSTF breast cancer screening, 2024 · USPSTF cervical cancer screening · CNN report on the breast screening update
Read more on the blog: Breast Cancer Isn’t Waiting Until You’re 40. Neither Should We.
Know what you wear.
Fabric School
Learn how six common fabrics compare, what GOTS and OEKO-TEX actually certify, what “natural” and “eco-friendly” really mean, and how to care for your underwear so it stays soft and comfortable.
Visit Fabric School →Related reading: Girl, Your Underwear Matters More Than You Think
Research and reading.
Every claim in the Health Hub traces back to a study or a clinical source. Browse the full set, grouped by topic, in the Research Library.
Open the Research Library →From the Puure blog
- Understanding Fibroids: A Personal Journey and a Call for Awareness
- Girl, It’s Not You. It’s Perimenopause.
- The Period Audit: How Your Cycle Reveals Health Clues You Can’t Afford to Ignore
- Breast Cancer Isn’t Waiting Until You’re 40. Neither Should We.
- Girl, Your Underwear Matters More Than You Think
This hub is for educational purposes only and is not medical advice, diagnosis or treatment. Talk to a qualified healthcare provider about your symptoms and options.
Underwear you can verify
Organic. Certified. Tested.
Because what touches your body should be safe by default.
Shop Puure →