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Since their invention, tampons have been the subject of moral panic, health scares, tax protests and ridiculous advertising.

There are many myths and misconceptions about them:

  • Can you lose your virginity by wearing a tampon?
  • Can a tampon fall out?
  • What happens if you leave a tampon in too long?

Read on for the answers…

Tampons and your body

  • Does it hurt to insert or remove a tampon?

It shouldn’t hurt. You might want to try different types of tampons—with or without an applicator—to see which you prefer. Sometimes it’s slightly uncomfortable to insert or remove a tampon simply because your vagina is dry, or your flow is very light.

Using a small amount of water-based lubricant should help relieve the dryness and make it easier for the tampon or applicator to slide in. If you notice a dry, uncomfortable feeling when removing your tampon, try switching to a lighter absorbency type. If you continue to experience vaginal pain when using tampons, see your healthcare provider.

  • Should I be able to feel a tampon inside me?

No. When a tampon is inserted correctly (pushed far enough in) you won’t be able to feel it. Tampons are designed to be worn in the upper part of the vagina, the part furthest away from the vaginal opening. If you can feel your tampon, try pushing it in a little further.

  • Can a tampon get “lost” inside me?

No. The cervix (at the end of the vagina) only has a tiny opening to allow blood or semen through. If you are having difficulty removing your tampon, try pushing—as if you were about to poop. It may help if you squat rather than sitting or standing. Move your fingers around the inside of your vagina and try to feel towards the top and back. Once you can feel the tampon or tampon string, grab it between your fingers and pull it out.

  • Can a tampon “fall out”?

Not usually. When a tampon is properly inserted (pushed in far enough), your vagina naturally holds the tampon in place, even if you are running or doing something active. If you are pushing hard while pooping, your tampon might fall out. If that happens, insert a new one.

  • Can I lose my virginity by inserting a tampon?

No. Virginity is not something physical or medical. It’s a cultural idea, about which many people have different definitions and opinions. Concepts of virginity are sometimes linked with the idea that your vaginal opening is covered by a membrane, often referred to as the hymen, that is “broken” by vaginal sex.

The vaginal corona (also known as the hymen) consists of thin folds of mucous tissue located 1–2 centimeters just inside the vaginal opening (1). Anna Knöfel Magnusson of the RFSU (the Swedish Association for Sexuality Education) wrote about it in the booklet Vaginal Corona: Myths surrounding virginity: “Every corona looks different, and differs in size, colour and shape. It is slightly pink, almost transparent, and may resemble the petals of a flower, a jigsaw piece or a half-moon. In the vast majority of cases, it is elastic and stretchy. Very rarely, the mucous tissue folds may cover the entire vaginal opening. In that case, it might be necessary to see a gynaecologist and have the vaginal corona opened to release menstrual blood, to enable insertion of a tampon or penetrative sex.”

The vaginal corona can be gradually diminished by basic daily physical activity, not just by inserting things (like tampons, menstrual cups, toys, or fingers) into the vagina. The hormonal changes that occur as people mature through puberty can also change the shape and flexibility of the vaginal corona (2). Regardless of whether you use tampons or not, your vaginal corona (if you had one, to begin with) will wear away over time. The anatomy and purpose of the vaginal corona is not very well understood, and more research is needed.

Tampons and your health

  • Will tampons give me Toxic Shock Syndrome?

Probably not, but it’s good to be informed. Toxic Shock Syndrome (TSS) is a rare condition affecting around 1 in 100,000 menstruating people (3). More than half of reported TSS cases are associated with tampon use, but it can affect people of any age—including men and children. Wearing a tampon for a long duration of time (over 8 hours) is associated with TSS (4). The symptoms of TSS start suddenly and can get worse quickly.

TSS can be fatal if not treated promptly, so it’s important to know the symptoms (5,6):

  • A high temperature (fever) of 102.2F (39C) or above
  • Flu-like symptoms, such as a headache, chills, muscle aches, a sore throat and a cough
  • Feeling and being sick
  • Diarrhoea
  • A widespread sunburn-like rash
  • The whites of the eyes, lips and tongue turning a bright red
  • Dizziness or fainting
  • Breathing difficulties
  • Confusion, drowsiness, loss of consciousness

TSS is a medical emergency. While these symptoms could be due to an illness other than TSS, it’s important to contact your healthcare provider or hospital as soon as possible if you have a combination of these symptoms. It’s very unlikely that you have TSS, but these symptoms shouldn’t be ignored. If you have severe symptoms or your symptoms are getting rapidly worse, then go to your nearest hospital or call for an ambulance immediately.

  • How can I reduce my chances of getting TSS?

Use lower-absorbency tampons and change them more often, and avoid leaving a tampon in for more than 8 hours. Alternately, you can use a different menstrual product, like pads or a menstrual cup. Menstrual cups are not considered a TSS risk. There has been only one documented case of TSS linked with using a menstrual cup, and this occurred when a woman scratched the inside of her vagina while inserting the cup (7).

When to change your tampon

  • How often should I change a tampon?

The best way to know if your tampon needs changing is to give a light pull on the tampon string. If it starts to pull out easily, then it’s time to change it; if not, it usually means you can leave it a bit longer. Do not leave a tampon in for more than 8 hours as this increases the risk for developing Toxic Shock Syndrome (8).

A fully saturated light tampon can hold up to 3 mL of fluid, while a fully saturated super tampon may hold up to 12 mL (9,10). A normal amount of blood loss per period is between 5 mL to 80 mL (11). If you are repeatedly soaking through a tampon or pad every two hours, this is considered heavy menstrual bleeding and should be brought to your healthcare provider’s attention.

  • Can you pee with a tampon in?

Yes. You don’t need to change your tampon every time you pee, although you might want to tuck the string into your vagina or hold it out of the way so you don’t get urine on it. This is just for personal comfort—it’s unlikely that would you experience health issues from accidentally urinating on the tampon string.

Some people poop while wearing a tampon, while others chose to change their tampon after they poop—both of these options are fine. When pooping with a tampon in, be careful not to get any poop on the string. Bacteria that live in your intestines can cause urethral and bladder infections (12).

  • Can you flush tampons down the toilet?

It’s better not to flush tampons. Tampons are made to absorb liquid and expand, so they can clog toilets and pipes—especially if the plumbing is old, or if it’s a low-flow toilet, or a septic tank arrangement. Most tampons are not biodegradable, and even those that are do not break down in the wastewater system. For your plumbing and the environment, the safest option is to wrap the tampon (and applicator) in toilet paper and throw it in the trash.

Is it OK to use tampons when…

  • Can I use tampons during my first period?

Yes. If you want to, you can use tampons from the beginning of your first period. Just check the instructions or ask for tips from a family member, healthcare provider, or friend. Choose the right absorbency for your flow (mini or small for not much blood, normal or super if you have more blood). If you have any trouble inserting the tampon, you could try using one with an applicator, or add a small amount of water-based lubricant to the tampon to help it slide in easier.

  • Can you shower with a tampon in?

Yes. You can wear a tampon in the shower or bath. Tampons (and menstrual cups) are also great options for swimming during your period.

If you can’t or don’t want to use them, you have a few other options too: If your flow is light, you can wear absorbent swimwear or a dark coloured suit to prevent stains. Waterproof absorbent swimwear looks like regular bikini bottoms but has a hidden, leak-proof lining that helps absorb menstrual blood. You can wear a pad before and after swimming.

  • Do tampons expire?

Yes. The shelf life of tampons is around five years if they are kept in their packaging and stored in a dry environment. They are sanitary but not sterile, so if they are stored in a moist place—like your bathroom—bacteria and mould can grow.

The most important thing to pay attention to is the packaging: Do you have an “emergency tampon” that’s been rolling around inside your bag for weeks, and the wrapper is damaged? If so, don’t use it—a tampon that is mouldy or dirty may cause a vaginal infection. If you notice any itching or irritation after using tampons, see your healthcare provider.

  • Is it OK to use tampons if you have an IUD?

Yes. Immediately after insertion of an IUD, you may experience some bleeding—do not use tampons for this bleeding. After this insertion bleeding is finished, it’s fine to use tampons or a menstrual cup if you have an IUD. The IUD threads extend just a few centimetres from the cervix, so they should not interfere at all with tampon insertion and removal.

This article was written and published first on Clue

References
  1. Knöfel Magnusson A. Vaginal corona: Myths surrounding virginity: Your questions answered. Stockholm: RFSU. 2009.
  2. Hornor G. Genitourinary assessment: An integral part of a complete physical examination. Journal of Pediatric Health Care. 2007 Jun 30;21(3):162–70.
  3. Gaventa S, Reingold AL, Hightower AW, Broome CV, Schwartz B, Hoppe C, Harwell J, Lefkowitz LK, Makintubee S, Cundiff DR, et al. Active surveillance for toxic shock syndrome in the United States, 1986. Rev Infect Dis. 1989 Jan-Feb;11 Suppl 1:S28-34.
  4. American college of obstetricians and gynecologists. Your first period (especially for teens. FAQ049. May 2015. Available from: https://www.acog.org/Patients/FAQs/Your-First-Period-Especially-for-Teens
  5. Centers for disease control and prevention (CDC). Case definitions for infectious conditions under public health surveillance. MMWR Morb Mortal Wkly Rep 1997; 46(RR-10):39.
  6. Centers for disease control and prevention (CDC). Toxic Shock Syndrome (other than streptococcal) (TSS) 2011 Case Definition. Available from: http://wwwn.cdc.gov/nndss/conditions/toxic-shock-syndrome-other-than-streptococcal/case-definition/2011/
  7. Mitchell MA, Bisch S, Arntfield S, Hosseini-Moghaddam SM. A confirmed case of toxic shock syndrome associated with the use of a menstrual cup. Canadian Journal of Infectious Diseases and Medical Microbiology. 2015;26(4):218-20.
  8. American college of obstetricians and gynecologists. Your first period (especially for teens. FAQ049. May 2015. Available from: https://www.acog.org/Patients/FAQs/Your-First-Period-Especially-for-Teens
  9. Wyatt KM, Dimmock PW, Walker TJ, O’Brien PM. Determination of total menstrual blood loss. Fertil Steril. 2001 Jul;76(1):125-31.
  10. Dasharathy SS, Mumford SL, Pollack AZ, Perkins NJ, Mattison DR, Wactawski-Wende J, et al. Menstrual bleeding patterns among regularly menstruating women. Am J Epidemiol. 2012;175(6):536-45.
  11. Fraser IS, Critchley HO, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011 Sep;29(5):383-90.
  12. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84.