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A tampon is a
menstrual The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
product designed to absorb blood and vaginal secretions by insertion into the
vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
during
menstruation Menstruation (also known as a period, among other colloquial terms) is the regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. The menstrual cycle is characterized by the rise and fall of hor ...
. Unlike a pad, it is placed internally, inside of the
vaginal canal In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hyme ...
. Once inserted correctly, a tampon is held in place by the vagina and expands as it soaks up menstrual blood. However, in addition to menstrual blood, the tampon also absorbs the vagina's natural lubrication and bacteria, which can change the normal pH, increasing the risk of
infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
s from the bacterium ''
Staphylococcus aureus ''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
'', which can lead to
toxic shock syndrome Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyeliti ...
(TSS). TSS is a rare but life-threatening infection that requires immediate medical attention. The majority of tampons sold are made of
rayon Rayon is a semi-synthetic fiber, made from natural sources of regenerated cellulose, such as wood and related agricultural products. It has the same molecular structure as cellulose. It is also called viscose. Many types and grades of viscose f ...
, or a blend of rayon and
cotton Cotton is a soft, fluffy staple fiber that grows in a boll, or protective case, around the seeds of the cotton plants of the genus ''Gossypium'' in the mallow family Malvaceae. The fiber is almost pure cellulose, and can contain minor perce ...
, along with synthetic fibers. Some tampons are made out of organic cotton. Tampons are available in several absorbency ratings. Brands include (but are not limited to)
Kotex Kotex is an American brand of menstrual hygiene products, which includes the Kotex maxi, thin and ultra thin pads, the Security tampons, and the Lightdays pantiliners. Most recently, the company has added U by Kotex to its line of menstrual ...
, Playtex,
Tampax Tampax (a portmanteau of tampon and pack) is a brand of tampon currently owned by Procter & Gamble. It was based in White Plains, New York, US until its sale to Procter & Gamble in 1997. It is a subsidiary of P&G's Always brand and is sold in o ...
(
Always Always may refer to: Film and television * ''Always'', a 1985 film directed by Henry Jaglom * ''Always'' (1989 film), a 1989 romantic comedy-drama directed by Steven Spielberg * ''Always'' (2011 film), a 2011 South Korean film, also known as '' ...
), O.B., Cora, Lola, Sustain, Honest Company, Seventh Generation, Solimo, and Rael Tampons. Several countries regulate tampons as medical devices. In the United States, they are considered to be a Class II medical device by the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA). They are sometimes used for
hemostasis In biology, hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. This involves coagulation, whi ...
in
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
.


Design and packaging

Tampon design varies between companies and across product lines in order to offer a variety of applicators, materials and absorbencies. There are two main categories of tampons based on the way of insertion - digital tampons inserted by finger, and applicator tampons. Tampon applicators may be made of plastic or cardboard, and are similar in design to a syringe. The applicator consists of two tubes, an "outer", or barrel, and "inner", or plunger. The outer tube has a smooth surface to aid insertion and sometimes comes with a rounded end that is petaled. Differences exist in the way tampons expand when in use: applicator tampons generally expand axially (increase in length), while digital tampons will expand radially (increase in diameter). Most tampons have a cord or string for removal. The majority of tampons sold are made of rayon, or a blend of
rayon Rayon is a semi-synthetic fiber, made from natural sources of regenerated cellulose, such as wood and related agricultural products. It has the same molecular structure as cellulose. It is also called viscose. Many types and grades of viscose f ...
and
cotton Cotton is a soft, fluffy staple fiber that grows in a boll, or protective case, around the seeds of the cotton plants of the genus ''Gossypium'' in the mallow family Malvaceae. The fiber is almost pure cellulose, and can contain minor perce ...
. Organic cotton tampons are made from only 100% cotton. Tampons may also come in scented or unscented varieties.


Absorbency ratings


In the US

Tampons are available in several absorbency ratings, which are consistent across manufacturers in the U.S. These differ in the amount of cotton in each product and are measured based on the amount of fluid they are able to absorb. The absorbency rates required by the
U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
(FDA) for manufacturer labeling are listed below:


In Europe

Absorbency ratings outside the US may be different. The majority of non-US manufacturers use absorbency rating and Code of Practice recommended b
EDANA
(European Disposables and Nonwovens Association).


In the UK

In the UK, the Absorbent Hygiene Product Manufacturers Association (AHPMA) has written a Tampon Code of Practice which companies can follow on a volunteer basis. According to this code, UK manufacturers should follow the (European) EDANA code (see above).


Testing

A piece of test equipment referred to as a Syngyna (short for synthetic vagina) is usually used to test absorbency. The machine uses a
condom A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection (STI). There are both male and female condoms. With proper use—and use at every act of in ...
into which the tampon is inserted, and synthetic menstrual fluid is fed into the test chamber. A novel way of testing was developed by feminist medical experts after the
toxic shock syndrome Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyeliti ...
(TSS) crisis, and used blood - rather than the industry standard blue saline - as a test material.


Labeling

The
FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
requires the manufacturer to perform absorbency testing to determine the absorbency rating using the Syngyna method or other methods that are approved by the FDA. The manufacturer is also required to include on the package label the absorbency rating and a comparison to other absorbency ratings as an attempt to help consumers choose the right product and avoid complications of TSS. In addition, The following statement of association between tampons and TSS is required by the FDA to be on the package label as part of the labeling requirements: "Attention: Tampons are associated with Toxic Shock Syndrome (TSS). TSS is a rare but serious disease that may cause death. Read and save the enclosed information." Such guidelines for package labeling are more lenient when it comes to tampons bought from vending machines. For example, tampons sold in vending machines are not required by the FDA to include labeling such as absorbency ratings or information about TSS.


Costs

The average woman may use approximately 11,400 tampons in her lifetime (if using only tampons). Generally, a box of tampons costs can range from $6 to $10 USD and has 12 to 40 tampons per box. Thus, women could use around 9 boxes a year, leading to a total cost between $54 to $90 USD a year (around $0.20-$0.40 a tampon). Activists call the problem some women have when not being able to afford products "
period poverty Menstrual hygiene management (MHM) or menstrual health and hygiene (MHH) refers to access to menstrual hygiene products to absorb or collect the flow of blood during menstruation, privacy to change the materials, and access to facilities to disp ...
".


Health aspects


Toxic shock syndrome

Menstrual toxic shock syndrome (mTSS) is a life-threatening disease most commonly caused by infection of superantigen-producing ''
Staphylococcus aureus ''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...
''. The superantigen toxin secreted in ''S. aureus'' infections is TSS Toxin-1, or
TSST "Tsst" is the seventh episode in the tenth season of the American animated television series ''South Park''. The 146th episode of the series overall, it originally aired on Comedy Central in the United States on May 3, 2006. In the episode, Lian ...
-1. Incidence ranges from 0.03 to 0.50 cases per 100,000 people, with an overall mortality around 8%. mTSS signs and symptoms include fever (greater than or equal to 38.9 °C), rash,
desquamation Desquamation occurs when the outermost layer of a tissue, such as the skin, is shed. The term is . Physiologic desquamation Keratinocytes are the predominant cells of the epidermis, the outermost layer of the skin. Living keratinocytes reside in ...
,
hypotension Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Blood pressure is indicated by two numbers, the systolic blood pressure (the top number) and the dias ...
(
systolic blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...
less than 90 mmHg), and multi-system organ involvement with at least three systems, such as gastrointestinal complications (vomiting),
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...
(CNS) effects (disorientation), and
myalgia Myalgia (also called muscle pain and muscle ache in layman's terms) is the medical term for muscle pain. Myalgia is a symptom of many diseases. The most common cause of acute myalgia is the overuse of a muscle or group of muscles; another likel ...
. Toxic shock syndrome was named by James K. Todd in 1978. Philip M. Tierno Jr., Director of Clinical
Microbiology Microbiology () is the scientific study of microorganisms, those being unicellular (single cell), multicellular (cell colony), or acellular (lacking cells). Microbiology encompasses numerous sub-disciplines including virology, bacteriology, prot ...
and
Immunology Immunology is a branch of medicineImmunology for Medical Students, Roderick Nairn, Matthew Helbert, Mosby, 2007 and biology that covers the medical study of immune systems in humans, animals, plants and sapient species. In such we can see there ...
at the
NYU Langone Medical Center NYU Langone Health is an academic medical center located in New York City, New York, United States. The health system consists of NYU Grossman School of Medicine and NYU Long Island School of Medicine, both part of New York University (NYU), and m ...
, helped determine that tampons were behind
toxic shock syndrome Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyeliti ...
(TSS) cases in the early 1980s. Tierno blames the introduction of higher-absorbency tampons made with rayon in 1978, as well as the relatively recent decision by manufacturers to recommend that tampons can be worn overnight, for the surge in cases of TSS. However, a later
meta-analysis A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
found that the material composition of tampons is not directly correlated to the incidence of toxic shock syndrome, whereas
oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements as wel ...
and
carbon dioxide Carbon dioxide (chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is transpar ...
content of menstrual fluid uptake is associated more strongly. In 1982, a liability case called ''Kehm v. Proctor & Gamble'' took place, where the family of Patricia Kehm sued
Procter & Gamble The Procter & Gamble Company (P&G) is an American multinational consumer goods corporation headquartered in Cincinnati, Ohio, founded in 1837 by William Procter and James Gamble. It specializes in a wide range of personal health/consumer hea ...
for her death on September 6, 1982, from TSS, while using Rely brand tampons. The case was the first successful case to sue the company. Procter & Gamble paid $300,000 in compensatory damages to the Kehm family. This case can be attributed to the increase in regulations and safety protocol testing for current FDA requirements. Some risk factors identified for developing TSS include recent
labor and delivery Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
, tampon use, recent staphylococcus infection, recent
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
, and foreign objects inside the body. The FDA suggests the following guidelines for decreasing the risk of contracting TSS when using tampons: * Choose the lowest absorbency needed for one's flow (test of absorbency is approved by FDA) * Follow package directions and guidelines for insertion and tampon usage (located on box's label) * Change the tampon at least every 6 to 8 hours or more often if needed * Alternate usage between tampons and
pads Pads (also called leg guards) are a type of protective equipment used in a number of sports and serve to protect the legs from the impact of a hard ball, puck, or other object of play travelling at high speed which could otherwise cause injuries t ...
* Avoid tampon usage overnight or when sleeping * Increase awareness of the warning signs of Toxic Shock Syndrome and other tampon-associated health risks (and remove the tampon as soon as a risk factor is noticed) The FDA also advises those with a history of TSS not to use tampons and instead turn to other
feminine hygiene Feminine hygiene products are personal care products used during menstruation, vaginal discharge, and other bodily functions related to the vulva and vagina. Products that are used during menstruation may also be called menstrual hygiene produ ...
products to control menstrual flow. Other menstrual hygiene products available include pads,
menstrual cup A menstrual cup is a menstrual hygiene device which is inserted into the vagina during menstruation. Its purpose is to collect menstrual fluid (blood from the uterine lining mixed with other fluids). Menstrual cups are usually made of flexible ...
s, menstrual discs, and reusable period underwear. Cases of tampon-connected TSS are very rare in the United Kingdom and United States. A controversial study by Tierno found that all-cotton tampons were less likely than rayon tampons to produce the conditions in which TSS can grow. This was done using a direct comparison of 20 brands of tampons, including conventional cotton/rayon tampons and 100% organic cotton tampons. In a series of studies conducted after this initial claim, it was shown that all tampons (regardless of composition) are similar in their effect on TSS and that tampons made with rayon do not have an increased incidence of TSS. Instead, tampons should be selected based on minimum absorbency rating necessary to absorb flow corresponding to the individual.
Sea sponge Sponges, the members of the phylum Porifera (; meaning 'pore bearer'), are a basal animal clade as a sister of the diploblasts. They are multicellular organisms that have bodies full of pores and channels allowing water to circulate through t ...
s are also marketed as
menstrual The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
hygiene products. A 1980 study by the
University of Iowa The University of Iowa (UI, U of I, UIowa, or simply Iowa) is a public university, public research university in Iowa City, Iowa, United States. Founded in 1847, it is the oldest and largest university in the state. The University of Iowa is org ...
found that commercially sold sea sponges contained
sand Sand is a granular material composed of finely divided mineral particles. Sand has various compositions but is defined by its grain size. Sand grains are smaller than gravel and coarser than silt. Sand can also refer to a textural class of s ...
, grit, and
bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were among ...
. Hence, sea sponges could also potentially cause toxic shock syndrome. Studies have shown non-significantly higher mean levels of mercury in tampon users compared to non tampon users. No evidence showed an association between tampon use and inflammation biomarkers.


Other considerations


Bleached products

According to the Women's Environmental Network research briefing on menstrual products made from wood pulp:
The basic ingredient for menstrual pads is wood pulp, which begins life as a brown coloured product. Various ‘purification’ processes can be used to bleach it white. Measurable levels of dioxin have been found near paper pulping mills, where chlorine has been used to bleach the wood pulp. Dioxin is one of the most persistent and toxic chemicals, and can cause reproductive disorders, damage to the immune system and cancer (26). There are no safe levels and it builds up in our fat tissue and in our environment.


Marine pollution

In the UK, the Marine Conservation Society has researched the prevalence and problem of plastic tampon applicators found on beaches.


Disposal and flushing

Disposal of tampons, especially flushing (which manufacturers warn against) may lead to clogged drains and waste management problems.


Tampon-drug interactions

There are multiple cases in which the use of tampons may need medical advice from a healthcare professional. For example, as part of the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
, the
U.S. National Library of Medicine The United States National Library of Medicine (NLM), operated by the United States federal government, is the world's largest medical library. Located in Bethesda, Maryland, the NLM is an institute within the National Institutes of Health. Its ...
and its branch
MedlinePlus MedlinePlus is an online information service produced by the United States National Library of Medicine. The service provides curated consumer health information in English and Spanish with select content in additional languages. The site brings t ...
advise against using tampons while being treated with any of several medications taken by the vaginal route such as vaginal suppositories and creams, as tampons may decrease the absorbance of these drugs by the body. Example of these medications include
clindamycin Clindamycin is an antibiotic medication used for the treatment of a number of bacterial infections, including osteomyelitis (bone) or joint infections, pelvic inflammatory disease, strep throat, pneumonia, acute otitis media (middle ear infec ...
, terconazole,
miconazole Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina. It is used for ring worm of the body, groin (jock itch), and ...
,
clotrimazole Clotrimazole, sold under the brand name Lotrimin, among others, is an antifungal medication. It is used to treat vaginal yeast infections, oral thrush, diaper rash, tinea versicolor, and types of ringworm including athlete's foot and jock itch ...
, when used as a vaginal cream or vaginal suppository, as well as
butoconazole Butoconazole (trade names Gynazole-1, Mycelex-3) is an imidazole antifungal used in gynecology. It is administered as a vaginal cream.Butoconazole Synthesis Reaction of epichlorohydrin with 4-Chlorobenzyl magnesium bromide leads to 1-chloro-4 ...
vaginal cream.


Increased risk for infections

According to the American Society for Blood and Marrow Transplantation (ASBMT), tampons may be responsible for an increased risk of infection due to the erosions it causes in the tissue of the cervix and vagina, leaving the skin prone to infections. Thus, ASBMT advises hematopoietic stem-cell transplantation recipients against using tampons while undergoing therapy.


Other uses


Clinical use

Tampons are currently being used and tested to restore and/or maintain the normal microbiota of the vagina to treat
bacterial vaginosis Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination ...
. Some of these are available to the public but come with disclaimers. The efficacy of the use of these
probiotic Probiotics are live microorganisms promoted with claims that they provide health benefits when consumed, generally by improving or restoring the gut microbiota. Probiotics are considered generally safe to consume, but may cause bacteria-host i ...
tampons has not been established. Tampons have also been used in cases of tooth extraction to reduce post-extraction bleeding. Tampons are currently being investigated as a possible use to detect
endometrial cancer Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most o ...
. Endometrial cancer does not currently have effective
cancer screening Cancer screening aims to detect cancer before symptoms appear. This may involve blood tests, urine tests, DNA tests, other tests, or medical imaging. The benefits of screening in terms of cancer prevention, early detection and subsequent treatme ...
methods if an individual is not showing symptoms. Tampons not only absorb menstrual blood, but also vaginal fluids. The vaginal fluids absorbed in the tampons would also contain the cancerous DNA, and possibly contain precancerous material, allowing for earlier detection of endometrial cancer. Clinical trials are currently being conducted to evaluate the use of tampons as a screening method for early detection of endometrial cancer.


Environment and waste

Appropriate disposal of used tampons is still lacking in many countries. Because the lack of menstrual management practices in some countries, many sanitary pads or other menstrual products will be disposed into domestic solid wastes or garbage bins that eventually becomes part of a solid wastes. The issue that underlies the governance or implementation of menstrual waste management is how country categorizes menstrual waste. This waste could be considered as a common household waste, hazardous household waste (which will required to be segregated from routine household waste), biomedical waste given amount of blood it contains, or plastic waste given the plastic content in many commercial disposal pads (some only the outer case of the tampon or pads). Ecological impact varies according to disposal method (whether a tampon is flushed down the toilet or placed in a garbage bin - the latter is the recommended option). Factors such as tampon composition will likewise impact
sewage treatment plants Sewage treatment (or domestic wastewater treatment, municipal wastewater treatment) is a type of wastewater treatment which aims to remove contaminants from sewage to produce an effluent that is suitable for discharge to the surrounding envir ...
or waste processing. The average use of tampons in menstruation may add up to approximately 11,400 tampons in someone's lifetime (if they use only tampons rather than other products). Tampons are made of cotton, rayon, polyester, polyethylene, polypropylene, and fiber finishes. Aside from the cotton, rayon and fiber finishes, these materials are not
biodegradable Biodegradation is the breakdown of organic matter by microorganisms, such as bacteria and fungi. It is generally assumed to be a natural process, which differentiates it from composting. Composting is a human-driven process in which biodegradati ...
. Organic cotton tampons are biodegradable, but must be composted to ensure they break down in a reasonable amount of time. Rayon was found to be more biodegradable than cotton. Environmentally friendly alternatives to using tampons are the
menstrual cup A menstrual cup is a menstrual hygiene device which is inserted into the vagina during menstruation. Its purpose is to collect menstrual fluid (blood from the uterine lining mixed with other fluids). Menstrual cups are usually made of flexible ...
, reusable sanitary pads, menstrual sponges, reusable tampons, and reusable absorbent underwear. The Royal Institute of Technology in Stockholm carried out a
life-cycle assessment Life cycle assessment or LCA (also known as life cycle analysis) is a methodology for assessing environmental impacts associated with all the stages of the Product lifecycle, life cycle of a commercial product, Process lifecycle, process, or ...
(LCA) comparison of the environmental impact of tampons and sanitary pads. They found that the main environmental impact of the products was in fact caused by the processing of raw materials, particularly
LDPE Low-density polyethylene (LDPE) is a thermoplastic made from the monomer ethylene. It was the first grade of polyethylene, produced in 1933 by Imperial Chemical Industries (ICI) using a high pressure process via free radical polymerization. Its ...
(low density polyethylene) – or the plastics used in the backing of pads and tampon applicators, and cellulose production. As production of these plastics requires a lot of energy and creates long-lasting waste, the main impact from the life cycle of these products is
fossil fuel A fossil fuel is a hydrocarbon-containing material formed naturally in the Earth's crust from the remains of dead plants and animals that is extracted and burned as a fuel. The main fossil fuels are coal, oil, and natural gas. Fossil fuels m ...
use, though the waste produced is significant in its own right. The menstrual material was disposed according to the type of product, and even based on cultural beliefs. This was done regardless of giving any importance to the location and proper techniques of disposal. In some areas of the world, menstrual waste is disposed into pit latrines, as burning and burial were difficult due to limited private space.


History

Women have used tampons during menstruation for thousands of years. In her book ''Everything You Must Know About Tampons'' (1981), Nancy Friedman writes,
ere is evidence of tampon use throughout history in a multitude of cultures. The oldest printed medical document, papyrus ebers, refers to the use of soft papyrus tampons by Egyptian women in the fifteenth century B.C. Roman women used wool tampons. Women in ancient Japan fashioned tampons out of paper, held them in place with a bandage, and changed them 10 to 12 times a day. Traditional Hawaiian women used the furry part of a native fern called
hapu'u ''Cibotium'' (from Greek , ''kibṓtion'', "little chest" or "box"), also known as manfern, is a genus of 11 species of tropical tree ferns. It is the only genus in family Cibotiaceae in the Pteridophyte Phylogeny Group classification of 2016 (PP ...
; and grasses, mosses and other plants are still used by women in parts of Asia and Africa.
R. G. Mayne defined a tampon in 1860 as: "a less inelegant term for the ''plug'', whether made up of portions of rag, sponge, or a silk handkerchief, where plugging the ''vagina'' is had recourse to in cases of hemorrhage."
Earle Haas Earle Haas, D.O. (1888–1981) was an osteopathic physician and inventor of the tampon with an applicator, marketed as "Tampax". He graduated from the Kansas City College of Osteopathy in 1918 and spent 10 years in Colorado as a country general ...
patented the first modern tampon,
Tampax Tampax (a portmanteau of tampon and pack) is a brand of tampon currently owned by Procter & Gamble. It was based in White Plains, New York, US until its sale to Procter & Gamble in 1997. It is a subsidiary of P&G's Always brand and is sold in o ...
, with the tube-within-a-tube applicator. Gertrude Schulte Tenderich (née Voss) bought the patent rights to her company trademark Tampax and started as a seller, manufacturer, and spokesperson in 1933. Tenderich hired women to manufacture the item and then hired two sales associates to market the product to drugstores in Colorado and Wyoming, and nurses to give public lectures on the benefits of the creation, and was also instrumental in inducing newspapers to run advertisements. In 1945, Tampax presented a number of studies to prove the safety of tampons. A 1965 study by the Rock Reproductive Clinic stated that the use of tampons "has no physiological or clinical undesired side effects". During her study of female anatomy, German gynecologist Judith Esser-Mittag developed a digital-style tampon, which was made to be inserted without an applicator. In the late 1940s, Carl Hahn and Heinz Mittag worked on the mass production of this tampon. Hahn sold his company to
Johnson & Johnson Johnson & Johnson (J&J) is an American multinational corporation founded in 1886 that develops medical devices, pharmaceuticals, and consumer packaged goods. Its common stock is a component of the Dow Jones Industrial Average and the company i ...
in 1974. In the late 1990s, it was found that tampon manufacturers were using
dioxin Dioxin may refer to: * 1,2-Dioxin or 1,4-Dioxin, two unsaturated heterocyclic 6-membered rings where two carbon atoms have been replaced by oxygen atoms, giving the molecular formula C4H4O2 *Dibenzo-1,4-dioxin, the parent compound also known as ...
, a known carcinogen, in their rayon bleaching processes. Following this, major commercial tampon brands began switching from dioxin-producing chlorine gas bleaching methods to either elemental “chlorine-free” or “totally chlorine free” bleaching processes. In the United States, the Tampon Safety and Research Act was introduced to Congress in 1997 in an attempt to create transparency between tampon manufacturers and consumers. The bill would mandate the conduct or support of research on the extent to which additives in feminine hygiene products pose any risks to the health of women or to the children of women who use those products during or before the pregnancies involved. Although yet to be passed, the bill has been continually reintroduced, most recently in 2019 as the Robin Danielson Feminine Hygiene Product Safety Act. Data would also be required from manufacturers regarding the presence of dioxins, synthetic fibers, chlorine, and other components (including contaminants and substances used as fragrances, colorants, dyes, and preservatives) in their feminine hygiene products.


Society and culture


Tampon tax

"Tampon tax" refers to tampons' lack of tax exempt status that is often in place for other basic need products. Several political statements have been made in regards to tampon use. In 2000, a 10% goods and services tax (GST) was introduced in Australia. While lubricant, condoms, incontinence pads and numerous medical items were regarded as essential and exempt from the tax, tampons continue to be charged GST. Prior to the introduction of GST, several states also applied a
luxury tax A luxury tax is a tax on luxury goods: products not considered essential. A luxury tax may be modeled after a sales tax or VAT, charged as a percentage on all items of particular classes, except that it mainly directly affects the wealthy bec ...
to tampons at a higher rate than GST. Specific petitions such as "Axe the Tampon Tax" have been created to oppose this tax, although no change has been made. In the UK, tampons are subject to a zero rate of
value added tax A value-added tax (VAT), known in some countries as a goods and services tax (GST), is a type of tax that is assessed incrementally. It is levied on the price of a product or service at each stage of production, distribution, or sale to the end ...
(VAT), as opposed to the standard rate of 20% applied to the vast majority of products sold in the country. The UK was previously bound by the EU VAT directive, which required a minimum of 5% VAT on sanitary products. Since 1 January 2021, VAT applied to menstrual sanitary products has been 0%. In Canada, the federal government has removed the goods and services tax (GST) and harmonized sales tax (HST) from tampons and other menstrual hygiene products as of July 1, 2015. In the US, access to menstrual products such as pads and tampons and taxes added on these products, have also been controversial topics especially when it comes to people with low income. Laws for exempting such taxes differ vastly from state to state. The
American Civil Liberties Union The American Civil Liberties Union (ACLU) is a nonprofit organization founded in 1920 "to defend and preserve the individual rights and liberties guaranteed to every person in this country by the Constitution and laws of the United States". T ...
(ACLU) has published a report discussing these laws and listing the different guidelines followed by institutions such as schools, shelters, and prisons when providing menstrual goods. The report by ACLU also discusses the case of Kimberly Haven who was a former prisoner that had a
hysterectomy Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may b ...
after she had experienced
toxic shock syndrome Toxic shock syndrome (TSS) is a condition caused by bacterial toxins. Symptoms may include fever, rash, skin peeling, and low blood pressure. There may also be symptoms related to the specific underlying infection such as mastitis, osteomyeliti ...
(TSS) due to using handmade tampons from toilet paper in prison. Her testimony supported a Maryland bill that is intended to increase access of menstrual products for imprisoned women.


Etymology

Historically, the word "tampon" originated from the medieval French word "
tampion A tampion or tompion (in the Royal Navy)#refSimmons1812, Simmons, 1812, p. 163. is a wooden plug, or a metal, canvas, rubber, or plastic cover, for the Muzzle (firearm), muzzle of a gun or mortar (weapon), mortar.#refDuane1810, Duane, 1810, p ...
", meaning a piece of cloth to stop a hole, a ''stamp'', ''plug'', or ''stopper''.


Virginity

Tampon use may stretch or break the
hymen The hymen is a thin piece of mucosal tissue that surrounds or partially covers the external vaginal opening. It forms part of the vulva, or external genitalia, and is similar in structure to the vagina. In children, a common appearance of the h ...
of individuals that have never been sexually active. Some cultures regard preservation of the hymen as a supposed evidence of
virginity Virginity is the state of a person who has never engaged in sexual intercourse. The term ''virgin'' originally only referred to sexually inexperienced women, but has evolved to encompass a range of definitions, as found in traditional, modern ...
, which may discourage some people from using tampons.


In popular culture

In Stephen King's novel ''Carrie'', the title character is bullied for menstruating and is bombarded with tampons and pads by her peers. In 1985, Tampon Applicator Creative Klubs International (TACKI) was established to develop creative uses for discarded, non-biodegradable, plastic feminine hygiene products, commonly referred to as “beach whistles”. TACKI President Jay Critchley launched his corporation in order to develop a global folk art movement and cottage industry, promote awareness of these throwaway objects washed up on beaches worldwide from faulty sewage systems, create the world's largest collection of discarded plastic tampon applicators, and ban their manufacture and sale through legislative action. The project and artwork was carried out during numerous site-specific performances and installations.


See also

*
Cloth menstrual pad Cloth menstrual pads are cloth pads worn in the underwear to collect menstrual fluid (blood from uterine lining). They are a type of reusable menstrual hygiene product, and are an alternative to sanitary napkins or to menstrual cups. Because t ...
*
Menstrual cup A menstrual cup is a menstrual hygiene device which is inserted into the vagina during menstruation. Its purpose is to collect menstrual fluid (blood from the uterine lining mixed with other fluids). Menstrual cups are usually made of flexible ...
*
Sanitary napkin Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems ...
*
Tamponade Tamponade () is the closure or blockage (as of a wound or body cavity) by or as if by a tampon, especially to stop bleeding. Tamponade is a useful method of stopping a hemorrhage. This can be achieved by applying an absorbent dressing directl ...
* Menstruation and culture


References


External links


Myths About Tampons
(web article)



(archived)
Can Tampons Cause a UTI
by TamponsAndMenstrualCups.com {{menstrual cycle Feminine hygiene Personal hygiene products Menstrual cycle Disposable products Vagina