The age-old dilemma of tampons vs. pads prevails. You’ve probably chosen your ride-or-die period product, but do you actually know the good and bad of what you’re using every month?

Tampons are one method of absorbing menstrual flow during periods. They are designed to be inserted into the vagina with or without an applicator. They are made of cotton, rayon, polyester, polyethylene, polypropylene, and fibre finishes. 

Pads, also known as sanitary napkins, sanitary towels, menstrual pads, are absorbent items worn in the underwear when menstruating. 

Some women prefer pads to tampons and vice versa. Medical experts weigh in on both.

Pads: The pros

People with heavy periods and anyone who’s ever woken up to a mess swears by them. They’re also great if your new to the world of menstruation or have a hard time wearing tampons, writes Adrienne Santos-Longhurst, in the article ‘Tampons vs. Pads: The Ultimate Showdown’, published by Healthline. 

Other pros of pads include:

•They come in lots of options to accommodate changes in your flow and activities.

•They carry almost no risk of TTS.

•You can wear them overnight.

•You don’t need to insert anything.

Cons

Even though pads are thinner than ever, they’re more likely to be visible under certain types of clothing. Again, there’s nothing to hide here, but you also don’t want to feel self-conscious all day, says  Santos-Longhurst. 

Other cons:

•You can’t swim in them. 

•Like tampons, there’s the environmental factor, though reusable options are now available.

•They can shift out of place and wrinkle up in the centre when you’re moving.

•They aren’t very discreet thanks to the very obvious sound of pulling them off your underwear.

•Pad rash. Thanks to something called contact dermatitis, you may occasionally find yourself with an annoying little rash from using pads. This might be because of chemicals, adhesive, or fragrance in the pads.

Tampons: The pros

According to Dr Kenneth Ruzindana, a Consultant at University Teaching Hospital of Kigali (CHUK), tampons have pros, they come in different levels of absorbency to serve light to heavy periods and one doesn’t have to worry about them being visible. They can’t be felt if they are properly inserted in.

You don’t need to be a tampon user to see the obvious pros of tampons. Their size makes them small enough to fit in a tiny pocket or in the palm of your hand, so they’re convenient and discreet (not that menstruation is anything to be ashamed of), writes Santos-Longhurst. 

Other tampon pros:

•You can swim in them.

•You don’t have to worry about them being visible (minus the whole issue of tampon strings in swimsuit).

•You can’t feel them when they’re in properly.

Opt for tampons if you;

•are working out or otherwise on the move

•are heading to the beach or a pool party

•need something you can throw in your pocket

Cons

Unfortunately, the biggest downside is the risk of toxic shock syndrome. This is a very rare condition but it’s a life-threatening complication of certain types of bacterial infections. It used to be primarily associated with using very super-absorbent tampons, but many manufacturers have made changes to these products since the 1980s, he adds.

Ruzindana points out that to reduce the risk of toxic shock syndrome for girls and women is to use the lowest absorbency tampons they can.

Ruzindana urges changing the tampon very frequently and then alternate between tampons and pads when the flow is light.

He also notes that women should avoid wearing a single tampon all night. Usually, at night, it is recommended that you put on a pad instead of a tampon because it has to stay for a longer period of time which is not advisable.

"Tampons can at times irritate and dry out the vagina, making it itchy and uncomfortable,” he says.

Dr Joseph Ryarasa Nkurunziza, the chairperson of Health Development Initiative Rwanda-HDI, says that tampons are a substitute for the use of pads. However, the tampons do possess some side effects such as a foul smell.

"Since tampons are inserted inside the vagina, they absorb large quantities of menstrual flow and if left for a longer period without changing, they can lead to an unpleasant smell. It’s recommended to change a tampon every three hours,” he says.

He also notes that the vagina irritation and rashes are sometimes a result of tampons since they are wholly inserted in the vagina for extended periods, they have been documented to cause irritation, itching, and rashes.

Nkurunziza adds that there is a possibility of the string that holds the tampon coming off which may require an emergency.

It is estimated that the average woman will use over 11,000 tampons or menstrual pads over her lifetime – many health experts agree that this level of repeated exposure to toxins like dioxin is problematic, especially as dioxin can bio-accumulate in the human body due to its ability to be absorbed and stored by fatty tissue.

According to the World Health Organization (WHO), it takes between seven to eleven years for the body to eliminate just 50 per cent of all dioxins it contains. Because of this, intrauterine exposure to dioxin could have implications for unborn children during pregnancy, while breast milk can also be a source of dioxin exposure.

This may cause effects on children later in life, such as changes in liver function, thyroid hormone levels, and decreased learning capability.