Ask the Doctor: I’m afraid to use tampons

Dear Doctor, This is more of an inquiry than it is a problem. During menstruation, I always use pads. But my cousin uses tampons and she says that they are actually better than pads. One day we had some friends over and we got to talking. The topic came up and these other girls said that tampons leave you ‘damaged’ down there and that they can even cause cancer. Is this true? I was actually thinking about trying them out but now I’m scared to death of them. Charlotte, 25, Kimihurura Dear Charlotte A vaginal tampon is a mass of absorbent material, made of cotton or rayon or a mixture of the two, used for absorbing fluid after being inserted into the vagina. Tampons are better than sanitary pads in the sense that they absorb more fluid, can be left in place for a long time without the risk of blood or its stain leaking out, and hence more useful during menstrual cycles of a woman. They have been in use since ancient times in different forms, made of different materials. Way back around the seventh decade of the last century, tampons made of rayon and cotton were introduced and designed to remain in place for 12 hours, meanwhile absorbing all liquid and keeping the individual dry. With the absorption of moisture, they would swell in the vaginal cavity. Along with menstrual blood, they also absorbed vaginal fluid. Naturally they became very popular. Vaginal fluid keeps the vagina lubricated and protects it from infectious germs. As their use increased, it was found to be associated with the increase in the number of cases of toxic shock syndrome (T.S.S.) among women. Toxic shock syndrome occurs due to severe bacterial infection caused by staphylococcus aureus or streptococcal pyogenes. This manifests as high fever, rashes, nausea, vomiting and shock. Unless treated immediately, there is a high risk of death. Apart from this, there is a risk of pelvic infections due to the tampon being in the vagina for long time. This would cause pain in the lower abdomen and burning or pain during urination by contaminating the urinary tract. Recurrent use of tampons carries the risk of chronic irritation of the vaginal mucosa (inner lining) which can lead to malignancy. This is not very common, but statistics apart, the affected individual suffers 100%. There is no problem with using tampons. They are more useful in situations like where a woman has to be in active sports like swimming or athletic events during their menstrual cycle or has to travel or work for a long time, with not much pause or space in between to change sanitary pads. But it is advisable that one should possibly use tampons made of only cotton. After inserting it, one should change the tampon once in 6 to 8 hours. During sleeping hours, one should preferably avoid using tampons. While using tampons, a lady should be aware of the symptoms of pelvic infection and T.S.S. At the earliest symptom or sign of these infections it is advisable to seek early medical treatment. Hence use of tampons should be one’s individual choice. Before using it, advantages should be weighed against the risks and situations should be assessed as to how necessary a tampon is against a simple sanitary pad. Dr. Rachna Pande is a specialist in Internal Medicine at Ruhengeri Hospital.