SKIP AHEAD. . .
What is a tampon and how does it work?
Tampons have been around for a long time–there’s documentation that ancient Romans used wool as tampons! (1) (Man, that must have been itchy!) Now, tampons usually made of cotton, rayon or a cotton/rayon blend and are used to absorb the blood that is released during menstruation (2). Tampons, like pads, menstrual cups or menstrual disks, can help keep you, your clothes, your sheets, and your furniture dry and protected from blood.
Although they are typically cylinders at least an inch long, tampons come in a variety of different sizes. These cotton cylinders have strings that start at the top of the tampon and extend past the bottom of the cotton (imagine a white, cotton baby carrot with a long string attached to it).
A cool thing about tampons is that they are used internally. They are placed inside the vaginal canal (more on that later) and your vaginal muscles actually help to keep a tampon in place (2). The cotton absorbs the menstrual blood instead of the blood flowing out in your underwear, around your pelvic area and surroundings. Tampons are single-use so once they have absorbed blood, you toss it in the trash (not the toilet!).
How do I pick a size?
There are a lot of tampon options.
There are dozens of different brands, materials, and sizes found in any drugstore, or now deliverable straight to your door via a subscription service (like this one!). These sizes correlate to absorbency (2). Popular tampon brands come in the following sizes (3):
- Light tampons (absorbs 6g blood)
- Regular (absorbs 6-9g blood)
- Super (absorbs 9-12g blood)
- Super plus (absorbs 12-15g blood)
- Ultra (absorbs 15-18g)
The lighter the absorbency, the smaller the tampon will be in diameter and length. Of course, few of us (if any) have actually measured the amount of menstrual blood secreted so these measurements feel arbitrary.
The best rule of thumb is to use the lightest absorbency needed to last you for a few hours (2). There is a little bit of trial and error that comes along with this and depending on where you are in your cycle, different sizes may work better on different days.
Do tampons expire?
Great Q. Yes, tampons do expire. Cotton can grow bacteria and mold (4). Expired tampons may not look or smell different to a naked eye, so if the tampon box is covered in dust it’s best to be on the safe side and check it out. On some tampon boxes, you might find an expiration date on the side or the bottom. For non-organic tampons, companies suggest there is a five-year shelf life. Organic tampons, do not recommend using their organic tampons three years past the expiration date (5). Each tampon manufacturer may have a different standard for exactly when tampons expire but the short answer is yes, tampons do expire. You should check the box or a website to find out when exactly it’s time to toss your box.
The above diagram from Menstrupedia shows a rough illustration of how to put a tampon in;
Step 1: Wash your hands! Vaginas are sensitive to bacteria so it’s always best to make sure your hands are clean before insertion.
Step 2: Get in a comfortable position. This may require some trial and error to figure out what works for you. Some folks like to sit on the toilet, others like to put one leg on a toilet seat or some like to stand with bent knees to get ready for insertion.
Step 3: Once you’re in a comfortable position, unwrap the tampon.
Step 4: Hold the tampon and its applicator (if using) outside of your vagina. At first, it may be helpful to spread your labia apart and situate the tampon right outside of the opening of your vagina. Angle the tampon at about a 45-degree angle, angling towards your back.
Step 4a: If you are using a tampon with an applicator– once the tampon and its applicator are inside your vagina (about an inch, although this will be different for everyone!) place your fingers on the bottom of the applicator and press. This will push the tampon further into the vaginal canal.
Step 4b: Some tampons without applicators may require you to spread the strings apart to expand the tampon. Once you have done this, hold the tampon in a position that is comfortable for you so that you are able to push the tampon, again, towards your back. You may have to continue pushing the tampon towards your back with your finger.
Step 5: At this point, you should not be able to feel anything and the tampon string will be hanging outside of the vagina. However, if you still feel the tampon, gently pull on the string and try to re-insert a new one. Throw away the wrapper of the tampon in a trash can.
Step 6: To remove, gently pull on the string, wrap up the tampon and discard.
If inserting a tampon is continuously painful, you may want to contact a doctor or midwife– you should not live in pain and it may be a sign of something going on with your pelvic floor. Also, if you’re experiencing pain while putting a tampon in at the beginning of your period you may find that adding a little bit of unscented lubricant on the tampon may relieve some of the pain (2). Typically during a medium or heavy flow, you may not need lubrication because menstrual blood acts as a natural lubricant.
Also, remember to breathe and relax! If you’re very nervous you may tense up and make it harder to insert a tampon.
One of the most important things to know about tampons is that you need to remember to change them frequently. Tampons should be used at the lightest absorbency that works for you and changed every 4-8 hours (6). If tampons are left in for too long, you could be susceptible to a dangerous (but rare) infection known as Toxic Shock Syndrome (TSS), which is caused by the presence of a bacteria called Staphlococcus aureus (7). If you are using a tampon and experience the following symptoms:
- High fever
- Muscle soreness or muscle aches
- Sore throat
- Faintness or weakness
- Sunburn-type rash
Be sure to take the tampon out immediately and contact your doctor right away as these can be signs of TSS, which can be fatal (2).
Additionally, there are concerns over chemicals used in tampon production (8). Some reports have found that pesticides can be found in tampons (8). Organic all-cotton tampons are an alternative.
Sometimes tampons come as “scented.” It’s best to use unscented tampons as scented tampons can lead to irritation or infection (2). This is particularly true if you tend to be susceptible to B.V (bacterial vaginosis). However, tampons are not your only period product option!
Other options besides tampons
Luckily, there are lots of different options on the market now for your period needs!
Menstrual cups: Offer protection similar to a tampon as they are used internally and are an eco-friendly and long-lasting alternative (2). Can be worn up to 12 hours (2).
Menstrual disc: Similar to a menstrual cup but cannot be used more than once. Menstrual discs, such as those from FLEX are more flexible than a menstrual cup (and lighter!). They can be worn for up to 12 hours and during sex!
Pads: Made of an absorbent material that is placed on top of your underwear and offers period protection (2). They vary in thickness, length, and overall size, similar to tampons. We have reusable ones here! Just wash em before use (way less gross than it sounds, promise!)
Pantyliners: A lighter version of a pad meant to help on days you’re just spotting. They can also be used for a tampon, menstrual cup, and menstrual disk back up. Like an insurance policy in your undies!
Period underwear: Period protection underwear essentially has a pad embedded in the lining of the underwear. If you are on a lighter day you can just put them on and go. Similar to pantyliners, these can also be used as extra assurance when wearing other products.
Ultimately, there are a lot of options out there for your period needs. Figuring out what works best for you will likely take some trial and error, but if one of these options does not feel right, know that you do not have to use it. Experiment with different options to see what works best for your body.
Can tampons get lost inside you?
Allbodies physician and badass, Aisha Wagner, MD, would also like to clear up one age-old myth:
Tampons cannot get “lost” in your body.
The cervix is a beautiful thing and, amongst its many other awesome jobs, it’s head of security in these matters. Your cervix acts as a barrier and prevents tampons or any of your other menstrual products from ending up where they don’t belong.
Written by: Moriah Engelberg
Medically Reviewed by: Aisha Wagner, Family Physician with fellowships focusing on contraception and abortion advocacy
1. Fetters, Ashley. “The Tampon: A History.” The Atlantic. Atlantic Media Company, June 1, 2015. https://www.theatlantic.com/health/archive/2015/06/history-of-the-tampon/394334/.
2. Parenthood, Planned. “How Do I Use Tampons, Pads & Menstrual Cups?: Facts & Info.” Planned Parenthood. Planned Parenthood , n.d. https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/how-do-i-use-tampons-pads-and-menstrual-cups.
3. Tampax Pearl Tampons. Product Detail Label. Procter and Gamble Company, Cincinnati, OH, 2019.
4. “Do Tampons Expire.” TAMPAX tampons & period advice. https://tampax.co.uk/en-gb/tampax-articles/my-first-tampon/do-tampons-expire.
5. “Do Organic Tampons Expire?” Natracare, July 24, 2019. https://www.natracare.com/blog/do-organic-tampons-expire/.
6. Commissioner, Office of the. “The Facts on Tampons-and How to Use Them Safely.” U.S. Food and Drug Administration. FDA. Accessed September 1, 2019. https://www.fda.gov/consumers/consumer-updates/facts-tampons-and-how-use-them-safely.
7. Vostral, Sharra. “Toxic Shock Syndrome, Tampons and Laboratory Standard- Setting.” Canadian Medical Association Journal 189, no. 20 (May 23, 2017): E726–E728. https://doi.org/10.1503/cmaj.161479.
8. Nicole, Wendee. Environmental Health Perspectives 122, no. 3 (March 2014): A70–A75. https://doi.org/10.1289/ehp.122-A70.
9. “FLEX™ Disc: Tampon & Cup Replacement: Alternative Period Product.” The Flex Company. Accessed September 1, 2019. https://flexfits.com/?gclid=Cj0KCQjw2K3rBRDiARIsAOFSW_7k_vdI_7xBi5mAgiQXj1KcEWAF0X1znDxvjvbL2MqDDYcoGvtyL0gaAphNEALw_wcB.