Just behind sanitary napkins, the tampon is the most common intimate protection used by women. Practical and discreet, it allows you to continue your activities during menstruation. Different types of tampon, composition and precautions for use: an update on this essential woman.

The tampon is a single-use intra-vaginal device used during menstruation. Introduced inside the vagina, it absorbs the menstrual flow as it flows naturally. 

The tampon can be used at any age from the start to the end of your period. Including in young virgins, whose hymen he will not tear. There is also no risk of it going back into the uterus.

The tampon is made up of these different elements:

• an absorbent central part, composed of fibers obtained from cellulose: viscose and / or cotton;
• a veil. This thin outer layer allowing smooth insertion and removal can be made of fibers derived from cellulose (cotton or viscose) and / or synthetic fibers (polyester, polyethylene, polypropylene);
• a cord for removing the tampon, made of cardboard, paper or polyethylene;
• a polyester, cotton and / or polypropylene applicator. 

Some manufacturers add perfumes and odor neutralizers.

Since it was first marketed in 1936, the tampon has undergone multiple improvements for greater reliability and comfort. Thus, today there are different types of tampon according to these criteria:

With or without applicator

The applicator is a small plastic device that makes it easier to insert the tampon. 

Size

Each girl and woman have different anatomy and menstrual flow, the tampon is available in different sizes, from “mini” to “maxi”, including “regular”. 

Absorption capacity

It depends on the design and composition of the tampon. To facilitate the choice of women, the European Code of Good Practice relating to tampons provides for a classification system with pictograms in the form of drops, to indicate the absorbency of each model. 

It is up to each woman to choose her tampon according to her experience, her anatomy, her flow but also the moment of the cycle. So young girls can, for their first experiences with a tampon, opt for a mini model which will be easier to insert. 

Regarding the absorption capacity, it is recommended to choose the minimum absorption level in relation to its flux. If the tampon is completely soaked in less than three hours, switch to the next higher absorption level. If it is not fully soaked after four hours, choose a lower absorption level.

How to apply a tampon?

Putting on a tampon is quite simple, but it is true that the first few times it can seem tricky. Manual.

For a tampon without applicator

• wash your hands well and dry them;
• relax, and get into the position that suits you best: squatting or lying down, standing with one foot raised (on the bathtub or toilet bowl);
• remove the tampon from its packaging, and pull the small string at its end;
• place the tip of his index finger in the small hollow at the base of the tampon;
• with the other hand, spread the lips located at the opening of the vagina;
• position the tampon at the opening of the vagina, and push it inside, slightly at an angle upwards (towards the kidneys). The cord should hang on the outside. The tampon is securely in place when you no longer feel it. If it causes some discomfort or itching, it is because it has not been inserted enough;
• wash one’s hands.

For a tampon with applicator 

The insertion stage is a little different:

• hold the tampon between your thumb and middle finger, at the junction of the applicator and the absorbent part;
• insert the applicator into the vagina, tilting it upwards (towards the kidneys), pushing it deep into the vagina;
• push the absorbent part of the tampon into the applicator, until the two parts fit together;
• remove the applicator. The tampon stays in her vagina.

How to remove the tampon?

To remove it, simply pull gently on the small cord. The tampon is for single use. After use, it must be disposed of with household waste (never in the toilet).

In recent years, the composition of tampons has been the subject of various alerts, primarily due to the lack of transparency. In the absence of specific regulations governing the composition and manufacture of intimate protections, brands are in fact not obliged to display the composition of their products, unless they incorporate a lotion or one of the 26 allergenic fragrances listed in the European regulation on cosmetics.  

The tests of March 2016

In March 2016, following tests carried out on tampons sold in France, “60 million consumers” detected residues of toxic substances. Following this, ANSES was contacted in April 2016 to assess the safety of intimate protection products. On the basis of surveys carried out from May 2016 to August 2017, a first report was submitted in June 2018, then revised in November 2019. 

In this revised opinion, the Agency noted:

• a lack of information from manufacturers regarding the composition of products;
• the presence, in certain buffers, of dioxins / furans and DnOP (phthalates), that is to say as many substances with demonstrated carcinogenic, mutagenic or reprotoxic (CMR) effects, or considered as endocrine disruptors. 

Even if the health thresholds are not exceeded for these substances, the agency recommends however to the manufacturers “to eliminate or to reduce as much as possible the presence of the chemical substances”.

In recent years, more and more brands have been offering ecological stamps, with different labels:

European Ecolabel

It guarantees the reduction of the environmental impact of the tampon throughout its life cycle and the reduction of the use of hazardous substances. 

The GOTS repository

It is a standard for textiles made from organic fibers. In particular, it prohibits the presence of endocrine disruptors. 

Les certifications TCF (Totally chlorine Free), PCF (Processed chlorine Free) et SI (Sustainability Index)

They certify that the product has been manufactured and bleached without any use of chlorine.

Another problem that has been highlighted in recent years with respect to tampons: toxic shock syndrome (TSS) linked to menstruation. As a reminder, toxic shock syndrome (TSS) is a rare phenomenon linked to toxins (bacterial toxins TSST-1) released by certain strains of bacteria, such as Staphylococcus aureus (Staphylococcus aureus). It is a common bacterium, of which 20 to 30% of women are believed to be carriers. When produced in large quantities, these toxins can attack various organs, and in the most dramatic cases, lead to amputation of a limb or even death.

A study conducted by researchers from the International Center for Infectious Disease Research and the National Reference Center for Staphylococci at the Hospices de Lyon identified several risk factors, including wearing the tampon for more than 6 hours or overnight. The stagnation of blood in the vagina, which will then act as a culture medium, indeed promotes the development of Staphylococcus aureus.

The hypothesis of a link between the risk of menstrual TSS and the composition of tampons or the presence of residual chemicals has been put forward by the experts, but it is not yet supported by any element of the scientific literature, specifies the ANSES report.

To limit the risk of SCT but also of intimate concerns (vaginal infections in particular), it is important to respect these rules of good use of the tampon:

• wash your hands well before and after putting on your tampon;
• change your tampon very regularly, and at least every 6 hours;
• choose protection suited to your flow;
• it is possible to put on a tampon overnight, as long as it is not worn for more than 6 hours. For longer nights, opt for sanitary napkins;
• use a tampon only during menstruation, never outside to, for example, absorb vaginal discharge;
• change your tampon after swimming (in the pool, sea, jacuzzi, etc.);
• If the tampon packaging is torn, throw it away as it may have become dirty.

The sanitary napkin

The sanitary napkin and panty liner are external protections, so there is no blood stagnation. External intimate protections have never been involved in menstrual TSS, ANSES recalls in its report. 

The cup, or menstrual cup

The cup, or menstrual cup, is an internal device. It comes in the form of a bell ending in a small rod for easy removal. Inserted into the vagina, it will collect the blood there, like a small cup. Reusable, it must be removed and then emptied during the day and washed with hot water and mild soap each time. Like the tampon, its misuse (too prolonged use in particular) can lead to toxic shock syndrome because the stagnant blood promotes the proliferation of bacteria. 

The menstrual panties

The menstrual panties are washable and reusable panties with an absorbent zone. It can, depending on the model and the flow, be worn for up to 12 hours. Like towels, it lets blood flow and is therefore not associated with any risk of toxic shock syndrome.