Tampon

A tampon is a plug of cotton or other absorbent material inserted into a body cavity or wound to absorb fluid. The most common type in daily use (and the topic of the remainder of this article) is a usually disposable plug that is designed to be inserted into the vagina during menstruation to absorb the flow of blood. The use of these devices has occasionally caused infection and (rarely) death (see Toxic shock syndrome). In the United States, the Food and Drug Administration (FDA) regulates tampons as medical devices.

History
As a medical device, the tampon (from the French for plug, or stopper ) has been around since the 19th century, when antiseptic cotton tampons treated with  salicylates were used to stop the bleeding from bullet wounds, and there have been reports of modern menstrual tampons being used for the same purpose by soldiers in the Iraq War.

The tampon with an applicator and string was invented in 1929 and submitted for patent in 1931 by Dr. Earle Haas, an American from Denver, Colorado. Tampons based on Dr. Haas' design were first sold in the U.S. in 1936. Later, the expansible tampon was invented in 1974 (patent in 1976) by world-renowned obstetrician/gynaecologist, Dr. Kermit E Krantz.

Design and packaging
Tampons come in various sizes, which are related to their absorbency ratings and packaging.

The shape of all tampons is basically the same; long oval cylinders. Tampons sold in the United States are made of cotton, rayon, or a blend of the two. Tampons are sold individually wrapped to keep them clean, although they are not sterile, nor are tampon companies required by law to list the ingredients in them. They have a string for ease of removal, and may be packaged inside an applicator to aid insertion.

Tampon applicators may be made of plastic or cardboard, and are similar in design to a syringe. The applicator consists of a bigger tube and a narrower tube. The bigger tube has a smooth surface and a round end for easier insertion. Some applicators have a star shape opening at the round end, others are open ended. The tampon itself rests inside the bigger tube, near the open end. The narrower tube is nested inside the other end of the bigger tube. The open end of the bigger tube is placed and held in the vagina, then the narrower tube is pushed into the bigger tube (typically using a finger) pushing the tampon through and into the vagina. If not inserted at a 45 degree angle it can cause discomfort and make removal difficult.

Digital or non-applicator tampons are tampons sold without applicators; these are simply unwrapped and pushed into the vagina with the fingers (digits).

Probiotic tampons are available in Europe. These tampons can help prevent or cure vaginal infections, like Bacterial Vaginosis and/ or Candida, by strengthening the natural microbiotic vaginal flora. These tampons include probiotics, or three strains of lactic acid bacteria, which naturally occur in the healthy vagina. The vaginal flora of a healthy woman is dominated by lactic acid bacteria, which produce lactic acid as part of their metabolism. The lactic acid makes the vagina acidic, about pH 3.8 to 4.2. Most pathogens do not thrive in such an acidic environment. Therefore, lactic acid bacteria are part of the human female's first line of defense against infection.

It is not normally necessary to remove a tampon before urinating or having a bowel movement.

Absorbency ratings
Tampons are available in several different absorbency ratings, which are consistent across manufacturers in the U.S.:
 * Junior absorbency: 6 grams and under
 * Regular absorbency: 6 to 9 grams
 * Super absorbency: 9 to 12 grams
 * Super plus absorbency: 12 to 15 grams
 * Ultra absorbency: 15 to 18 grams

Toxic shock syndrome
Tampons have been shown to have a connection to toxic shock syndrome (TSS), a rare but sometimes fatal disease caused by bacterial infection. The U.S. FDA suggests the following guidelines for decreasing the risk of contracting TSS when using tampons:


 * Follow package directions for insertion
 * Choose the lowest absorbency for your flow
 * Change your tampon at least every 4 to 8 hours
 * Consider alternating disposable or cloth pads with tampons
 * Avoid tampon usage overnight when sleeping
 * Know the warning signs of toxic shock syndrome
 * Don't use tampons between periods

Following these guidelines can help to protect a woman from TSS, and cases of tampon connected TSS are extremely rare in the United States.

Other health concerns
Many chemicals are present in tampons, including pesticides used on the cotton and chlorine used to bleach the tampons. Some of the chemicals used to bleach tampons have been implicated in the formation of dioxin. A study by the FDA done in 1995 says there are not significant amounts of dioxin to pose a health risk; the amount detected ranged from undetectable to 1 part in 3 trillion, which is far less than the normal exposure to dioxin in everyday life. However, the presence of dioxin in a product that enters a major body orifice, where there is more risk of absorption, caused a great deal of concern. Nevertheless, manufacturers insist that bleaching is needed to produce effective products, despite tampons not using bleaching or chemical treatment being available.

Another concern is related to the use of rayon in tampons. Rayon consists of tiny strings of plastic. Some speculate that these strands of plastic can cause microtears on the vaginal wall when inserted and taking out. There is further speculation that, if microtears are present, the condition could leave the vagina more open to infection.

Although some say that 100% cotton tampons may be safer than using tampons with a cotton and rayon mix because of there being less dioxin, there is still a risk with all-cotton tampons. All-cotton tampons are generally harder to find and usually cost more than generic tampon brands. Some researchers claim that although switching to a 100% cotton alternative reduces the risk of TSS, it does not remove it entirely. We are also exposed to dioxins in other ways, so eliminating dioxin in tampons will not mean there will be no contact with dioxin in the environment.

Fiber loss along with damage done to the vaginal tissue from fiber has also been a concern, but fiber loss is more likely with all-cotton tampons. Furthermore, as tampons are absorbent and placed within an area such as the vagina, this significantly increases the risk of bacterial infections.

Alternative choices
Prior to the development of tampons, Western women generally resorted to reusable cloth rags. These would be soaked in a diaper pail after use. Rags continue to be used by women in Third-World countries today, including much of Africa, out of affordability and distribution problems associated with other methods.

The Museum of Menstruation proposes that most premodern women used nothing at all, but bled into their clothing. It should also be remembered that many premodern women would have menstruated relatively little, being pregnant or breast-feeding most of their fertile lives.

In some cultures, the use of tampons by virgins is discouraged for fear of damaging their hymens (regarded as proof of virginity), or habituating them to the act of penetration. A satire by Landover Baptist Church alludes to such mores in a mock-sermon "Tampons: Satan's Little Cotton Fingers."

Most of the world's women today use methods other than tampons for absorbing menstrual fluid. Women in East Asia generally use pads.

Environmentally conscious women may be interested in menstral cups (such as the keeper cup) or reusable glad rags, because they create less waste. Other alternatives to standard tampons include organic tampons (made from organic cotton) and home-made tampons.

Non-tampon alternatives include the following:

Disposable

 * disposable menstrual pads (sanitary napkins/towels)
 * organic menstrual pads (sanitary napkins/towels)
 * Diaphragm-style menstrual cups

Reusable

 * Menstrual cup made of silicone, or gum rubber. (Examples include the DivaCup and The Keeper/Moon Cup).
 * diaphragm as menstrual cup
 * cloth menstrual pads
 * homemade menstrual pads
 * Free-flow (layering [using layers of clothing to avoid obvious leaking] or instinctive [learning to recognize when you will bleed])
 * padded panties/period pants/Lunapanties
 * sea sponges (used like tampons)