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{{pp-move-indef|small=yes}}{{short description|Feminine hygiene product to absorb menstrual flow by insertion into the vagina}}{{For|the commune of Réunion|Le Tampon}}{{For|tampons for urinary incontinence|Urinary incontinence}}{{distinguish|Tambon}}(File:Gestion menstrual tampon toallitas menstruación periodicas 06.jpg|thumb|A tampon in its dry, unused state|262x262px)A tampon is a menstrual product designed to absorb blood and vaginal secretions by insertion into the vagina during menstruation. Unlike a pad, it is placed internally, inside of the vaginal canal.WEB, Period Products: The Good, the Bad, and the Ugly,weblink 2020-08-04, UT Health Austin, en-us, Once inserted correctly, a tampon is held in place by the vagina and expands as it soaks up menstrual blood. However, in addition to menstrual blood, the tampon also absorbs the vagina's natural lubrication and bacteria, which can change the normal pH, increasing the risk of infections from the bacterium Staphylococcus aureus, which can lead to toxic shock syndrome (TSS).JOURNAL, Vostral, Sharra L., December 2011, Rely and Toxic Shock Syndrome: A Technological Health Crisis, The Yale Journal of Biology and Medicine, 84, 4, 447–459, 0044-0086, 3238331, 22180682, TSS is a rare but life-threatening infection that requires immediate medical attention.WEB, Toxic Shock Syndrome (TSS),weblink 2020-08-05, Saint Luke's Health System, en, The majority of tampons sold are made of rayon, or a blend of rayon and cotton, along with synthetic fibers.WEB, Nadia Kounang, What's in your pad or tampon?,weblink 2020-07-28, CNN, 13 November 2015, Some tampons are made out of organic cotton. Tampons are available in several absorbency ratings. Brands include (but are not limited to) Kotex, Playtex, Tampax, O.B., Cora, Lola, Sustain, Honest Company, Seventh Generation, Solimo, and Rael Tampons.WEB, Amanda Woerner, 2019-09-17, If You've Been Wearing The Same Tampon Brand Since You Were 13, It Might Be Time To Switch It Up,weblink 2020-08-05, Women's Health, en-US, Several countries regulate tampons as medical devices. In the United States, they are considered to be a Class II medical device by the Food and Drug Administration (FDA).WEB, Product Classification,weblink 2020-08-03, www.accessdata.fda.gov, They are sometimes used for hemostasis in surgery.(File:Tampon inserted.svg|thumb|A tampon (magenta) inserted into the vagina (blue) to collect blood from the uterus (green)|alt=|259x259px){{TOC limit|3}}

Design and packaging

(File:Playtex tampon.jpg|alt=|thumb|Applicator tampon|263x263px)Tampon design varies between companies and across product lines in order to offer a variety of applicators, materials and absorbencies.WEB,weblink Tampons, Palo Alto Medical Foundation, October 28, 2014, There are two main categories of tampons based on the way of insertion – digital tampons inserted by finger, and applicator tampons. Tampon applicators may be made of plastic or cardboard, and are similar in design to a syringe. The applicator consists of two tubes, an "outer", or barrel, and "inner", or plunger. The outer tube has a smooth surface to aid insertion and sometimes comes with a rounded end that is petaled.WEB,weblink Using Tampons: Facts And Myths, SteadyHealth, October 28, 2014, BOOK, Lynda Madaras, What's Happening to My Body? Book for Girls: Revised Edition,weblink 8 June 2007, Newmarket Press, 978-1-55704-768-7, 180, Differences exist in the way tampons expand when in use: applicator tampons generally expand axially (increase in length), while digital tampons will expand radially (increase in diameter).WEB,weblink Pain While Inserting A Tampon, Steadyhealth.com, October 28, 2014, Most tampons have a cord or string for removal. The majority of tampons sold are made of rayon, or a blend of rayon and cotton. Organic cotton tampons are made from only 100% cotton.WEB,weblink Tampons for menstrual hygiene: Modern products with ancient roots, October 28, 2014, {{Dead link|date=February 2022 |bot=InternetArchiveBot |fix-attempted=yes }} Tampons may also come in scented or unscented varieties.

Absorbency ratings

(File:Tampon Drawing.jpg|thumb|The main elements of a tampon depicted, labeling the tampon, plunger, barrel, finger grip, and string)

In the US

Tampons are available in several absorbency ratings, which are consistent across manufacturers in the U.S. These differ in the amount of cotton in each product and are measured based on the amount of fluid they are able to absorb.WEB, Tampon Absorbency Ratings - Which Tampon is Right for You,weblink October 28, 2014, Pms.about.com, The absorbency rates required by the U.S. Food and Drug Administration (FDA) for manufacturer labeling are listed below:WEB, CFR - Code of Federal Regulations Title 21,weblink 2020-08-04, www.accessdata.fda.gov, {| class="wikitable"|+FDA Absorbency Ratings!Ranges of absorbency in grams!Corresponding term of absorbency|6 and under|Light absorbency|6 to 9|Regular absorbency|9 to 12|Super absorbency|12 to 15|Super plus absorbency|15 to 18|Ultra absorbency|Above 18|No term

In Europe

Absorbency ratings outside the US may be different. The majority of non-US manufacturers use absorbency rating and Code of PracticeWEB,weblink Edana Code of Practice for tampons placed on the European market, September 2020, EDANA, recommended by EDANA (European Disposables and Nonwovens Association).{| class="wikitable"|+European absorbency ratings!Droplets!Grams!Alternative size description|1 droplet|< 6||2 droplets|6–9|Mini|3 droplets|9–12|Regular|4 droplets|12–15|Super|5 droplets|15–18||6 droplets|18–21|

In the UK

In the UK, the Absorbent Hygiene Product Manufacturers Association (AHPMA) has written a Tampon Code of Practice which companies can follow on a volunteer basis.WEB, Tampon Code of Practice,weblink 2020-10-19, AHPMA, en-GB, According to this code, UK manufacturers should follow the (European) EDANA code (see above).

Testing

A piece of test equipment referred to as a Syngyna (short for synthetic vagina) is usually used to test absorbency. The machine uses a condom into which the tampon is inserted, and synthetic menstrual fluid is fed into the test chamber.WEB,weblink Data, www.ahpma.co.uk, 2019-06-02, 2015-05-07,weblink" title="web.archive.org/web/20150507233555weblink">weblink dead, A novel way of testing was developed by feminist medical experts after the toxic shock syndrome (TSS) crisis, and used blood – rather than the industry standard blue saline – as a test material.JOURNAL, Vostral, Sharra, 2017-05-23, Toxic shock syndrome, tampons and laboratory standard–setting, CMAJ: Canadian Medical Association Journal, 189, 20, E726–E728, 10.1503/cmaj.161479, 0820-3946, 5436965, 28536130,

Labeling

The FDA requires the manufacturer to perform absorbency testing to determine the absorbency rating using the Syngyna method or other methods that are approved by the FDA. The manufacturer is also required to include on the package label the absorbency rating and a comparison to other absorbency ratings as an attempt to help consumers choose the right product and avoid complications of TSS. In addition, The following statement of association between tampons and TSS is required by the FDA to be on the package label as part of the labeling requirements: "Attention: Tampons are associated with Toxic Shock Syndrome (TSS). TSS is a rare but serious disease that may cause death. Read and save the enclosed information."Such guidelines for package labeling are more lenient when it comes to tampons bought from vending machines. For example, tampons sold in vending machines are not required by the FDA to include labeling such as absorbency ratings or information about TSS.

Costs

The average woman may use approximately 11,400 tampons in her lifetime (if using only tampons). Generally, a box of tampons costs can range from $6 to $10 USD and has 12 to 40 tampons per box. Thus, women could use around 9 boxes a year, leading to a total cost between US$54 and $90 per year (around $0.20–$0.40 per tampon). Activists call the problem some women have when not being able to afford products "period poverty".

Health aspects

Toxic shock syndrome

Menstrual toxic shock syndrome (mTSS) is a life-threatening disease most commonly caused by infection of superantigen-producing Staphylococcus aureus. The superantigen toxin secreted in S. aureus infections is TSS Toxin-1, or TSST-1. Incidence ranges from 0.03 to 0.50 cases per 100,000 people, with an overall mortality around 8%.JOURNAL, Berger, Selina, Kunerl, Anika, Wasmuth, Stefan, Tierno, Philip, Wagner, Karoline, Brügger, Jan, September 2019, Menstrual toxic shock syndrome: case report and systematic review of the literature, The Lancet. Infectious Diseases, 19, 9, e313–e321, 10.1016/S1473-3099(19)30041-6, 1474-4457, 31151811, 172138016, mTSS signs and symptoms include fever (greater than or equal to 38.9 Â°C), rash, desquamation, hypotension (systolic blood pressure less than 90 mmHg), and multi-system organ involvement with at least three systems, such as gastrointestinal complications (vomiting), central nervous system (CNS) effects (disorientation), and myalgia.WEB, Toxic Shock Syndrome (Other Than Streptococcal) {{!, 2011 Case Definition|url=https://wwwn.cdc.gov/nndss/conditions/toxic-shock-syndrome-other-than-streptococcal/case-definition/2011/|access-date=2020-08-05|website=wwwn.cdc.gov|language=en-us|url-status=dead|archive-url=https://web.archive.org/web/20200713202021weblink|archive-date=13 July 2020}}Toxic shock syndrome was named by James K. Todd in 1978.BOOK,weblink The Curse: A Cultural History of Menstruation, Delaney, Janice, Lupton, Mary Jane, Toth, Emily, 1988, University of Illinois Press, 9780252014529, en, Philip M. Tierno Jr., Director of Clinical Microbiology and Immunology at the NYU Langone Medical Center, helped determine that tampons were behind toxic shock syndrome (TSS) cases in the early 1980s. Tierno blames the introduction of higher-absorbency tampons made with rayon in 1978, as well as the relatively recent decision by manufacturers to recommend that tampons can be worn overnight, for the surge in cases of TSS.NEWS,weblink The Seattle Times, A new generation faces toxic shock syndrome, January 26, 2005, However, a later meta-analysis found that the material composition of tampons is not directly correlated to the incidence of toxic shock syndrome, whereas oxygen and carbon dioxide content of menstrual fluid uptake is associated more strongly.JOURNAL, Lanes, Stephan F., Rothman, Kenneth J., Tampon absorbency, composition and oxygen content and risk of toxic shock syndrome, Journal of Clinical Epidemiology, 43, 12, 1990, 1379–1385, 0895-4356, 10.1016/0895-4356(90)90105-X, 2254775, JOURNAL, Ross, R. A., Onderdonk, A. B., Production of Toxic Shock Syndrome Toxin 1 by Staphylococcus aureus Requires Both Oxygen and Carbon Dioxide, Infection and Immunity, 68, 9, 2000, 5205–5209, 0019-9567, 10.1128/IAI.68.9.5205-5209.2000, 10948145, 101779, JOURNAL, Schlievert, Patrick M., Davis, Catherine C., 2020-05-27, Device-Associated Menstrual Toxic Shock Syndrome, Clinical Microbiology Reviews, en, 33, 3, e00032–19, /cmr/33/3/CMR.00032–19.atom, 10.1128/CMR.00032-19, 0893-8512, 7254860, 32461307, In 1982, a liability case called Kehm v. Proctor & Gamble took place, where the family of Patricia Kehm sued Procter & Gamble for her death on September 6, 1982, from TSS, while using Rely brand tampons. The case was the first successful case to sue the company. Procter & Gamble paid $300,000 in compensatory damages to the Kehm family. This case can be attributed to the increase in regulations and safety protocol testing for current FDA requirements.Some risk factors identified for developing TSS include recent labor and delivery, tampon use, recent staphylococcus infection, recent surgery, and foreign objects inside the body.WEB, Toxic shock syndrome: MedlinePlus Medical Encyclopedia,weblink 2020-08-05, medlineplus.gov, en, The FDA suggests the following guidelines for decreasing the risk of contracting TSS when using tampons:WEB, e-CFR: Title 21: Food and Drugs Administration,weblink 11 February 2017, Code of Federal Regulations, U.S. Food and Drug Administration, Section 801.430: User labeling for menstrual tampons, JOURNAL, Commissioner, Office of the, 2019-02-09, The Facts on Tampons—and How to Use Them Safely,weblink FDA, en,

• Choose the lowest absorbency needed for one's flow (test of absorbency is approved by FDA)
• Follow package directions and guidelines for insertion and tampon usage (located on box's label)
• Change the tampon at least every 6 to 8 hours or more often if needed
• Alternate usage between tampons and pads
• Avoid tampon usage overnight or when sleeping
• Increase awareness of the warning signs of Toxic Shock Syndrome and other tampon-associated health risks (and remove the tampon as soon as a risk factor is noticed)

The FDA also advises those with a history of TSS not to use tampons and instead turn to other feminine hygiene products to control menstrual flow.WEB, Toxic Shock Syndrome (TSS),weblink 2020-07-30, www.hopkinsmedicine.org, 19 November 2019, en, Other menstrual hygiene products available include pads, menstrual cups, menstrual discs, and reusable period underwear.Cases of tampon-connected TSS are very rare in the United KingdomWEB, Kent, Ellie, I nearly died from toxic shock syndrome and never used a tampon, BBC Three, 2019-02-07,weblink 2019-10-19, WEB, TSS: Continuing Professional Development, Toxic Shock Syndrome Information Service, 2007-10-01,weblink 2019-10-19, WEB, Mosanya, Lola, Recognising the symptoms of toxic shock syndrome saved my life, BBC Newsbeat, 2017-02-14,weblink 2019-10-19, and United States.WEB, Toxic Shock Syndrome, NORD (National Organization for Rare Disorders), 2015-02-11,weblink 2019-10-19, WEB, What You Need To Know About Toxic Shock Syndrome, University of Utah Health, 2018-07-02,weblink 2019-10-19, A controversial study by Tierno found that all-cotton tampons were less likely than rayon tampons to produce the conditions in which TSS can grow.JOURNAL, Tierno, Philip M., Hanna, Bruce A., 1985-02-01, Amplification of Toxic Shock Syndrome Toxin-1 by Intravaginal Devices, Contraception, 31, 2, 185–194, 10.1016/0010-7824(85)90033-2, 3987281, 0010-7824, This was done using a direct comparison of 20 brands of tampons, including conventional cotton/rayon tampons and 100% organic cotton tampons.JOURNAL, Tierno, Philip M., Hanna, Bruce A., 1998-03-01, Viscose Rayon versus Cotton Tampons, The Journal of Infectious Diseases, en, 177, 3, 824–825, 10.1086/517804, 9498476, 0022-1899, free, In a series of studies conducted after this initial claim, it was shown that all tampons (regardless of composition) are similar in their effect on TSS and that tampons made with rayon do not have an increased incidence of TSS. Instead, tampons should be selected based on minimum absorbency rating necessary to absorb flow corresponding to the individual.Sea sponges are also marketed as menstrual hygiene products. A 1980 study by the University of Iowa found that commercially sold sea sponges contained sand, grit, and bacteria. Hence, sea sponges could also potentially cause toxic shock syndrome.WEB,weblink Ask John, 10 July 2018, 4 December 2013, 25 August 2010,weblink" title="web.archive.org/web/20100825041933weblink">weblink dead, Studies have shown non-significantly higher mean levels of mercury in tampon users compared to non tampon users. No evidence showed an association between tampon use and inflammation biomarkers.JOURNAL, Singh, Jessica, Mumford, Sunni L., Pollack, Anna Z., Schisterman, Enrique F., Weisskopf, Marc G., Navas-Acien, Ana, Kioumourtzoglou, Marianthi-Anna, 11 February 2019, Tampon use, environmental chemicals and oxidative stress in the BioCycle study, Environmental Health: A Global Access Science Source, 18, 1, 11, 10.1186/s12940-019-0452-z, 1476-069X, 6371574, 30744632, free,

Other considerations

Bleached products

According to the Women's Environmental Network research briefing on menstrual products made from wood pulp:REPORT, "Seeing Red: Menstruation & The Environment",weblink Women's Environmental Network, 2018, The basic ingredient for menstrual pads is wood pulp, which begins life as a brown coloured product. Various 'purification' processes can be used to bleach it white. Measurable levels of dioxin have been found near paper pulping mills, where chlorine has been used to bleach the wood pulp. Dioxin is one of the most persistent and toxic chemicals, and can cause reproductive disorders, damage to the immune system and cancer (26). There are no safe levels and it builds up in our fat tissue and in our environment.

Marine pollution

In the UK, the Marine Conservation Society has researched the prevalence and problem of plastic tampon applicators found on beaches.WEB, Campaigning for plastic-free periods,weblink Erin, O'Neill, 28 August 2019, Marine Conservation Society, dead,weblink 20 October 2020, en,

Disposal and flushing

Disposal of tampons, especially flushing (which manufacturers warn against) may lead to clogged drains and waste management problems.Agencies NA of CW. International Water Industry Position Statement on non-flushable and flushable labelledproducts. 2016; Available fromweblink

Tampon-drug interactions

There are multiple cases in which the use of tampons may need medical advice from a healthcare professional. For example, as part of the National Institutes of Health, the U.S. National Library of Medicine and its branch MedlinePlus advise against using tampons while being treated with any of several medications taken by the vaginal route such as vaginal suppositories and creams, as tampons may decrease the absorbance of these drugs by the body. Example of these medications include clindamycin,WEB, Clindamycin Vaginal: MedlinePlus Drug Information,weblink 2020-08-05, medlineplus.gov, en, terconazole,WEB, Terconazole Vaginal Cream, Vaginal Suppositories: MedlinePlus Drug Information,weblink 2020-08-05, medlineplus.gov, en, miconazole,WEB, Miconazole Vaginal: MedlinePlus Drug Information,weblink 2020-08-05, medlineplus.gov, en, clotrimazole,WEB, Clotrimazole Vaginal: MedlinePlus Drug Information,weblink 2020-08-05, medlineplus.gov, en, when used as a vaginal cream or vaginal suppository, as well as butoconazole vaginal cream.WEB, Butoconazole Vaginal Cream: MedlinePlus Drug Information,weblink 2020-08-05, medlineplus.gov, en,

Increased risk for infections

According to the American Society for Blood and Marrow Transplantation (ASBMT), tampons may be responsible for an increased risk of infection due to the erosions it causes in the tissue of the cervix and vagina, leaving the skin prone to infections. Thus, ASBMT advises hematopoietic stem cell transplantation recipients against using tampons while undergoing therapy.WEB, Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients,weblink 2020-08-06, www.cdc.gov,

Other uses

Clinical use

Tampons are currently being used and tested to restore and/or maintain the normal microbiota of the vagina to treat bacterial vaginosis.JOURNAL, Statement of the Polish Gynecological Society Expert Group on the use of ellen probiotic tampon, pl, Ginekol. Pol., 83, 8, 633–8, 2012, 23342891, Zespoł Ekspertów Polskiego Towarzystwa Ginekologicznego, Some of these are available to the public but come with disclaimers.MARKETS ABSORBED BY PROBIOTIC SWEDISH TAMPONS >PUBLISHER=THE LOCAL,weblink 2015-06-06 , Tampons have also been used in cases of tooth extraction to reduce post-extraction bleeding.JOURNAL, Kalantar Motamedi, M H, Navi, F, Shams Koushki, E, Rouhipour, R, Jafari, S M, June 2012, Hemostatic Tampon to Reduce Bleeding following Tooth Extraction, Iranian Red Crescent Medical Journal, 14, 6, 386–388, 2074-1804, 3420033, 22924121, Tampons are currently being investigated as a possible use to detect endometrial cancer.JOURNAL, Fiegl, Heidi, Gattringer, Conny, Widschwendter, Andreas, Schneitter, Alois, Ramoni, Angela, Sarlay, Daniela, Gaugg, Inge, Goebel, Georg, Müller, Hannes M., Mueller-Holzner, Elisabeth, Marth, Christian, 2004-05-01, Methylated DNA Collected by Tampons—A New Tool to Detect Endometrial Cancer,weblink Cancer Epidemiology, Biomarkers & Prevention, en, 13, 5, 882–888, 10.1158/1055-9965.882.13.5, 1055-9965, 15159323, 6352434, free, Endometrial cancer does not currently have effective cancer screening methods if an individual is not showing symptoms.JOURNAL, Matteson, Kristen A., Robison, Katina, Jacoby, Vanessa L., 2018-09-01, Opportunities for Early Detection of Endometrial Cancer in Women With Postmenopausal Bleeding,weblink JAMA Internal Medicine, en, 178, 9, 1222–1223, 10.1001/jamainternmed.2018.2819, 30083765, 51928791, 2168-6106, Tampons not only absorb menstrual blood, but also vaginal fluids. The vaginal fluids absorbed in the tampons would also contain the cancerous DNA, and possibly contain precancerous material, allowing for earlier detection of endometrial cancer.WEB, Women's Wellness: Tampon test for endometrial cancer, 14 December 2016,weblink 2020-08-04, en-US, Clinical trials are currently being conducted to evaluate the use of tampons as a screening method for early detection of endometrial cancer.

Environment and waste

(File:Used and unused tampon.jpg|thumb|Unused (left) and used (right) tampon)Appropriate disposal of used tampons is still lacking in many countries. Because the lack of menstrual management practices in some countries, many sanitary pads or other menstrual products will be disposed into domestic solid wastes or garbage bins that eventually becomes part of a solid wastes.JOURNAL, Kaur, Rajanbir, Kaur, Kanwaljit, Kaur, Rajinder, 2018-02-20, Menstrual Hygiene, Management, and Waste Disposal: Practices and Challenges Faced by Girls/Women of Developing Countries, Journal of Environmental and Public Health, 2018, 1–9, 10.1155/2018/1730964, 1687-9805, 5838436, 29675047, free, The issue that underlies the governance or implementation of menstrual waste management is how country categorizes menstrual waste. This waste could be considered as a common household waste, hazardous household waste (which will required to be segregated from routine household waste), biomedical waste given amount of blood it contains, or plastic waste given the plastic content in many commercial disposal pads (some only the outer case of the tampon or pads).JOURNAL, Elledge, Myles F., Muralidharan, Arundati, Parker, Alison, Ravndal, Kristin T., Siddiqui, Mariam, Toolaram, Anju P., Woodward, Katherine P., November 2018, Menstrual Hygiene Management and Waste Disposal in Low and Middle Income Countries—A Review of the Literature, International Journal of Environmental Research and Public Health, 15, 11, 2562, 10.3390/ijerph15112562, 1661-7827, 6266558, 30445767, free, Ecological impact varies according to disposal method (whether a tampon is flushed down the toilet or placed in a garbage bin – the latter is the recommended option). Factors such as tampon composition will likewise impact sewage treatment plants or waste processing.WEB,weblink What's the environmental impact of my period?, Slate.com, Rastogi, Nina, October 28, 2014, 2010-03-16, The average use of tampons in menstruation may add up to approximately 11,400 tampons in someone's lifetime (if they use only tampons rather than other products).JOURNAL, Nicole, Wendee, A Question for Women's Health: Chemicals in Feminine Hygiene Products and Personal Lubricants, Environmental Health Perspectives, March 2014, 122, 3, A70–5, 10.1289/ehp.122-A70, 24583634, 3948026, 3, dmy-all, Tampons are made of cotton, rayon, polyester, polyethylene, polypropylene, and fiber finishes. Aside from the cotton, rayon and fiber finishes, these materials are not biodegradable. Organic cotton tampons are biodegradable, but must be composted to ensure they break down in a reasonable amount of time. Rayon was found to be more biodegradable than cotton.JOURNAL, Park, Chung Hee, Kang, Yun Kyung, Im, Seung Soon, 2004-09-15, Biodegradability of cellulose fabrics, Journal of Applied Polymer Science, en, 94, 1, 248–253, 10.1002/app.20879, 1097-4628, free, Environmentally friendly alternatives to using tampons are the menstrual cup, reusable sanitary pads, menstrual sponges, reusable tampons,NEWS,weblink How Reusable Tampons Work, Elite Daily, and reusable absorbent underwear.NEWS,weblinkweblink 2022-01-12, subscription, live, Period nappies: The only new sanitary product in 45 years. Seriously - Telegraph, Sanghani, Radhika, 3 June 2015, Telegraph.co.uk, {{cbignore}}WEB,weblink Could 'period-proof pants' spell the end for tampons and sanitary towels?, Kirstie McCrum, 4 June 2015, mirror, NEWS,weblink Disposable tampons aren't sustainable, but do women want to talk about it?, Spinks, Rosie, 2015-04-27, the Guardian, The Royal Institute of Technology in Stockholm carried out a life-cycle assessment (LCA) comparison of the environmental impact of tampons and sanitary pads. They found that the main environmental impact of the products was in fact caused by the processing of raw materials, particularly LDPE (low density polyethylene) – or the plastics used in the backing of pads and tampon applicators, and cellulose production. As production of these plastics requires a lot of energy and creates long-lasting waste, the main impact from the life cycle of these products is fossil fuel use, though the waste produced is significant in its own right.WEB,weblink The Environmental Impact of Everyday Things, The Chic Ecologist, 2010-04-05, The menstrual material was disposed according to the type of product, and even based on cultural beliefs. This was done regardless of giving any importance to the location and proper techniques of disposal. In some areas of the world, menstrual waste is disposed into pit latrines, as burning and burial were difficult due to limited private space.

History

Women have used tampons during menstruation for thousands of years. In her book Everything You Must Know About Tampons (1981), Nancy Friedman writes,Who invented tampons? 6 June 2006, The Straight Dope[T]here is evidence of tampon use throughout history in a multitude of cultures. The oldest printed medical document, Ebers Papyrus, refers to the use of soft papyrus tampons by Egyptian women in the fifteenth century B.C. Roman women used wool tampons. Women in ancient Japan fashioned tampons out of paper, held them in place with a bandage, and changed them 10 to 12 times a day. Traditional Hawaiian women used the furry part of a native fern called hapu'u; and grasses, mosses and other plants are still used by women in parts of Asia and Africa.R. G. Mayne defined a tampon in 1860 as: "a less inelegant term for the plug, whether made up of portions of rag, sponge, or a silk handkerchief, where plugging the vagina is had recourse to in cases of hemorrhage."BOOK, R. G., Mayne, An Expository Lexicon of the Terms, Ancient and Modern, in Medical and General Science including a Complete Medico-Legal Vocabulary, 1860, London, John Churchill, 1249,weblink Earle Haas patented the first modern tampon, Tampax, with the tube-within-a-tube applicator. Gertrude Schulte Tenderich (née Voss) bought the patent rights to her company trademark Tampax and started as a seller, manufacturer, and spokesperson in 1933.WEB, The History of Tampax,weblink 2020-08-05, tampax.com, en-us, Tenderich hired women to manufacture the item and then hired two sales associates to market the product to drugstores in Colorado and Wyoming, and nurses to give public lectures on the benefits of the creation, and was also instrumental in inducing newspapers to run advertisements.In 1945, Tampax presented a number of studies to prove the safety of tampons. A 1965 study by the Rock Reproductive Clinic stated that the use of tampons "has no physiological or clinical undesired side effects".During her study of female anatomy, German gynecologist Judith Esser-Mittag developed a digital-style tampon, which was made to be inserted without an applicator. In the late 1940s, Carl Hahn and Heinz Mittag worked on the mass production of this tampon. Hahn sold his company to Johnson & Johnson in 1974.WEB,weblink Johnson & Johnson History, Funding Universe, 14 March 2014, In 1992, Congress found an internal FDA memo about the presence of dioxin, a known carcinogen, in tampons.BOOK, Houppert, Karen, The Curse, Farrar, Straus, and Giroux, 1999, 0374273669, 1st, New York, 18–21, English, Dioxin is one of the toxic chemicals produced when wood pulp is bleached with chlorine.JOURNAL, Sharma, Nirmal, Bhardwaj, Nishi K., Singh, Ram Bhushan Prashad, 2020-05-20, Environmental issues of pulp bleaching and prospects of peracetic acid pulp bleaching: A review,weblink Journal of Cleaner Production, en, 256, 120338, 10.1016/j.jclepro.2020.120338, 214154074, 0959-6526, Congressional hearings were held and tampon manufacturers assured Congress that the trace levels of dioxin in tampons was well below EPA level. The EPA has stated there is no acceptable level of dioxin. Following this, major commercial tampon brands began switching from dioxin-producing chlorine gas bleaching methods to either elemental "chlorine-free" or "totally chlorine free" bleaching processes.JOURNAL, Bobel, Chris, 2006-11-02, "Our Revolution Has Style": Contemporary Menstrual Product Activists "Doing Feminism" in the Third Wave, Sex Roles, en, 54, 5–6, 331–345, 10.1007/s11199-006-9001-7, 17610463, 0360-0025, In the United States, the Tampon Safety and Research Act was introduced to Congress in 1997 in an attempt to create transparency between tampon manufacturers and consumers. The bill would mandate the conduct or support of research on the extent to which additives in feminine hygiene products pose any risks to the health of women or to the children of women who use those products during or before the pregnancies involved.WEB, Maloney, Carolyn B., 1997-11-14, H.R.2900 - 105th Congress (1997-1998): Tampon Safety and Research Act of 1997,weblink 2020-08-03, www.congress.gov, Although yet to be passed, the bill has been continually reintroduced, most recently in 2019 as the Robin Danielson Feminine Hygiene Product Safety Act.WEB, Maloney, Carolyn B., 2019-07-22, Text - H.R.3865 - 116th Congress (2019-2020): Robin Danielson Feminine Hygiene Product Safety Act of 2019,weblink 2020-08-03, www.congress.gov, Data would also be required from manufacturers regarding the presence of dioxins, synthetic fibers, chlorine, and other components (including contaminants and substances used as fragrances, colorants, dyes, and preservatives) in their feminine hygiene products.

Society and culture

Tampon tax

"Tampon tax" refers to tampons' lack of tax exempt status that is often in place for other basic need products. Several political statements have been made in regards to tampon use. In 2000, a 10% goods and services tax (GST) was introduced in Australia. While lubricant, condoms, incontinence pads and numerous medical items were regarded as essential and exempt from the tax, tampons continue to be charged GST. Prior to the introduction of GST, several states also applied a luxury tax to tampons at a higher rate than GST. Specific petitions such as "Axe the Tampon Tax" have been created to oppose this tax, and the tax was removed in 2019.WEB,weblink The tampon tax is gone: what now?, Kin Fertility, Australia, In the UK, tampons are subject to a zero rate of value added tax (VAT), as opposed to the standard rate of 20% applied to the vast majority of products sold in the country.NEWS, Tampon Tax Abolished From Today,weblink 2021-01-01, HM Treasury, 2021-03-15, en-UK, The UK was previously bound by the EU VAT directive, which required a minimum of 5% VAT on sanitary products. Since 1 January 2021, VAT applied to menstrual sanitary products has been 0%.In Canada, the federal government has removed the goods and services tax (GST) and harmonized sales tax (HST) from tampons and other menstrual hygiene products as of 1 July 2015.NEWS,weblink Federal government taking the tax off tampons and other feminine hygiene products, effective July 1, 2015-05-28, National Post, 2018-09-27, en-US, In the US, access to menstrual products such as pads and tampons and taxes added on these products, have also been controversial topics especially when it comes to people with low income. Laws for exempting such taxes differ vastly from state to state.WEB, November 2019, The Unequal Price of Periods,weblink 2020-08-05, American Civil Liberties Union, en, The American Civil Liberties Union (ACLU) has published a report discussing these laws and listing the different guidelines followed by institutions such as schools, shelters, and prisons when providing menstrual goods.The report by ACLU also discusses the case of Kimberly Haven who was a former prisoner that had a hysterectomy after she had experienced toxic shock syndrome (TSS) due to using handmade tampons from toilet paper in prison.WEB, 2018-03-27, No tampons in prison? #MeToo helps shine light on issue,weblink 2020-08-05, AP NEWS, Her testimony supported a Maryland bill that is intended to increase access of menstrual products for imprisoned women.

Etymology

Historically, the word "tampon" originated from the medieval French word "tampion", meaning a piece of cloth to stop a hole, a stamp, plug, or stopper.WEB,weblink Oxford Languages | The Home of Language Data, languages.oup.com,

Virginity

Tampon use may stretch or break the hymen of individuals that have never been sexually active.JOURNAL, Goodyear-Smith, F. A., Laidlaw, T. M., 1998-06-08, Can tampon use cause hymen changes in girls who have not had sexual intercourse? A review of the literature, Forensic Science International, 94, 1–2, 147–153, 10.1016/s0379-0738(98)00053-x, 0379-0738, 9670493, Some cultures regard preservation of the hymen as a supposed evidence of virginity, which may discourage some people from using tampons.

In popular culture

In Stephen King's novel Carrie, the title character is bullied for menstruating and is bombarded with tampons and pads by her peers.In 1985, Tampon Applicator Creative Klubs International (TACKI) was established to develop creative uses for discarded, non-biodegradable, plastic feminine hygiene products, commonly referred to as "beach whistles". TACKI President Jay Critchley launched his corporation in order to develop a global folk art movement and cottage industry, promote awareness of these throwaway objects washed up on beaches worldwide from faulty sewage systems, create the world's largest collection of discarded plastic tampon applicators, and ban their manufacture and sale through legislative action. The project and artwork was carried out during numerous site-specific performances and installations.WEB, TACKI - Tampon Application Creative Klubs International,weblink 2020-10-19, Jay Critchley, en,

See also

• Cloth menstrual pad
• Menstrual cup
• Sanitary napkin
• Tamponade
• Menstruation and culture

References

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External links

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• Myths About Tampons (web article)
• Original patent by Earle Haas
• weblink" title="web.archive.org/web/20110715120036weblink">Tampon Related Patents (archived)
• Can Tampons Cause a UTI by TamponsAndMenstrualCups.com

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