The first tampons were introduced by the ancient Egyptians and were constructed from softened papyrus. Since then there have been many variations on the theme, using an assortment of materials - including lint¹, wool, plant fibre (like grass), paper, sponges, and cotton - often little more than an improvisation to manage the flow of menstrual fluids.

Commercially Viable Tampons

The first mass produced commercial tampons were introduced in the 1920s and 30s and were made from the same material used to make bandages in World War I. They did not come with applicators. Dr Earle C Haas came up with the idea of using an applicator, and his invention gave birth to the Tampax brand. They are disposable and should be used only once – they should be wrapped up and put in the bin, rather then flushed down the toilet, as they can end up on beaches.

Tampons - The Basics

Tampons are small rolls of pressed cotton and rayon (a synthetic product made from cellulose, which is in turn derived from wood pulp), with a string attached. Women use them to catch blood during menstruation. Some makes are inserted into the vagina with the fingers, whereas others come with an applicator. When in place, the withdrawal string remains outside the body. If the string breaks when it is time to change it, it is still possible to remove the tampon 'manually.' If this isn't possible, then help may be required. Having it removed by a doctor or nurse might be less embarrassing than asking your mum to do it for you.

They usually come in regular, super and super plus sizes, although some manufacturers make a smaller size for new users who are often young teenagers.

However, for all the simplicity and convenience they seem to represent when described like this, the use of tampons is not necessarily universally appreciated as an option during menstruation.

Applicators

Some tampons come with applicators. This consists of two tubes, in a telescopic-type arrangement. One tube is larger and holds the tampon. Also within this tube is a smaller tube which is used to place the tampon in the correct position. They can be made of cardboard or plastic. Despite the cardboard applicators being described as 'flushable' it is better to wrap all types in a little toilet paper or specially-designed bag or cover and be placed in the bin or in a sanitary disposal unit.

Other Issues

Any woman should be able to use tampons, even if they are still a virgin and have an intact hymen. Hymens can be different shapes, but they generally have holes in to let the menstrual blood flow out, and so tampons can be used.

Wearing a tampon does allow women to do activities that they may otherwise have had to restrict. Swimming is the best example, but they have also had a significantly positive impact on women's athletics.

Toxic Shock Syndrome

Toxic Shock Syndrome (TSS) is a serious, if uncommon, illness caused by a toxin produced by staphylococcus aureus bacterium. This infection can cause shock and kidney and liver failure. Treatment is by intravenous fluids and antibiotics, in hospital. The condition can occur as a result of a variety of circumstances. The use of tampons has been identified as one such circumstance, though the specific link between TSS and tampons remains unclear, and the risk is considered to be low.

While not an exclusive relationship, some statistical link seems to exist between 'super absorbent' tampons and cases of reported TSS. Overlong use of a single tampon may also lead to issues with TSS. The number of reported instances of TSS has dropped since manufactures took 'super absorbent' tampons off the market and information about TSS has also appeared among the information on tampon boxes.

Symptoms of TSS include:

• Sudden high temperature
• Diarrhoea
• Dizziness/lightheadedness
• Sunburn-like rash
• Red eyes
• Muscle aches

These symptoms should always mean removal of your tampon and then immediately seek professional medical advice – explaining that you are menstruating and have used a tampon. Care should always be taken to follow the instructions for proper use, and using a tampon with the least amount of absorbency to control the menstrual flow will help to avoid this infection, as will making sure that tampons are changed every four to eight hours. Tampons should never be left in for longer than eight hours and should never be used at other times of the month.

If you have previously been diagnosed with TSS, then you should not use tampons again without taking medical advice.

The Menstrual Cup - an Alternative

An unusual alternative to the tampon is the menstrual cup. These cups were first introduced in the 1930s at around the same time as the first tampons. Polite society considered it improper for a woman to touch her vaginal area, which was a necessity with tampons prior to the introduction of the applicator, and the menstrual cup provided an acceptable alternative. Menstrual cups are reusable and constructed so as not to interfere with the natural cleansing processes of the vagina. Having been inserted, through a process that involves folding the soft rubber cup up, menstrual blood fills the cup. It needs to be removed and emptied periodically, depending upon how heavy the blood flow is, and needs to be thoroughly boiled and sterilised between periods.

Alternate Uses

First and foremost, it should be kept in mind that improper use of anything can be dangerous - and this applies to tampons too. The alternate uses suggested are largely innocuous, but in some instances you should exercise due caution.

• First Aid - The absorbent qualities of a tampon make it a useful item to have around in an emergency where you need to stem the flow of blood and other suitable materials are not to hand.
• Packing Materials - tampons may be amongst the items useful for filling small holes in packing crates when moving house.
• Tricks - While not condoned and suggested with due caution, tampons may form part of some fairly bizarre party tricks or fraternity traditions.
• Humorous Prop - A tampon might be used as a humorously large cigarette or unusual earrings.

Fascinating Facts

• Tampons can also made out of natural materials, including organic cotton and sea sponges. Sea sponges can be rinsed out and reinserted. They should be thoroughly cleaned at the end of each cycle and should last between six and eight cycles. These might need to be bought in health food shops.

• There is a National Tampon Alert Week every year, generally in June. It was set up to commemorate a 15-year-old girl who died of TSS in 1991.

• Visit the Museum of Menstruation, which can be found online.

• Tampons can be difficult to get the hang of, especially for young girls, and some women never get to grips with them. Don't be embarrassed if you don't know how to insert one, even following the instructions on the packet. You might need to wait until you are more used to your own body, and then try again to insert one.