If you’re someone who menstruates, you’ve probably done sophisticated period math while shifting uncomfortably in your seat. If I combine a super tampon with absorbent underwear and black pants, can I make it through my flight home without an embarrassing leak? Or What are the odds of me finding an empty public restroom within a two-minute walk because I need to rinse my cup without scaring other restroom users?
The right menstrual products for you will depend on your lifestyle and preferences. But one rule is universal. Avoid scented feminine hygiene products with added fragrance.
“Scents can be irritating to the skin of the vulva. They can cause contact dermatitis or irritation,” says Megan Cheney, M.D., M.P.H., a Mayo Clinic gynecologist.
A variety of new period products available on the market might solve some of your problems. Dr. Cheney offers some advice for what to consider when choosing a product for your monthly flow.
The Pros and Cons of Pads
Pads are the starting point for many people who menstruate. They’re comfortable to use because you don’t have to insert anything in the vagina, Dr. Cheney explains. But they also have some cons. Of the menstrual products, pads have the highest environmental impact since they’re about 90% plastic.
Some people find them bulky and uncomfortable to use. They also can shift around, particularly while playing sports or exercising. Pads also can irritate the skin of the vulva, which is the outer part of the female genitalia.
The Pros and Cons of Tampons
Tampons are generally considered safe for most people to use. However, some people find them painful or have difficulty inserting them. Tampons can sometimes cause vaginal dryness or irritation, especially if they are not changed frequently enough. This can lead to discomfort, itching and even pain. Spasms can occur when using force to push tampons into the vagina.
“I tell my patients that — similar to if you have symptoms with intercourse penetration in the vagina — don’t force use because then you could lead to more problems,” Dr. Cheney says.
Another concern is toxic shock syndrome (TSS), which is a bacterial infection that can occur when tampons are left in the vagina too long. The general rule is not to leave one in more than eight hours. But TSS is rare.
“We don’t see a lot of toxic shock syndrome and maybe that’s due to increased safety of products that are being made or patients being more educated about toxic shock syndrome and not leaving tampons in,” Dr. Cheney says. “I’ve also retrieved a few tampons that were in there for numerous days and patients never had any signs of infection or toxic shock syndrome.”
Which leads us to another common fear: That tampons can get stuck in your body. But Dr. Cheney says there’s no risk of a tampon moving beyond your vagina and getting anywhere else in your body.
“There’s always an end to your vagina,” Dr. Cheney explains. “So as long as you’re able to reach about the length of your finger into your vagina, you can find the tampon.”
But some people are uncomfortable reaching into their vagina. If you just can’t find or remove a tampon, don’t panic; a medical professional can remove it, using a special tool if necessary.
FDA-approved tampons are made of rayon, cotton or a blend of the two. They should be disposed of in a trash can rather than flushed to avoid water contamination. Some consumer organizations have voiced concern about ingredients used in tampons. The FDA reviews tampon safety and limits what can be in them. New York state started requiring tampon manufacturers to list ingredients.
The Pros and Cons of Menstrual Cups
Cups are reusable, bell-shaped devices made from medical-grade silicone, rubber or latex. They are inserted into the vagina to collect menstrual blood. Cups can be emptied, washed and reused multiple times. Manufacturers advertise that cups hold more blood than tampons and can be used for 12 hours. That reduces the need for middle-of-the-night changes or next-morning laundry after a leak.
“And some patients find it more comfortable and with less uterine cramping on their periods,” Dr. Cheney says.
Cups can be tricky to use, though. They must be placed just right to get a good seal, otherwise they can leak.
“You have to do to learn how to properly insert them as low as is comfortable for you to get a good seal,” Dr. Cheney says. “You have to be comfortable with putting something in your vagina if you’re going to use a menstrual cup.”
Some menstrual cups have a ring at the end to pull to remove the cup. To remove, you have to break the seal that is preventing leakage. You also might need to think ahead about cup removal. Some reviewers recommend removing cups — at least the first couple of times — in the shower in case of a leak. Because you need to clean the cup, you might prefer being in your own bathroom. To clean, first pour it out into the toilet, then rinse the cup and wash with gentle soap. Then it’s ready for reuse. Once a month, boil the cup to sanitize it.
One user told Mayo Clinic Press that she found the cup didn’t fit well in her life since she lived with roommates. “Part of why I gave up on it was that it can’t all be taken care of in the privacy of the bathroom, since you are supposed to boil between uses. And also, for me at least, it also took up more bathroom time.”
The Pros and Cons of Menstrual Discs
Menstrual discs are like flexible Frisbees. Like menstrual cups, discs can be left in the vagina for up to 12 hours and can collect more blood than a tampon. They take some practice though. To insert, fold it in half like a taco then insert it cup-side down.
“Just make sure that it’s up above your pubic bone in the front because that’s what keeps it in place and not slipping right back out again,” Dr. Cheney says.
To remove, gently hook the rim of the device with a finger. Users recommend removing it in the shower until you get the hang of it. Cheney says her patients who use discs tend to like them. But they do require you to feel comfortable placing items in your vagina.
One benefit is that you can have sexual intercourse with the disc in place. Period discs can be either disposable or reusable.
The Pros and Cons of Period Underwear
Period underwear look like your cute panties but have absorbent layers to collect menstrual blood. A concern with these is the potential for dampness, which can irritate the vulva. They need to be changed when they get saturated. Absorbent underwear comes in different thicknesses for more or less absorbency.
That also requires some planning ahead. One user says she packs extra pairs along with a plastic bag to carry used pairs home for washing. Some people prefer to use absorbent underwear as a backup along with a tampon. Some people use only the underwear at night, even on heavy flow days.
How Much Do Women Spend on Feminine Products?
People generally use about 3 to 6 tampons or pads per day of their period. This costs on average $20 per month. When people can’t afford the products (that are taxed as luxury goods in some states) they resort to using items like paper towels or toilet tissue. Those substitutes can increase the risk of infections and don’t stay in place, so they can lead to leaks. Another problem is using period products longer than is recommended, which also can lead to infections.
Lack of effective period products can lead to withdrawal from regular activities like going to work or school. It is also associated with an increased risk of depression.
Lightning round Q&A on periods with Dr. Cheney
Any suggestions for people who are prone to bacterial or yeast infections?
Look for trends. Try to notice if certain period products make you more likely to experience those symptoms afterwards. Avoid the things that seem to be irritating.
Do vaginas need a cleaning after a period?
No, you don’t need to clean your vagina. Don’t put any soap or odor treatments in your vagina. The best thing to clean the vagina is really just water. If you must use soap outside on the vulva, then use just a really gentle soap that has no perfumes.
What are signs of a heavy period?
If you’re soaking through two pads or tampons per hour for more than two hours, that’s a very heavy flow. Discuss it with your health care professional. It might be a sign of an underlying condition that can be treated.
One advantage of pads and tampons is that they’re an easy way to monitor your flow and then tell your health care professional how heavy it is. We commonly are measuring your flow and we ask you based on how fast you saturate a tampon or pad. It is harder to estimate how full a cup was when you dumped it.
What do you recommend wearing to bed?
It is important to choose period products that are comfortable, effective and safe. Choose something that is not likely to overflow because no one wants to be changing their sheets. You don’t want to leave tampons in more than eight hours, so change it right before you get into bed, if you want to use tampons overnight.
Also, we recommend cotton-only underwear to help prevent yeast infections. Skipping underwear at bedtime or wearing loose boxer-style underwear can also help prevent yeast infections.
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