Are tampons bad for you? Let’s explain

Are tampons bad for you? Woman on blue chair worried

Ever wonder if tampons are bad for you? Or if they throw you off “down there?” Or can they make your cramps worse? Let’s go through the pros and cons of using them—and the alternatives.

Answers: are tampons bad for your health?

Are tampons bad for you? Picture of bathroom counter with 2 containers of tampons and a box of menstrual pads on the countertop

The pros of tampons get a lot of attention. They’re reliable, come in a variety of absorbencies, and are (usually) comfortable. But are they bad for you in any way? If they’re your period go-to, you might be surprised to know that they aren’t anything new. In fact, even though they looked different than they do now, the history of tampon-like use for menstrual cycles goes as far back as 1700s. (Curious about the history? Check out this article in The Atlantic.) But the ones we’d all recognize today date back to the 1930s. Since then, we’re happy to say they’ve only been improved for health and safety.

Toxic shock syndrome

That said, tampons can be unhealthy in a few situations. Even though it’s very rare, there is something called toxic shock syndrome (TSS) you should know about. TSS can happen if you leave your tampon in too long. So how long is too much? Aim to switch yours out at least every 8 hours.

Accidentally forgot? That’s okay. It’s really unlikely that you’ll get TSS. The point is: don’t keep an old tampon in your vagina and forget to change it. At any time, if you realize you left a tampon in for too many hours or days, if you were to get TSS, you’d probably start to notice symptoms in 2 to 5 days. Don’t wait if you begin to have a fever, feel fatigued, notice a red, flat rash that covers most of your body, or any other TSS symptoms. Call your provider and go to the emergency room ASAP. TSS doesn’t get better on its own.

Chemical exposure

It’s important to recognize that most tampons aren’t just cotton and rayon. There can also be (and especially used to be) chemicals in them that you wouldn’t want to put in your body. Now, the FDA says that all FDA-approved tampons no longer utilize elemental chlorine to bleach their products, making dioxin levels low in each tampon you use. (What are dioxins, anyway? They’re forever chemicals that can disrupt your hormones. We talk more about them here.)

Buying menstrual pads or tampons (or douches) with fragrance? We’d advise you to go unscented instead. First of all, your vagina’s pretty amazing—it’s not dirty, even when you have your period. And fragrance can do more harm than most people realize. Fragrances often are made from a variety of chemicals. Not only can those chemicals disrupt the delicate pH balance of your vagina, you can absorb some of them right through the vaginal walls. Toxins like these can affect your fertility, your endocrine system, and your overall health. (Catch up on that here with fertility specialist Shala Salem, MD.)

Your natural vaginal pH and tampons

One of the reasons tampons are great is because they absorb your flow. But here’s the drawback: during the time you’re using it, you have something moist up in your vagina. That can impact your natural pH. What’s also true is that tampons can’t discriminate between your flow and the good mucous and bacteria that live in your vagina. It absorbs everything. Without enough good bacteria doing its job or enough natural fluids to keep your pH ideal, you can become more susceptible to sexually transmitted diseases (STDs), bacterial vaginosis, and yeast infections, too.

So, can tampons make pelvic pain worse? Or make my cramps worse?

Can tampons make pelvic pain worse? Young woman in blue shirt laying on white bedspread with hands on belly and cramps

Ever insert a tampon and feel like your pain level kicked up a notch? There are instances where the tampon’s to blame—and when it’s not.

Cramps and your period

If your cramps get worse while using a tampon, it’s pure coincidence. The reason: when you get your period, your uterus contracts to shed its lining—and that lining is the period blood you see. In order to make your uterus contract, compounds called prostaglandins take action. (Prostaglandins aren’t hormones but act like them.) It’s these prostaglandin levels that affect how strongly your muscles are contracting—and, therefore, the severity of your cramps.

Pelvic pain and tampons

Tampons do cause pain in a few ways. Sometimes, it’s simple. Not inserting your tampon all the way can make things get uncomfortable fast. Another reason for discomfort? If you go to pull out a tampon but your flow is really light, it’ll hurt because it’s not very lubricated. In these situations, any pain usually only lasts for a short time.

But there are also some situations where tampons can make pain you already feel even worse. For example, women who suffer from vaginismus already experience pain when inserting absolutely anything into their vagina. (Vaginismus is when the vagina involuntarily contracts and has spasms.) Trying to use a tampon will absolutely cause and intensify pain with this condition. Pain can also occur with dyspareunia and vulvodynia. Dyspareunia technically means “painful vaginal intercourse.” A tampon may contribute or replicate pain, just as vaginal intercourse would. Many underlying causes can be behind dyspareunia, and many are treatable. Pelvic floor therapy also helps.

Tampons also may cause more pain for women with vulvodynia. Vulvodynia is a pain disorder of the vulva (the external areas surrounding your vagina). About 14 million women will suffer from vulvodynia at some point during their lifetime. Having fibromyalgia or chronic fatigue syndrome (CFS) can make women more susceptible to vulvodynia. With this condition, it can be very difficult to bear sexual intercourse, endure the burning, and even sit for long periods of time. Wearing a tampon can cause similar discomfort.

Endometriosis and tampon pain

With endometriosis, or endo, uterine cells grow outside of your uterus. Though most are found in the pelvis, it’s possible for them to grow anywhere in the body. No matter what stage your endometriosis is classified as, you can experience disabling pain due to these growths and the inflammation and scarring they cause. Can tampons make that pain worse? That’s a little bit of a tricky question to answer. Usually, that’s a no. But if your growths are positioned anywhere a tampon would cause an increase in pressure on them—then it’s a definite possibility.

What are the best alternatives?

Are tampons bad for you? Illustration of female hands marking days of period in calendar. Around calendar are different methods for periods: cups, tampons, pads, etc.

If tampons work for you, there’s no reason to stop using (unscented!) ones. Just be sure you change it regularly and use an absorbency that’s not too high for your flow. That said, we totally understand wanting to look at other good options—whether you are experiencing pain from another condition or just because.

Pads are the obvious choice, but there are a few other options available, too. If you’re worried about chemicals and your vaginal pH—but don’t have any pain with tampons—then you could try out a menstrual cup. Some women swear by these, but others experience some irritation from the material. Menstrual cups are reusable (so take care when cleaning it!), and they can also take some trial and error before you get a good fit.

Honestly, our absolute favorite alternative to tampons is washable, reusable period underwear. (Take a look at the brand Thinx. They come in a ton of styles, from boyshorts to hiphuggers and high-waisted and more.) Since you don’t have to insert anything into the vagina or ever worry about your pad shifting, this is a great option for all women—and especially if you have any type of pelvic pain or pain with tampons.