Dear Alice,

I am a 20 year old foreign student and I am new to the United States. One of the first things I learned about the American way of life for women is that tampons seem to be used by my sister students more often than pads. I was not familiar with them before I arrived here and am rather worried about trying to use tampons myself, despite the advantages claimed for them. Maybe you can help by answering a few of my questions, as I find it embarrassing to talk about this as frankly as some American girls do.

1. Should one use pads or tampons?
2. What kind of pads or tampons are recommended, as I am not familiar with the brands in the stores here?
3. What particular advantages do these types have over others?
4. I have seen some pads described as "overnight." Does that mean very absorbent? Is it possible to wear a pad and a tampon at the same time?
5. What are panty liners? Do you also use them with pads and with tampons?
6. I have heard that tampons are sold to girls as young as 13. How is it possible that they can use them?
7. Are there any risks or dangers in using tampons?

— New to Playtex

Dear New to Playtex,

You ask some great questions that many other folks have wondered as well. People who menstruate choose different products and brands depending on the heaviness of their flow, personal preference, and what fits their lifestyle. Keep reading for more about the menstrual hygiene tools you’ve mentioned (and a few additional ones)!

Pads, or sanitary napkins, are made of absorbent materials that are placed on the inside of the underwear to absorb menstrual blood. They come in varying sizes from panty liners, which are the thinnest pads, to “super” or “overnight” pads that are made to be worn for a particularly heavy flow. Many are disposable (one-time use only) and can be typically be purchased at pharmacies and grocery stores in the personal hygiene aisle. There are reusable varieties available as well. With either type, some also have extra material that fold over the sides of the underwear called “wings.” These wings help to hold the pad in place and to prevent leakage.

Tampons are made of soft, absorbent material and are inserted into the vaginal opening, resting in the vaginal canal to absorb menstrual fluid prior to it leaving the body. Similar to pads, tampons come in various sizes and absorbencies; scented or unscented; and with or without applicators, which can be plastic or cardboard. They may be used with panty liners or other types of pads as backup in case the tampon leaks. People of all ages can use tampons during their menstrual period, even if they haven't ever had sex — and using tampons does not affect virginity. To read more about this and to learn more about how to use tampons, consider reading Virgin eager to use tampons, but worried about hymen.

To answer your question about dangers and risks with tampon use, the biggest concern is the possibility of developing toxic shock syndrome (TSS). This is a rare, but serious bacterial infection (you can read more about it in the Go Ask Alice! Q&A, Lost tampon). To reduce your risk, here are a few tips:

  • Be careful not to scratch or scrape your skin when inserting the tampon.
  • Use the lowest absorbency rating necessary for your menstrual flow. More cases of TSS are associated with the use of super absorbency tampons.
  • Change your tampons frequently, about every four to six hours.
  • Consider using both tampons (during the day) and pads (while you sleep).
  • Make sure to only use tampons when menstrual blood is visible and not to absorb anything else (i.e., vaginal discharge at other times).

List adapted from Center for Young Women’s Health.

Beyond just pads and tampons, you might be interested to know that there are now even more products available to answer Aunt Flo’s call, including the menstrual cup and period underwear. Despite being armed with more information about options for that time of the month though, it still may take some time to decide which is the right size and absorbency for your needs. Your regular activities and lifestyle may also factor into your decision. If after considering these variables you’re still stumped on what to use, speaking to a health care provider may be helpful. Together, you can sort through the pros and cons of using certain methods, while taking your current experience with menstruating into consideration.

Hope you find what works for you!

Alice!

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