Bearded clam, beaver, box, camel toe, coochie, minge, poontang, pussy, quim, slit, snatch, trim, and twat; these are just some of the well-known English names for the vagina. This pattern of multiple names for the female genitalia occurs across many cultures, not just in the United States. Yet despite all these familiar names for referring to the vagina, women are not always comfortable discussing them. Recent research has shown that women worldwide believe that vaginal health is a neglected topic, that there are many associated mistaken beliefs and taboos, and that the majority of women would like more information about their vaginas. However, less than half of the women surveyed felt comfortable talking to their healthcare provider about vaginal health issues.

All women have a vagina, but how much do most women really know about it? For one week every month, the vagina provides an exit for menstrual blood. While it doesn’t appear to do much else, the rest of the time many things do and can go wrong within the vagina. The vagina is one opening for sexual intercourse, and for those who orgasm vaginally, it can therefore be an incredible place. It is also the pathway for sperm to find the uterus, fallopian tubes, and an unfertilized ovum. At other times, the vagina produces smells and tastes that women cannot explain. Some women or their sex partners have noted changes in the tastes and smells emitting from the vagina depending on the time of the month or even what she had eaten in the past few days.

Women use a variety of products to address menstruation, and to clean their vagina. While these products are being used on a very sensitive part of the woman’s reproductive system, there is not much open discussion concerning their safety.

Menstruation Products

While the American dollar seems shaky right now, one sure investment is feminine hygiene products. Items such as pads, tampons and vaginal cups will always be a necessity for women. Yet with that necessity comes what appears to be a general disregard for safety. Women have to use these products and the advertising focuses on comfort and ease of use, which are both important points. However, what little safety information the manufacturers provide is in fine print on an insert or on the box.

Tampons

Tampons are densely packed, absorbent cotton or rayon, or a combination of both, that can be inserted into the vagina to soak up menstrual fluids. Tampons can be inserted by hand or by using a plastic or cardboard tool that slides the tampon into the vagina. Tampons should not be felt once they are comfortably placed inside the vagina.

The major health safety concern for women using tampons is Toxic Shock Syndrome (TSS) and most tampon boxes come with an insert that gives information about TSS. It is a serious disease that occurs very infrequently, but despite the rarity of the disease, it is something all tampon users should be aware of. TSS is thought to be caused by the staphylococcus aureus bacterium. This bacterium can live on skin, in the nose, armpit, groin, or vagina and is carried by approximately 30 percent of the population. In a small number of people, some strains of the bacteria produce a toxic chemical that causes TSS. The tampons themselves do not cause TSS, but using a tampon while the bacteria are present increases the chances of getting TSS. Up to 17 of every 100,000 women who have their periods will get TSS each year.

The symptoms of TSS include a sudden high fever, diarrhea, vomiting, feeling dizzy, red rash, aching muscles, and fainting. If any of these symptoms are experienced, women should remove their tampon as soon as possible and contact a healthcare provider. Antibiotics are used to treat TSS and other medications may be prescribed to get rid of the symptoms.

TSS can be prevented by using tampons with the lowest possible absorbency level to control the flow of the period each day and women should not wear a tampon for longer than eight hours at a time. Tampons are made in a variety of absorbency levels. During the course of the menstrual cycle, a woman will need tampons in a variety of levels of absorbency.

Some women are concerned about using tampons due to the worry that the tampon will get lost inside their vagina. This is not possible. Tampons cannot get lost, as they have nowhere to go. The vagina is an opening approximately 3-5 inches long that ends at the cervix. It does lead to the uterus but the opening is no bigger than a pin, and a tampon will not fit through it. Occasionally a string may break on a tampon, making removal more difficult. If this happens, a woman should contact her doctor for help if it’s not possible to remove it herself.

There are some scented or deodorant tampons available to women. While many women will experience no problems with them, some women may have a negative reaction to the chemicals used to add the deodorant properties to the tampons. If any allergic reaction occurs, the tampons should not be used anymore and a healthcare professional should be consulted. Some women may develop a urinary tract infection from the use of deodorant tampons as the deodorant can irritate the urethra as well as the vagina.

Tampon materials have been well tested by the manufacturers before being sold to consumers. They conduct clinical and non-clinical trials to examine the safety of the products. The testing includes checking the vaginal tissue and the natural vaginal organisms for infections and allergies. As with any substance, there is always the potential for someone to be allergic to the material; however, according to the manufacturers, this is not common. The highest standards are used when selecting the materials and during the manufacturing process to ensure that women receive the best quality products.

Unfortunately for the consumer, all tampon and pad research has been conducted by the manufacturing companies. This was cause for concern for many people and a congressional bill was introduced to request that the National Institutes of Health (NIH) take on the responsibility to test the safety of feminine hygiene products. The major concern is the presence of dioxin, a substance that may cause cancer. Dioxin is a byproduct of the bleaching process for paper, generally used for processing of tampons and menstrual pads. Manufacturers are expected to monitor the levels of dioxin; however, they are not required to share this information with consumers. The U.S. Food and Drug Administration reports that the levels of dioxin in manufactured tampons are at or lower than the acceptable limit. The dioxin levels tampons pose a negligible health risk. The bill was introduced multiple times, but it was dropped each time.

Pads

Some women prefer to use pads to control the flow of their monthly periods. Sanitary pads are an absorbent item worn outside the vagina. They are attached to underwear to collect the flow of fluids and tissues out of the vagina. Just like tampons come in varying levels of absorbency, so do pads. Pads are available in a range of sizes to match the flow of menstrual blood; light days, regular, super, and maximum protection are the basic levels of absorbency. Pads come in different thickness as well as absorbency, so that women can choose the type that is the most comfortable. 

Because pads are worn outside the body, the safety concerns are different than those for tampons. The components of the sanitary pads are tested before they are used in manufacturing. Clinical trials are conducted to test the safety of the pads while they are being used. The testing that has taken place over the past 20 years has shown that pads do not negatively affect a woman’s body inside or out. The scented pads, which can be useful at covering some of the smell of the period, may cause irritation to a woman’s skin due to the substances used to create the fragrance. If a woman experiences irritation while using a scented pad, she should stop using that pad and visit her healthcare provider. Some women may develop a urinary tract infection from using deodorant pads because the deodorant may irritate the urethra as well as the rest of the tissues in the pelvic area.

Menstrual Cups

Vaginal or menstrual cups are other types of products that can be used to handle the monthly flow. This device is folded over and inserted into the vagina. It is carefully pushed into the passageway to a comfortable position where the vaginal muscles will keep it in place. Vaginal cups do not absorb menstrual flow, but allow women to collect, hold and dispose of the fluids. Some cups are reusable and others are just used once. As with tampons, a woman should not feel the cup once it is properly placed in the vagina. An advantage to using cups is that they do not pose a risk of TSS.

Vaginal cups can be made with a variety of non-absorbent materials. Some cups are made with latex, some with silicone, and others with polyethylene. While any of these materials have the potential to cause an allergic reaction in some women, allergies to silicone and polyethylene are very rare. Silicone is used in a variety of household items such as lotions and deodorants, and polyethylene is used in nipples for baby bottles. It is very important to find out what the cups are made of before using them if you have an allergy. If any women experience irritation during the use of the cup, they should stop using it and make an appointment with a healthcare professional.

Some women worry that they cups will be difficult to remove, as a user must reach into the vagina and pull them out. As with everything else, it’s a matter of practice. When grabbing the cup, women should be careful not to tip the cup over or the fluid inside will spill out.

Eco-Friendly Products

There are pads, tampons and cups made in an eco-friendly manner. Re-useable pads and tampons are available, made out of natural fibers such as organic cotton and sea sponges. Re-useable cups are made out of natural gum rubber. Many women are using these products because they know that no additional chemicals are used to produce these products. Unlike more commonly available pads and tampons, there is no legal requirement that feminine hygiene product manufacturers list the contents of the products on the box.

Douching

Twenty to 40 percent of women of reproductive age use douching as a means to clean the vagina after menstruation, to protect against sexually transmitted infections (STIs), or to get rid of smells on a regular basis. Douching products usually include baking soda, vinegar, or iodine mixed with water; however, most doctors recommend against douching because it can do more harm than good for most women.

It is normal for women to have some bacteria and other microorganisms in their vagina. This helps keep the vagina healthy. When women douche, it changes the chemical balance inside the vagina and can lead to more infections and irritations in the vagina. Douching can make the vagina more prone to STIs, yeast infections, and pelvic inflammatory disease.

The vagina secretes mucous which keeps the vagina healthy and clean. The smells are natural, and women trying to clean them only succeed in covering them up. Women should refrain from douching unless recommended by their doctor.

While feminine hygiene products for dealing with menstruation are fairly safe for regular use, douching is not considered a safe hygiene practice by most doctors. Women should be aware that if they have any reaction to the pads, tampons or cups used, they should stopping using the product and see a healthcare professional immediately. All the menstruation products are tested by manufacturers. However, full disclosure of all the substances and chemicals used in or on the products is not required. Therefore, the potential for allergic reaction or irritation exists. As an alternative, some women use eco-friendly products that are made with organic products to ensure that they are not inadvertently exposed to chemicals. Douching should only occur with doctor recommendation as it can cause irritation and infections to occur in the vagina and other parts of the reproductive system.