Abstract
Background Tampon usage among young females has been associated with toxic shock syndrome (TSS). We studied the prevalence of tampon use among young females, the factors and persons influencing this choice, the role of primary care physician (PCP), and the potential association of tampon use with sexually transmitted diseases (STDs) and urinary tract infections (UTIs). Methods An anonymous questionnaire regarding the use of feminine hygiene products was completed by 250 college female students between 17 and 21 years of age and 90 primary care physicians. Percentages were calculated for most outcome measurements and tisher’ s probability exact test was utilizea to compare between groups. Results Of the participants, 19% use pads, 29% use tampons, and 52% use combination of both or a total of 81% use tampons alone or in combination. The choice was influenced by the girl herself (58%) or her mother (42%). Convenience, comfort, and appearance were the most common reasons for continuing use of the product. Only 22% reported that their physician has discussed tampon usage with them but only one participant was influenced by her physician's input. Incidence of STDs was not significantly different (P 0.38) between those using pads (12%) and tampons (15%). In the pad group, 12% reported UTIs vs. 32% in the other group (P 0.007). Recurrent UTIs were reported by only one participant (2%) in the pad group vs. 28 (14%) in the tampon group (P 0.02). Of PCPs, 75% routinely discuss menstrual history with young females but only 30% said they discussed hygiene products, although 52% of them thought that the type of product used is medically important (female physicians 63% and males 44%). Of the female physicians, 71% said they used tampons alone or combined with pads and 29% exclusively use pads with 92% of those citing fear of TSS as a reason for their choice. Conclusion The majority of young females use tampons based on own decision or maternal influence for comfort, convenience, and appearance. Physician input in this regard is not routinely provided probably because of lack of agreement about the importance of the subject among physicians. Based on participants’ report in this survey, the incidence of UTIs as well as recurrent UTIs appears to be significantly higher in tampon users than in the pad using group. Physicians should assume a more active role in explaining the benefits and potential risks of feminine hygiene products and their appropriate use.
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