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The tampon debate: is them a connection to endometriosis? THE TAMPON DEBATE: IS THEM A CONNECTION TO ENDOMETRIOSIS?
In my practice, numbers of women who use tampons exclusively (or use them in combination with pads far heavy flow) worry that tampons may be implicated in the onset and progressive growth of endometriosis. There are a number of reasons for their concern:
If tampons block menstrual flow and keep blood in the vagina, they ask, won't the tampon help push some of the blood back into die uterus?
What about the chance for infection? Aren't tampons actually an unsanitary way to manage menstrual flow? They remember the scare years ago from toxic shock syndrome and its connection to tampons.
Finally, they might add, "I know something is wrong because sometimes my body seems to expel a portion of the tampon naturally. Isn't this an indication that I might be doing something harmful to my health? Aren't pads the safer choice?"
These issues have all been scrutinized by gynecologists and clinicians studying every subtlety involved in endometriosis. One such study, conducted by Karen Lamb. Ph.D., and Nancy Berg at the Medical College of Wisconsin, investigated the tampon-endometriosis connection with nearly five hundred respondents who were members of the Endometriosis Association and sufferers of the disease. The study resulted in a number of conclusions. Among the most significant of them are these: tampon usage for women with endometriosis was not greater than rates for the general population, and, as yet, there is no clue to the role tampons play, if any, in the disease.
The cardboard-encased tampon was invented in 1933 by an ingenious Colorado physician. Tampax Incorporated, which bought the patent three years later, popularized the product almost single-handedly over the next thirty years or so. Other companies then entered the tampon market, introducing their own version of the original. Although today Sanitary napkins outsell tampons by a small margin, to some women, tampons have the benefits of contained blood flow, comfort, and invisibility.
The tampon as we know it has not come this far without its own brand of controversy. The subject of some moral and scientific debate until the mid-1960s, the tampon triumphantly held its position as a safe and reliable women's hygiene product. Then in 1980 a sudden wave of toxic shock syndrome (TSS) mistakenly focused on tampons as the cause of this illness. One fact used for validation was that the illness seemed to strike white women, many of whom were menstruating at the time, and most of whom were using tampons.
Researchers into toxic shock syndrome, however, postulate one link between menstruation, tampons, and the illness. "Supctabsorbent" tampons, most notably, expand to creat a pluglike effect, thereby trapping excess menstrual blood in a pool in the vagina. This pool of Wood in combination with the blood-soaked tampon may in some cases create an airtight culture medium. In such an environment, bacteria might flourish and the toxin may develop. Another variable was found by researchers; tampons left in the vagina for periods of time greater than the four or five hours recommended (for example, those worn overnight) might cause abrasions, irritations, or sores in the vagina thereby encouraging bacterial growth.
It is became tampons can stop the flow of menstrual blood out of the body that endometriosis sufferers bring up their first worry; couldn't a tampon somehow create enough mechanical pressure to flush blood back into the uterus? The answer is no! Once menstrual blood has passed through the cervix and enters the Vagina, it will only leave the body. Since a tampon is placed in the lower part of the vagina, it does not block the blood's exit from the cervix.
What of the feeling that the body expels tampons because they arc unnatural devices? If endometriosis sufferers find that a tampon dislodges itself and moves down the vagina the reason is tied to uterine contractions and menstrual cramps, not to "intuitive" biological knowledge, women with endometriosis almost always have menstrual cramps, and these cramps exist in differing degrees of intensity: In fact, uterine contractions can even be measured on a scale. For example, the average force required to drive a baby out through the cervix is 50 millimeter mercury. The low end of the scale is 10 millimeter mercury. The force of severe menstrual cramps has been measured at 100 millimeter mercury. This gives you a good sense not only of the pain a woman will feel but of why a tampon would move down the vagina.
The wisest use of tampons is to change them every four or five hours, which gives the vagina a chance to cleanse itself; and to wear sanitary napkins overnight. Until further research is completed, 100 percent cotton tampons should be used, instead of those with synthetic fibers or deodorants.
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