Objective: To study the prevalence of tampon use among young females, the factors and persons influencing this choice, the role of primary care physicians, and the potential association of tampon use with sexually transmitted diseases and urinary tract infections.
Methods: An anonymous questionnaire regarding the use of feminine hygiene products was completed by 250 female college students between 17 and 21 years of age and 90 primary care physicians. Percentages were calculated for most outcome measurements and Fisher's Probability Exact Test was used to compare groups.
Results: Of the participants, 19% use pads, 29% use tampons, and 52% use both, with a total of 81% using tampons alone or in combination. The choice was influenced mostly by the woman herself or her mother. Only 22% reported that their physician discussed tampon usage with them. Incidence of sexually transmitted diseases was not significantly different between those using pads and tampons. In the pad group, 12% reported urinary tract infections versus 32% in the other group (P = 0.007). Among physicians, only 30% said they discussed hygiene products, although 52% of them thought it was medically important. Of the female physicians, 71% use tampons alone or in combination; 29% exclusively use pads, with 92% citing fear of toxic shock syndrome as a reason for their choice.
Conclusions: The majority of young women 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 urinary tract infections seems to be significantly higher among tampon users than among pad users. Physicians should assume a more active role in explaining the appropriate use, benefits, and potential risks of feminine hygiene products.