Can teenagers who have just begun to menstruate use tampons?

There is no reason why you cannot use tampons if you have just started mensturating, although it takes most girls a while to learn how to insert them. Try different brands; choose “junior” or “slender” tampons, the narrowest ones available. Read the package inserts and follow the directions carefully.

Very occasionally, a young girl who has not been sexually active has come into the office because she could not pull out a tampon that had become stuck on her hymen. I have helped remove it, which I could do without breaking the hymen. If it is impossible for a girl to use a tampon, she and her mother might want to consult a gynecologist about identifying and solving the problem.

Do tampons interfere with virginity?

Today most active young women, who bicycle, ride horses, and take part in other athletic activities, do not reach their first sexual intercourse with a completely intact hymen. These activities usually stretch the hymen enough that tampons can be inserted and removed without further damaging it. If someone’s hymen is so tight that she cannot insert a tampon, her first intercourse may be painful.

If you don’t want to use tampons or pads, are any other products available?

A few other products are on the market, though none has been widely accepted. One is a little rubber cup that is inserted into the vagina to collect the blood; it can be emptied, washed, and reused. There are also menstrual sponges, made of natural materials, that can be washed and reused; some women really like them.

How about scented or deodorized pads and parity liners?

Scented or deodorized pads are not advisable if you have sensitive skin. The advertisements for feminine hygiene products that speak of “delicate tissues” are right: the perineal tissue is probably the most sensitive skin on the body. If you cannot tolerate perfume on your neck, you may end up with irritation from scented pads.

Judy thinks she has vaginitis and comes in for an appointment. She has previously had a number of yeast infections, which cleared up with Monistat. This time she is very uncomfortable and the Monistat is not helping. Her examination shows inflamed perineal tissue but no evidence of infection and no vaginal discharge. A culture of her vaginal secretions does not reveal yeast or unwanted bacteria. It turns out that Judy tried a new brand of deodorized pads and developed a severe inflammatory reaction after using them for awhile.

Some women can wear a panty liner thirty days out of thirty with no problem, but if you have sensitive skin, you may develop perineal irritation. Cotton panties or panties with a cotton crotch are “breathable,” gentle to your skin, and do not provide the kind of environment in which yeast infections flourish. If your underwear becomes stained, wash it as soon as possible. (But it is better to have a few pairs of stained panties than a chronically inflamed perineum.)

Which are the best soaps and detergents?

My dermatologist friends tell me that white Dove soap is the least irritating of the brands commonly available. Though the advertisements for Ivory show babies, suggesting that the soap is gentle enough for their tender skin, it is very alkaline and can be irritating. Be gentle when you wash your perineal area; don’t scrub vigorously with a washcloth. If you have sensitive skin, don’t take bubble baths, as the perfumes and other chemicals in bubble products can affect your skin.

As for laundry detergent, find what works for you and stay with it. Some women prefer to wash their underwear separately and to use a product like Ivory Snow or Woolite. If you find those products nonirritating, then don’t change. Women have come into my office with what they thought was a yeast infection, and it turned out to be inflamed genital tissue. We check out the possibilities: Has the patient changed soaps or purchased a new brand of toilet paper? Sometimes I learn that her supermarket had a special on generic laundry detergent, which irritated her skin after she washed her underwear with it.

Naproxen

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