Your monthly menses can make you massively uncomfortable. Yep, from painful bloating and period farts to crappy cramps, Aunt Flo can be unforgiving. But there's one thing that should never (ever, ever) produce pain during your period: inserting a tampon.
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If using a tampon makes you twinge, something's up down south. We spoke with Jodie Horton, MD, a board-certified ob-gyn and chief wellness advisor for Love Wellness, to understand why you may develop discomfort using tampons and what you can do to relieve the pain (because periods are unpleasant enough).
If attempting to insert a tampon hurts, don’t force it to go in. Doing so may only amplify your agony or potentially damage the interior walls of your vagina.
1. You Have Vaginal Dryness
If you've got vaginal dryness, inserting or removing a tampon can cause increased friction and discomfort, Dr. Horton says.
Sometimes dryness simply happens when your flow is light. And using a tampon tends to worsen it. "The purpose of tampons is to absorb blood during the menstrual period, but they can also absorb moisture in the vagina and exacerbate vaginal dryness," Dr. Horton says.
Fix it: When your flow is lighter, or you're at the end of your period, you can switch to a smaller tampon and apply a small amount of lubrication to the plastic applicator (or on the vaginal opening) to make it easier to insert, Dr. Horton says. But if you'd rather toss the tampon entirely, menstrual pads and period underwear are great alternatives, she adds. (Period-proof leggings, too.)
However, if your vaginal dryness lasts more than a few days or seems to be a chronic issue, it could be the result of stress, hormonal changes (for instance, during breastfeeding or perimenopause) or even certain medications. In this case, it's best to have a frank discussion with your doctor to determine the underlying cause of your dryness.
2. You Have an Imperforate Hymen
An imperforate hymen may be hampering your ability to apply a tampon without pain.
The hymen is a thin membrane that usually covers part of the opening of the vagina, but some people are born with an imperforate hymen, which covers the entire vaginal entrance, according to the National Library of Medicine (NLM).
As a result, inserting tampons may be painful because the membrane — which covers the vaginal opening — makes the space too small for a tampon to enter, Dr. Horton says. In addition, people with imperforate hymens often experience abdominal and pelvic pain, she says.
This issue usually surfaces in adolescence, around the time you start your period, per the NLM. An imperforate hymen can also affect the flow of menses, blocking the blood from coming out, Dr. Horton says.
Fix it: Your doctor will perform a physical exam to determine if you have an imperforate hymen. If you do, a minor surgery can be done to remove the extra hymenal tissue, Dr. Horton says. "In the meantime, pads or period panties are a great option," she says.
3. You Have Vaginismus
Vaginismus — a condition where the vagina involuntarily spasms or tightens — can produce significant pain when you're inserting a tampon, Dr. Horton says.
These unintentional muscle contractions can happen whenever something foreign — a tampon, penis, finger or medical instrument — penetrates the vagina, according to the Cleveland Clinic.
While it's unclear why some people experience this painful vaginal issue, "vaginismus often starts after the body has experienced physical trauma, change or pain," Dr. Horton says.
Fix it: If you suspect you have vaginismus, talk with your gynecologist. Your doctor may recommend vaginal dilator therapy (the use of tube-shaped devices to help stretch the vagina with the goal of making vaginal penetration more comfortable) or refer you to a physical therapist who can teach you how to relax your pelvic floor muscles (which tighten during penetration), per the Cleveland Clinic.
Seeing a therapist can also be helpful for treating vaginismus because the condition often involves anxiety, fear and trauma related to penetration or sex.
In the short term, you can try using a slender tampon and inserting it while lying down, which may make it easier for your muscles to relax, Dr. Horton says. If even the thinnest tampon is too painful, stick to pads or period underwear.
4. You Have Vulvodynia
A burning or stinging sensation with tampon insertion could be a sign of vulvodynia, a condition characterized by chronic pain (lasting at least three months) of the vulva with no identifiable cause, Dr. Horton says.
ICYDK, here's a quick anatomy lesson: The vulva consists of the outer part of the genitals, including the labia, clitoris and openings of the vagina and urethra, i.e., your pee hole.
In vulvodynia, symptoms can vary: "The onset of pain can be intermittent or constant and can be generalized or localized to a specific area like the clitoris," Dr. Horton says. Recurrent discomfort related specifically to the entrance of the vagina is called vestibulodynia.
While vulvar pain can be provoked by penetration of the vagina with a tampon, finger, penis or medical instrument, even long periods of sitting can cause burning or irritation for some people, according to the Mayo Clinic.
Fix it: No one should suffer silently with this painful condition. Speak with your ob-gyn, who can help you identify or rule out underlying issues and provide treatment options.
Certain medications including steroids, tricyclic antidepressants, anticonvulsants, local anesthetics and nerve block injections can help relieve the pain, per the Mayo Clinic.
Biofeedback therapy and pelvic floor therapy, which teach you how to relax your pelvic muscles, can also be useful interventions for people with vulvodynia.
In addition, it's key to avoid triggers and take gentle care of the vulva. For instance, certain materials and fabrics can be irritating. "Wear 100 percent cotton underwear and switch to 100 percent cotton menstrual pads," Dr. Horton says.
5. You Have a Cyst
A vaginal cyst could be the source of the pain you feel when inserting a tampon. Usually occurring on or under the vaginal lining, a cyst can be filled with air, fluid, pus or other material, according to Mount Sinai. The most common types (called vaginal inclusion cysts) typically form due to injury during childbirth or after surgery.
While vaginal cysts generally don't cause symptoms, some can become painful if they grow too large or become inflamed, Dr. Horton says. When this happens, a cyst can block the vaginal opening and make inserting a tampon or having sex very uncomfortable.
Fix it: If you have a vaginal cyst, your doctor may choose to perform a minor surgery to remove or drain the cyst, or prescribe an antibiotic if you have an infection, per Mount Sinai.
In addition, Dr. Horton recommends avoiding tampons and using pads or period underwear until the cyst has been properly treated.
6. You Have Vaginitis
Vaginitis, which involves the inflammation of the vagina, tends to trigger pain when a tampon is placed inside you. While there's a variety of reasons for vaginitis, the most common types are, according to the Mayo Clinic:
- Bacterial vaginosis (an overgrowth of bad bacteria)
- Yeast infections (an overgrowth of fungus called Candida albicans)
- Trichomoniasis (a sexually transmitted infection caused by a parasite)
In addition to pain with penetration (during tampon use, sex or a pelvic exam), other signs of vaginitis can include, per the Mayo Clinic:
Fix it: Depending on the underlying cause of vaginal inflammation, your doctor may prescribe you antibiotics or antifungal medications to resolve the infection. Once again, you may want to avoid tampons until you've been properly treated.
7. You Have Cervical Inflammation
Cervical inflammation, also known as cervicitis, can be producing your tampon-related pain. This inflammatory issue happens when your cervix becomes irritated or infected.
"Cervicitis is caused by sexually transmitted infections, allergic reactions or bacterial vaginosis," Dr. Horton says. "There may be a pain when a tampon is inserted due to swelling and irritation."
Other symptoms of cervicitis include, per Johns Hopkins Medicine:
- Pus-like vaginal discharge
- Pelvic pain
- Bleeding between periods or after sexual intercourse
- Urinary problems
Fix it: Treatment for cervicitis may include antibiotics for you as well as your sexual partner if the underlying cause is an STI, according to Johns Hopkins.
Also, "you should not use tampons while being treated for cervical inflammation," Dr. Horton says. "Instead, menstrual pads, period panties and menstrual cups/discs may be used because they do not come in contact with the cervix," she explains.
8. You Have Endometriosis
Experiencing debilitating discomfort with tampon insertion could also indicate endometriosis. A painful disorder, endometriosis occurs when uterine-like cells grow outside of your uterus, Dr. Horton says. These misplaced cells cause inflammation, swelling and scarring, particularly during your period.
In the U.S., it's estimated that 2 to 10 percent of people assigned female at birth (AFAB) of childbearing age are afflicted by endometriosis, according to Johns Hopkins Medicine.
Pain during tampon use and intercourse are common symptoms, but other signs of endometriosis may include, per Johns Hopkins Medicine:
- Excessive menstrual cramps that may be felt in the abdomen or lower back
- Abnormal or heavy menstrual flow
- Painful urination during menstrual periods
- Painful bowel movements during menstrual periods
- Other gastrointestinal problems, such as diarrhea, constipation and/or nausea
Fix it: Treatment of endometriosis often depends on the stage and severity of the disorder. Your doctor may prescribe pain medication (such as nonsteroidal anti-inflammatory drugs or other over-the-counter analgesics) or hormone-based therapy to relieve your symptoms, according to Johns Hopkins Medicine. In more severe cases, surgical removal of endometrial tissue may be necessary.
And, again, if tampons are terribly uncomfortable, menstrual pads, period underwear and menstrual cups/discs may be better options, Dr. Horton says.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.