I’m 12 and recently got my period. I hate pads, but my mom told me that I’m not ready for tampons. Why? Is using tampons really a big deal?

Great question! For those who aren’t familiar with them, tampons are small cylinders of cotton with a string at one end. They’re inserted into the vagina when you’re on your period to absorb menstrual blood. They’re a great way to deal with your period, especially if you don’t like pads.

While we wouldn’t call tampons a “big deal” necessarily, using them does require some responsibility.

This is because, when not used properly, tampons could potentially lead to a very rare but serious infection called Toxic Shock Syndrome (TSS).

Staphylococcus aureus and Streptococcus pyogenes, two specific kinds of bacteria, are commonly found in your body, including in your vagina. Usually, they’re no big deal. But when the bacteria grow rapidly enough, they produce a toxin that can lead to TSS. In turn, TSS can lead to organ failure, limb loss and in rare cases even death. TSS isn’t always caused by tampons, but tampons are the best known cause.

When left in too long, tampons (especially super absorbent ones) can create the perfect environment for the bacteria to flourish. There was a lot of worry about TSS in the late ’70s, when a specific brand of super absorbent tampon lead to an increase in deaths from TSS. That brand, which used a combination of materials that the bacteria loved, was recalled. But the sudden increase in TSS cases meant that people became a lot more worried about it—even scaring some people off tampons all together.

Even though TSS is very rare—it occurs in fewer than 1 in 1 million people—it’s important to reduce the risk of getting it by following some simple tampon hygiene.

Here’s what you should know:

  • To reduce the chance of bacterial infections, wash your hands before and after putting tampons in.
  • Change your tampon every 4-8 hours. If you think you might forget, set an alarm to remind yourself. It’s ok to wear tampons when you sleep, so long as you change your tampon right before bed and when you wake up in the morning. If you might sleep for longer than 8 hours, use a pad at night instead.
  • Use the lowest absorbency tampon that will last for several hours. That means that you should avoid the extra absorbent tampons (usually labeled “super,” “super plus” or “ultra”) unless you have to change your regular-sized tampon more than every 4 hours or so.

Talk to your mom (calmly!) about why she doesn’t want you to use tampons right now.

It’s possible that she’s worried about you getting TSS, or whether you’ll use tampons responsibly. Tell her why you want to use tampons. Explain that you understand the importance of tampon hygiene. Seeing that you’re serious about wanting to use tampons, and that you’ll use them safely and responsibly, may be enough to change her mind.

Tampons can sometimes seem uncomfortable for cultural reasons.

Some people believe that using tampons affects your virginity. (Virginity is a big and complicated concept, but generally, a virgin is someone who hasn’t had sex.) Virginity can mean different things to different people. However, using a tampon does not affect your virginity. After all, virginity is about sex, and using a tampon isn’t a sexual experience! If your mom believes this, you may want to have a calm conversation about it with her. Keep in mind that changing what someone thinks and believes about virginity may take time and patience.

Your mom may also be concerned because she thinks a tampon can “break your hymen.” In fact, your hymen can tear or stretch for all sorts of reasons, including exercise or inserting a tampon (or having penis-in-vagina sex).   Hymens rarely cover the whole vaginal opening.  Often, they never tear—they just stretch.

If you talk to your mom and she still isn’t on board with you using tampons, you could ask about using a menstrual cup instead. Menstrual cups are small, reusable cups that are inserted into the vagina to “catch” your menstrual blood. We talk more about menstrual cups here.

If you have more questions about your body or health and live near NYC, you can make a free, confidential appointment at the Mount Sinai Adolescent Health Center to talk to one of our doctors. No judgment, no charge.