Provoked vestibulodynia (PVD) is characterized by severe pain, often induced by penetrative sex. This may lead to women abstaining from sexual intercourse, hence the recording of pain intensity ...levels in PVD research is often challenging. The standardized tampon test was designed as an alternative outcome measure to sexual intercourse pain and has frequently been used in clinical studies.
The aim of this mixed methods study is to evaluate the tampon test as a primary outcome measure for an upcoming randomized clinical trial for women with PVD.
An explanatory sequential design was applied, integrating quantitative and qualitative methods. In phase one, pain intensity levels were evaluated with the tampon test amongst 10 women, aged 18-33, with PVD. The test was repeated on day 1, 7 and 14. Pain intensity was rated on the Numerical Rating Scale (NRS), (0-10), 10 being worst possible pain. In phase two, the participants’ experiences with the test were explored with semi-structured interviews using a descriptive and inductive qualitative design. All participants were recruited from the Vulva Clinic, Oslo University Hospital, Norway.
The tampon test data and interviews were brought together to see how the interviews could refine and help to explain the quantitative findings.
The tampon test data demonstrated large intra- and inter-individual variability. Median tampon pain intensity was 4.5 (min=1.7; max=10; Q1=2.5; Q3=6). Many experienced the test as an inadequate representation of pain during intercourse as it was less painful, different in nature and conducted in an entirely different context. Four participants had a mean score of four or lower on the NRS, whilst concurrently reporting high levels of pain during sexual intercourse.
The findings indicate that the tampon test may underestimate severity of pain among some women with PVD. Participants with low pain scores would be excluded from studies where the tampon test is part of the trial eligibility criteria, even though severe pain was experienced during sexual intercourse. Large intra-individual variability in pain scores also reduces the test's ability to register clinical meaningful changes and hence necessitates repeated measurements per assessment time point.
Although the tampon test has many advantages, this study indicates several potential problems with the application of the test as a primary outcome measure in PVD. In our opinion the test is most useful as a secondary outcome, preferably undertaken repeatedly in order to increase precision of the pain estimation.
Kaarbø MB, Danielsen KG, Haugstad GK, et al. The Tampon Test as a Primary Outcome Measure in Provoked Vestibulodynia: A Mixed Methods Study. J Sex Med 2021;18:1083–1091.
Feminine hygiene products, used by millions of women worldwide on a daily basis, come in various forms. Among them, tampons are a prominent type that aims to absorb menstrual blood directly in the ...vagina. However, the underlying mechanisms governing liquid absorption in tampons have received limited research attention and remain poorly understood. This study aims to investigate these mechanisms by examining the two main types of viscose fibres used in tampons and their effects when employed in tampon production. The sole distinction between the fibre types lies in their geometric shape—round or trilobal—while all other fibre parameters remain constant. To explore these mechanisms, tampon proxies made from these fibres were created and subjected to tests measuring liquid absorption. In addition, a novel method employing infrared thermography was utilized to infer the stored energy within the compressed tampon. Furthermore, individual fibres were characterised for chemical composition, surface properties, fine structure, liquid interaction, mechanical parameters, and friction behaviour. The results revealed that trilobal fibres exhibited higher tampon absorbency compared to their round counterparts, despite sharing similar chemical composition and comparable mechanical characteristics. This disparity can be attributed to the greater specific surface area of trilobal fibres, leading to enhanced liquid uptake through fibre swelling. However, single fibre swelling only accounted for a minor fraction of the total liquid absorbency of a tampon. The most influential fibre parameter was the geometric shape, as trilobal fibres facilitated the construction and maintenance of a bulkier network with increased available volume for liquid absorption.
Graphic abstract
Plastic pollution is a global issue that endangers both human health and the ecosystem. Although interest in sustainable alternatives to single-use plastics has grown, their adoption has been ...insufficient, and menstrual products are no exception. Disposable menstrual products, such as sanitary napkins, continue to dominate over sustainable options like menstrual cups (MCs). Although studies on women’s perceptions and attitudes toward menstrual hygiene management have abounded, there is a lack of research on the development of promotional strategies for sustainable menstrual products. This study aims to fill this research gap by investigating consumers’ decision-making process in the face of a real-life option regarding menstruation products. In this comparative study, we conducted a labeled discrete choice experiment on consumers in Japan ( n = 1,929), Indonesia ( n = 2,031), and France ( n = 2,067) to reveal their preferences for sanitary napkins, tampons, and MCs. The respondents from each country were divided into three groups (one control group and two treatment groups with information provided). The results showed that in all countries, the information regarding the cost-effectiveness of MCs (i.e., per-use cost) was unequivocally significant, whereas information about their health and environmental benefits was not. Access to free MCs can contribute to their adoption and alleviation of period poverty in all countries, with a relatively moderate acceptance in Japan. The results also showed variations across countries in consumer characteristics (attitude toward menstruation, innovation-friendliness, and green consumption) and the use and perceptions of MCs. Hence, tailored promotional strategies should be considered for each market.
Individuals who menstruate grapple with diverse challenges in menstrual and reproductive health. This includes financial burdens, societal stigmas, and negative mental and physical health ...implications. Period poverty, marked by insufficient access to menstrual products, education, and sanitation, remains a prevalent and poorly addressed issue. Alarming statistics highlight the extent of this problem and shed light on the staggering number of individuals lacking access to essential menstrual products. The discourse extends to the safety and accessibility of a diverse array of menstrual products. A comprehensive comparison of the cost of available period products was conducted using data obtained from various retail websites. The often-overlooked potential indirect expenses and profound impacts on quality of life were also discussed. Amidst other public health initiatives, pharmacists have emerged as pivotal advocates and educators. Pharmacists are poised to drive initiatives that increase access to menstrual products through public health education and advocacy. By providing education on different menstrual product options, pharmacists can empower individuals to make informed decisions based on their needs. This perspective illuminates the complex impacts of menstruation on individuals and proposes that pharmacists can play a role in overcoming barriers to access. The proposed strategies, rooted in education, research, and advocacy, pave the way for enhancing access, reducing stigma, and elevating the quality of life for those navigating the intricate complexities of menstruation.
Failure to reconstruct the Lactobacillus microbiota is the major reason for the recurrence of vaginal infection. However, most empiric therapies focus on the efficacy of pathogen elimination but do ...not sufficiently consider the viability of Lactobacillus. Herein, cotton fibers with a lactic acid‐like surface (LC) are fabricated by NaIO4 oxidation and L‐isoserine grafting. The lactic acid analog chain ends and imine structure of LC can penetrate cell walls to cause protein cleavage in Escherichia coli and Candida albicans and inhibit vaginal pathogens. Meanwhile, the viability of Lactobacillus acidophilus is unaffected by the LC treatment, thus revealing a selective way to suppress pathogens as well as provide a positive route to re‐establish protective microbiota in the vaginal tract. Moreover, LC has excellent properties such as good biosafety, antiadhesion, water absorption, and weight retention. The strategy proposed here not only is practical, but also provides insights into the treatment of vaginal infections.
A strategy is proposed in this study by fabricating a lactic acid‐like surface on the cotton fiber (LC) to selectively inhibit pathogens in vaginal tract without turning down the probiotic Lactobacillus. In the vaginal infection, LC can assist Lactobacillus to be dominant and thus re‐establish protective microbiota thereafter.
A study was conducted to find the applicability of vaginal tampons as an alternative to regular cotton swabs as a nasal secretion collection tool for the higher recovery of DNA. Nasal secretions were ...collected from sheep and goats using regular cotton swab and tampon swab. The mean yield and purity of the DNA extracted from tampon were significantly higher than that of the DNA extracted from cotton swab. The tampon swabs resulted higher DNA recovery than the cotton swabs after they were allowed to absorb M. bovis culture. The tampon swab was also found to be more sensitive in detecting M. bovis by PCR. This study concluded that vaginal tampons are having a higher absorption capacity with more DNA yield and can be used as a nasal swab in the diagnosis of bovine tuberculosis.
Preserving streamside forest habitats or buffer strips is considered to reduce forestry-related biodiversity loss in commercial forest landscapes. However, it is still unclear what type of management ...in and near streamside forests can be undertaken without compromising their biodiversity and natural change through succession. Using a before–after, control–impact study design, we tested the impacts of forested buffer strips (15 or 30 m wide, with or without selective logging), preserved after clear-cutting, on the changes of polypore communities in streamside boreal forests in Finland. Manipulations in 28 sites produced four treatment classes, the community compositions of which were compared with seven unmanaged controls before and 12 years after the manipulations. The polypore community composition in 15 m wide buffer strips changed differently than that in controls and resembled the community composition typically found in production forests. Moreover, selective logging tended to homogenize polypore communities. These responses of polypore communities indicate that the natural biodiversity and succession of streamside forests was disturbed in both 15 m wide and selectively logged buffer strips. Streamside forests in nonlogged 30 m wide buffer strips seemed to retain the natural polypore community composition and succession, at least during the 12-year period.
The article examines the role of insider-outsider alliances and framing strategies in the campaign to end the "tampon tax" in Canada. Drawing on Kingdon's Multiple Stream Framework (MSF) and feminist ...policy studies, the study aims to explain how and why efforts to remove the federal sales tax on menstrual products succeeded in 2015 when previous attempts had failed. By mapping developments in the problem, policy and politics streams, the study shows how outside activists worked with political insiders to take advantage of emerging opportunities in the broader political and policy systems, successfully moving the issue of the tampon tax onto the government's agenda. The article concludes with suggestions for future research in feminist policy studies and menstruation studies.
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