What can be done to reduce body odor?

The source of your daughter’s body odor is her skin glands, especially under her arms. Beginning around the time they’re 8 years old, girls produce more sweat in this area. Initially, human sweat is odorless. (Honest!) But when it becomes mixed with the bacteria that are normally present on a person’s skin, and then you add in some body heat, watch out. The funky odor begins.

Once this biological process begins for your daughter, she may need to begin bathing daily in order to reduce the amount of bacteria on her skin. This doesn’t need to be an elaborate process of soaking in bubble bath and scrubbing her skin raw. (In fact, both of these steps would do more harm than good to her body.) Rather, a quick rinse in the shower with a mild soap on a regular basis should do the trick.

Another step you can take to help your daughter in this embarrassing situation is to buy her loose-fitting clothing made of natural fibers. These types of clothes allow air to circulate around your daughter’s body and let her sweat evaporate. And needless to say, she shouldn’t wear sweaty clothes two days in a row.

If regular showering and the appropriate clothing don’t fully address the problem, you may want to consider having your daughter use antibacterial soap. Also, you should take a look at her diet. As we all know as adults, people can take a shower every day and wear only freshly laundered clothes, but if they eat food with lots of garlic, onions, and spices, they’re undoubtedly going to produce a noticeable body odor. (And, undoubtedly, they’ll end up standing right next to you on a crowded elevator.)

Are there helpful tips for inserting tampons?

Now that you know all of this information about tampons, it’s time to tell you the secret to effortlessly inserting tampons so that you can pass it along to your daughter.

But guess what? The secret is that there really is no secret.We gynecologists don’t have any special insights or methods that we learned in medical school or elsewhere. (Sorry about that.) However, the tips and steps listed below can be quite helpful to you and your daughter.

• First, your daughter should read the instructions in the tampon package. The pictures that accompany the directions can be particularly helpful.
• You should tactfully ask your daughter whether she wants help inserting a tampon for the first time. It’s her decision.
• Your daughter should try her first tampon on one of the days that her menstrual flow is the heaviest. This helps to ensure that dryness is not an issue during insertion or removal.
• Your daughter should start out using “slim” or “slender” tampons because they tend to be more comfortable. Also, it would probably be wise for her to choose a tampon with a rounded, smooth applicator because they typically are more comfortable than applicators with blunt ends.
• She may want to apply a small amount of lubrication such as K-Y Jelly to the applicator tip because it can help ease the insertion.
• Your daughter should find a position that is comfortable for her to insert the tampon. Most women insert a tampon while sitting on the toilet, but other women, especially adolescents, may find it’s easier if they remain standing in the bathroom and place one foot up on the toilet seat.
• Your daughter should relax as she inserts the tampon. Tensing the vaginal muscles causes resistance to the tampon, thereby making insertion more uncomfortable.
• She should hold the applicator between her thumb and her middle finger. Her index finger should be kept free so that she can push in the tampon.
• Using her other hand, she should separate the labia (lips) of her vagina and insert the tampon applicator into the vaginal opening.
• Some adolescents find that a small hand mirror is initially helpful in locating the vaginal opening.
• Using her index finger, she should push the tampon all the way in while holding the applicator steady with her thumb and forefinger.
• She should then remove the applicator, being careful not to pull on the tampon string.
• Your daughter can remove the tampon at any time simply by pulling on the string.

It’s important for your daughter to know that once the tampon is inserted she shouldn’t feel it or even sense that it’s there. If it’s constantly making its presence known, it may be positioned incorrectly or not be inserted far enough. The best thing to do in that case is to remove the tampon and try again with a new one. Remind your daughter that practice makes perfect with tampon use, and with time it will become a comfortable routine during a rather uncomfortable time of the month.

What myths about tampons are circulating on the Internet?

When your daughter starts using tampons, she’ll probably rely on the Internet or her friends to get information about them. You should know that tall tales abound when it comes to tampons, and questionable Web sites often add unfounded, unproven, and just plain wrong information. Therefore, it’s important for you to be able to set the record straight. In doing so, you should remember the following facts to combat common, but completely silly, rumors:

1. Tampons CANNOT be lost forever in a woman’s body. A tampon remains in the vagina no matter what. It cannot migrate anywhere else.
2. Tampons do NOT cause AIDS.
3. Manufacturers do NOT add asbestos or other materials to tampons to cause an increase in menstrual bleeding, which then boosts sales.
4. Tampons do NOT contain hazardous levels of dioxins which are cancer-causing agents and which are claimed to be produced through the tampon bleaching process. (The bleaching process is designed to clean and purify the raw materials used in tampons. In conjunction with the Environmental Protection Agency, tampon manufacturers tested their products for dioxin. The levels of dioxin in tampons ranged from undetectable to 1 part in 3 trillion, far below the level that occurs through daily environmental exposure and considerably below the level the FDA believes would put consumers at risk.)
5. Tampon use does NOT affect virginity.

What is my daughter’s risk of getting TSS and how can she avoid it?

Younger females, such as those under 30, may be at a higher risk for TSS because they have not yet formed antibodies to the staph toxin. Therefore, it’s important for you and your daughter to be vigilant for TSS. However, it’s also important to know that there now are actually very few TSS cases reported each year.

Toxic Shock Syndrome became a hot topic in 1980 when 813 cases of menstrual-related cases of TSS—and 38 deaths—were reported. Research ended up showing that use of a specific type of tampon that is no longer on the market put women at a higher risk of TSS than use of other tampons. This tampon was made with a new combination of materials including polyester foam  and a highly absorbent cellulose that enhanced absorption. Although not all TSS cases occurred in women who used this specific type of tampon, it clearly played an important role. Therefore, it was removed from the market, along with other new, highly absorbent tampons of similar substances.

Because of the discontinued use of these types of tampons, as well as the Food and Drug Administration’s regulation of tampon materials and absorbency, there has been a dramatic drop in the number of TSS cases. In 1997, only six cases were confirmed, and in 1998, only three cases. Nevertheless, the FDA recommends that women take the following steps to avoid tampon problems:

• Follow the package directions for insertion;
• Choose the lowest absorbency that will handle your menstrual flow;
• Change your tampon at least every 4 to 8 hours;
• Consider alternating pads with tampons;
• Don’t use tampons between periods; and
• Know the warning signs of Toxic Shock Syndrome.

What are the symptoms of TSS?

The symptoms of TSS include fever, vomiting, dizziness, diarrhea, fainting, a sunburn-like rash, muscle aches, sore throat, headache, joint pain, red eyes, and sensitivity to light. As the illness progresses, TSS can also lead to mental confusion, kidney failure, a drop in blood pressure, and collapse. One to two weeks after the initial symptoms, peeling patches of skin on the palms and soles can occur.

These symptoms typically appear during a woman’s period or a few days after. If a woman suspects she has TSS, she should remove her tampon immediately and call her doctor or go to the emergency room for immediate evaluation. Treatment requires hospital admission for intravenous antibiotics to kill the bacteria, intravenous fluids to treat the low blood pressure and dehydration, and observation and treatment for signs of kidney failure. With appropriate treatment, most patients will recover in 2 to 3 weeks.

What is Toxic Shock Syndrome?

Toxic Shock Syndrome (or TSS) is a rare but potentially life-threatening illness. Researchers believe it is caused by an infection resulting from certain staph and strep bacteria that often exist even in a healthy woman’s vagina. The exact process is unknown, but it’s thought that these bacteria multiply in the presence of a bloodsoaked tampon. It’s actually not the bacteria that cause the TSS directly. Rather, it’s the toxins that the bacteria produce that do the harm.

It’s important to note that staph bacteria are very common.We all have them on our skin and inside our noses. Usually they are harmless, but if they gain access to the bloodstream or deeper tissue, they can cause a serious infection.

For TSS to occur, certain strains of the bacteria have to overpopulate and produce large amounts of toxin. This toxin then has to gain access to the bloodstream. One generally accepted theory is that super-absorbent tampons that are left in the vagina for extended periods of time can encourage growth of the bacteria. And importantly, these super-absorbent tampons can also adhere to the vaginal wall if they are dry and the menstrual flow is light, thereby causing tiny abrasions when removed. These abrasions then provide access to deeper tissue or to the bloodstream for the bacteria and toxins.

How can my daughter choose the right tampon?

The type of tampon that is right for your daughter depends on her menstrual flow. Simply stated, she should match the absorbency of the tampon to her flow. If she has a light flow, then she should try the junior or regular tampon. If her tampon is completely soaked before 4 hours, she should try one with higher absorbency.

However, you should caution your daughter that if a tampon is too absorbent for her flow, vaginal dryness and even vaginal ulcerations can occur. If a tampon is dry and hard to remove, shreds, or doesn’t need to be changed for many hours, she should switch to a less absorbent tampon. Why is this important? Because research suggests that the risk of Toxic Shock Syndrome may increase with tampon absorbency. However, please note this doesn’t mean your daughter should shy away from using higher absorbency tampons if she really needs them.