If tampons block menstrual flow and keep blood in the vagina, they ask, won’t the tampon help push some of the blood back into die uterus?

What about the chance for infection? Aren’t tampons actually an unsanitary way to manage menstrual flow? They remember the scare years ago from toxic shock syndrome and its connection to tampons.

Finally, they might add, “I know something is wrong because sometimes my body seems to expel a portion of the tampon naturally. Isn’t this an indication that I might be doing something harmful to my health? Aren’t pads the safer choice?”

These issues have all been scrutinized by gynecologists and clinicians studying every subtlety involved in endometriosis. One such study, conducted by Karen Lamb. Ph.D., and Nancy Berg at the Medical College of Wisconsin, investigated the tampon-endometriosis connection with nearly five hundred respondents who were members of the Endometriosis Association and sufferers of the disease. The study resulted in a number of conclusions. Among the most significant of them are these: tampon usage for women with endometriosis was not greater than rates for the general population, and, as yet, there is no clue to the role tampons play, if any, in the disease.

The cardboard-encased tampon was invented in 1933 by an ingenious Colorado physician. Tampax Incorporated, which bought the patent three years later, popularized the product almost single-handedly over the next thirty years or so. Other companies then entered the tampon market, introducing their own version of the original. Although today Sanitary napkins outsell tampons by a small margin, to some women, tampons have the benefits of contained blood flow, comfort, and invisibility.

The tampon as we know it has not come this far without its own brand of controversy. The subject of some moral and scientific debate until the mid-1960s, the tampon triumphantly held its position as a safe and reliable women’s hygiene product. Then in 1980 a sudden wave of toxic shock syndrome (TSS) mistakenly focused on tampons as the cause of this illness. One fact used for validation was that the illness seemed to strike white women, many of whom were menstruating at the time, and most of whom were using tampons.

Researchers into toxic shock syndrome, however, postulate one link between menstruation, tampons, and the illness. “Supctabsorbent” tampons, most notably, expand to creat a pluglike effect, thereby trapping excess menstrual blood in a pool in the vagina. This pool of Wood in combination with the blood-soaked tampon may in some cases create an airtight culture medium. In such an environment, bacteria might flourish and the toxin may develop. Another variable was found by researchers; tampons left in the vagina for periods of time greater than the four or five hours recommended (for example, those worn overnight) might cause abrasions, irritations, or sores in the vagina thereby encouraging bacterial growth.

It is became tampons can stop the flow of menstrual blood out of the body that endometriosis sufferers bring up their first worry; couldn’t a tampon somehow create enough mechanical pressure to flush blood back into the uterus? The answer is no! Once menstrual blood has passed through the cervix and enters the Vagina, it will only leave the body. Since a tampon is placed in the lower part of the vagina, it does not block the blood’s exit from the cervix.

What of the feeling that the body expels tampons because they arc unnatural devices? If endometriosis sufferers find that a tampon dislodges itself and moves down the vagina the reason is tied to uterine contractions and menstrual cramps, not to “intuitive” biological knowledge, women with endometriosis almost always have menstrual cramps, and these cramps exist in differing degrees of intensity: In fact, uterine contractions can even be measured on a scale. For example, the average force required to drive a baby out through the cervix is 50 millimeter mercury. The low end of the scale is 10 millimeter mercury. The force of severe menstrual cramps has been measured at 100 millimeter mercury. This gives you a good sense not only of the pain a woman will feel but of why a tampon would move down the vagina.

The wisest use of tampons is to change them every four or five hours, which gives the vagina a chance to cleanse itself; and to wear sanitary napkins overnight. Until further research is completed, 100 percent cotton tampons should be used, instead of those with synthetic fibers or deodorants.

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Denial

Some women cannot accept that they have a disease. They will not accept the fact that it may cause infertility, may interrupt their lives, relationships and careers. They believe that if they ignore it the symptoms and disease will just go away. They turn a blind eye to it all and bury their head in the sand.

Confusion

For others, the relief of finally knowing what is wrong is clouded by fear and confusion, particularly if they have never heard of endometriosis or know only a little about the disease.

Many women are told the best ‘cure’ is to have a baby. For teenagers, those not in a relationship, or those who had decided not to have children, this can be a confusing and annoying ‘solution’.

It is normal to want to know the answers to several questions. The most common questions are:

What causes endometriosis

Can I have children

What treatment is available

Will the treatment I choose get rid of the pain

Can I be cured

Is it hereditary

Is it a sexually transmitted disease

Where do I go from here.

The more accurate information and support that you receive soon after you have been diagnosed, the less likely you will be confused and unsure of the next steps in dealing with this disease.

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For the next year I tried to put up with the pain because I was sure the doctors would tell me it was ‘all in my head’. After another bout of severe pain my GP referred me to another specialist who ordered a barium enema. He said that I had an irritable bowel and to eat more fibre. Unfortunately, this made no difference to the pain. My GP then thought that perhaps I was suffering from pelvic inflammatory disease — a course of antibiotics made no difference. My mother wasn’t happy with the doctor’s explanations and so took me to another GP who immediately suspected I may have endometriosis even though I was only 17 years old. He sent me to a gynaecologist who immediately performed a laparoscopy and diagnosed endometriosis.

During the laparoscopy the gynaecologist ‘burnt off’ all the endometrial deposits that he could find. He explained to me that because there could still be microscopic endometrial deposits in the pelvis, I was to take Provera 30 milligrams a day for nine months. I am now pain free and have just finished the course of tablets. I am looking forward to starting university next year and enjoying life.

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To maintain this balance, your body works in a similar way to the thermostat on a central heating system. Just as the thermostat clicks into action as temperatures rise or fall, so your natural ‘thermostat’ clicks into action as glucose levels rise and fall. When your ‘thermostat’ recognizes that there is too much or too little, your body takes action:

•     When the glucose level falls too low adrenalin is released by the adrenal glands and glucagon is produced by the pancreas. Glucagon works in the opposite way to insulin and increases blood glucose by encouraging the liver to turn some of its glycogen stores into glucose to give us quick energy.

•     If the blood glucose level stays low for a period of time, hypoglycemia – low blood sugar – can occur. Symptoms include irritability, aggressive outbursts, palpitations, forgetfulness, lack of sex drive, crying spells, dizziness, fears and anxiety, confusion, inability to concentrate, fatigue, insomnia, headaches, muscle cramps, excessive sweating and excessive thirst.

•     Alternatively, when the glucose level rises too high, insulin is produced by the pancreas to lower it. If the blood sugar level remains too high, this causes the symptoms of hyperglycemia – high blood sugar level. The extreme form of this is diabetes. With this condition, insulin is supplied from outside the body by injection to bring the level down. The greater your weight, the higher your risk of developing diabetes. Obese people have a 77 times higher chance of developing it.

During a normal day, the amount by which your blood sugar level rises and falls depends on two main factors: what and when you eat or drink.

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