**Please note that the following should not replace medical advice. If you are having issues with painful insertion please seek out a health care professional for an assessment as there are many reasons why you may be experiencing pain.**
A lot of us can remember the first time we tried to insert a tampon. For many of us it was a relatively uneventful milestone, however for many women the thought of inserting a tampon is filled with stress, anxiety and a sense of failure. There are many reasons why it may be difficult to insert a tampon and as stated above it is important to be assessed by a medical professional to rule out any red flags or medical concerns before continuing on.
In clinic, I see a lot of women who feel like they are "hitting a wall" whenever they try and insert something vaginally. Many times this can be due to an increase in tone of the pelvic floor muscles. I have compiled some tips and tricks to help decrease discomfort and pain when inserting tampons:
1. The type of applicator:
For my patients that have pain with any type of insertion, I recommend using a plastic applicator (sorry environment!!) vs cardboard. This material glides along the vaginal wall easier and helps the tampon slide in with ease.
2. Size of the tampon:
In this case.. size does matter! I recommend buying a variety pack of tampons that contains different sizes so you can have a choice of what level of absorbency you want to use depending on your flow.
When first starting to use tampons, I recommend using the smallest size to make sure there is no discomfort on insertion. I also recommend using the “light days” size when you are at the beginning or tail end of your period when your flow is lighter.
I recommend using a small amount of water-based lubricant if you feel as though the vaginal tissue is more dry and the applicator is not gliding well. Dryness is common during the book ends of your period (beginning and towards the end) so using a small amount of lubricant will make it much easier to insert the applicator. Mid way through your period, when your flow is more heavy, a lubricant may not be needed as your body is producing enough lubrication on its own. If you are breastfeeding you may notice more dryness than usual so a lubricant is recommended during this time not only for tampon insertion but also during intercourse.
4. Situate your lady bits:
Before trying to insert a tampon wash your hands and gently move the inner labia out of the way. If your labia minora are a bit longer and reach past the labia majora, guess what? This is totally normal! It is worth noting though that the labia minora can be sensitive and if not moved out of the way you can feel some discomfort as you try and insert.
5. Deep breathing:
I have my patients master diaphragmatic breathing to help relax the pelvic floor. I get them to practice this outside of trying to insert a tampon so they can relax their muscles on a more regular basis as well. When a patient inhales through their nose and directs the air into their belly and to the bottom of their rib cage the diaphragm descends down and acts like a piston toward the pelvic floor to help relax it. On the exhale the pelvic floor naturally recoils back in. When inserting a tampon, in theory, as you inhale it should be easier to insert the tampon as the pelvic floor is more relaxed. I have found however in practice that some patients find it easy to insert on the exhale as the tampon feels like it is being drawn in. I always get patients to try both!
I recommend women with pain to first try and insert the tampon lying down in bed if they can. Prop some pillows behind your head to put you in a semi reclined position but still relaxed. You shouldn’t feel any strain through the abdominal muscles. This way they you can be more relaxed and the tampon is then easier to insert. When using this position in conjunction with the deep breathing techniques mentioned in number 5, it can sometimes be easier to insert a tampon this way instead of sitting on the toilet starting off.
When inserting the tampon many women feel like they cannot push the tampon any deeper when only the tip is in. This can be a couple of different things. It can be muscle tension or it can just be the angle that you are inserting. Instead of inserting the applicator perpendicular to the opening, try and slide the applicator along the back wall angling it toward the base of the spine.
I hope you enjoyed this first blog post and that these tips make using a tampon a breeze!