Painful Tampon Insertion—Reasons Why It Hurts

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When your period arrives, there are several options for hygiene products. For example, you might use pads, menstrual cups, period underwear, tampons, or a combination of products.

If your go-to choice is tampons, and you've become familiar with using them, you may become worried if it hurts to insert one. Here are some possible reasons why you might experience pain or discomfort when using tampons.

Painful Tampon Insertion From Dryness

Sometimes, it's slightly painful to insert or remove a tampon simply because your vagina is dry. One possible reason for dryness is that your flow may be very light.

The American College of Obstetricians and Gynecologists (ACOG) also explained a decrease in estrogen is often the cause of vaginal dryness. A decrease in estrogen can happen during menopause, while nursing or pumping milk for a child, during cancer treatment, or if you take medications that lower your estrogen levels.

Using a lubricant can help relieve the dryness and make it easier for the applicator to slide in.

Your Pelvic Muscles May Be Tense

Your pelvic muscles may not be relaxed enough while you put the tampon in or pull it out. See if it helps to take a deep breath and then completely release your pelvic muscles before you attempt to remove or insert the tampon.

Additionally, although it's uncommon, some individuals have a condition known as vaginismus—per MedlinePlus—which makes the muscles of the vaginal canal tense up. Individuals with this condition may feel a tearing or burning sensation if anything is inserted.

A 2021 study published in the journal Sexual Medicine explored the various treatment options available for those with vaginismus. The study looked specifically at the grade or severity of vaginismus and the length and success rate of various treatment options.

Treatments for this condition may include, but are not limited to, various forms of cognitive therapy, relaxation exercises, hypnotherapy, and pelvic floor physical therapy.

You May Be Dealing With Vulvodynia

If you would describe the pain as more of a stinging when you put a tampon in, it could be a sign of vulvodynia, a pain disorder that affects the vulva. According to MedlinePlus, this would be considered localized vulvodynia, where the pain comes from pressure in one part of the vulva due to situations such as inserting a tampon, having sexual intercourse, or sitting too long.

Per MedlinePlus, treatment varies from individual to individual. Some find relief by using a cold pack or taking a low-dose antidepressant. Switching to cotton menstrual products and underwear may also help relieve symptoms.

Painful Tampon Insertion From Vaginal Cysts

If you're having trouble getting a tampon in at all, there's also a possibility that you have a cyst—a small sac typically filled with fluid either on or in the vaginal lining. A cyst can form if the vaginal wall is injured during childbirth, surgery, or due to a bacterial infection, as noted by MedlinePlus.

Many vaginal cysts do not cause symptoms. If the cyst is small and isn't really bothering you (aside from obstructing your tampon insertion a bit), you probably don't need to treat it. Some vaginal cysts go away on their own.

However, if the cyst is growing in size or causing pain, it may require medical treatment. For example, the cyst could be infected and may need to be surgically removed or drained. Bartholin gland cysts are an example of a type of cyst that may return and cause pain. They may require ongoing treatment.

Additional Causes of Pain

Other causes of vaginal pain could also cause you to experience pain with tampon use. Vaginitis (the term used for any vaginal inflammation) might be one contributor. Possible causes of vaginitis include bacteria, yeast, viruses, and other causes such as fluctuations in hormones.

A Quick Review

Because the cause is not always immediately clear, you may want to stop using tampons if it's uncomfortable and reach out to a healthcare provider. If the cause is infectious (such as from a bacterial or viral infection), the infection can travel to your cervix, causing a painful condition known as cervicitis.

A healthcare provider can perform a pelvic exam, help you determine the cause of your pain, and work with you to come up with a treatment plan.

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  1. American College of Obstetricians and Gynecologists. Experiencing vaginal dryness? Here's what you need to know.

  2. MedlinePlus. Vaginismus.

  3. Kiremitli S, Kiremitli T. Examination of treatment duration, treatment success and obstetric results according to the vaginismus gradesSex Med. 2021;9(5):100407. doi:10.1016/j.esxm.2021.100407

  4. MedlinePlus. Vulvodynia.

  5. MedlinePlus. Vaginal cysts.

  6. MedlinePlus. Vaginitis.

  7. MedlinePlus. Cervicitis.

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