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On Aug. 18, 2011, a thread titled “I design tampons. AMA!” appeared on the news-conversation website Reddit. Hosted by a user named “karnim” who identified himself only as a college-aged male research-and-development intern at one of the “big three” tampon brands (Tampax, Kotex, and Playtex), the thread began with a polite invitation to “ask me anything” (AMA) and a disclaimer. “Much of my work is confidential, so I can't give details about my projects,” karnim wrote, but he could answer “overall” questions about tampons. In the grander canon of AMA threads—online Q&A sessions hosted by Reddit users with compelling life stories or careers—karnim’s wasn’t the most glamorous or flashy. President Obama, for example, participated in an AMA in 2012. But karnim soon found himself avalanched with reader questions about tampon technology, ranging from the curious (“Why don't they just stop making the cardboard ones?”) to the wisecracking (“Can you make medicated tampons to make women stop actin’ fool when they get their menses?”) to the imploring (“Can you please make tampons with a black or flesh-coloured string? Please?” “How about one that you can leave in for 10 hours and not worry about it?”).

Ten hours later, karnim ended his IAmA, exhausted. “Sorry y'all, but it's been 10 hours, and the questions just keep coming. I need a break.” ​* * * The lowly, mighty, mysterious, depended-upon, despised tampon: common enough to be sold in drugstores and public restrooms all over America, integral enough to the female experience to merit its own memorable jeremiad in The Vagina Monologues (“a wad of dry fucking cotton”), and yet still taboo enough to be the central prop in one of the only Fifty Shades of Grey sex scenes deemed too risqué for the movie adaptation. The average American woman is estimated to use more than 16,000 tampons in her lifetime—and yet, as that daylong AMA suggests, they remain surprisingly mystifying. The tampon is still taboo enough to be the central prop in one of the only Fifty Shades of Grey scenes deemed too risqué for the movie adaptation. But every time a tampon user pops in a Playtex Sport or a Tampax Pearl, she’s handling a disposable, absorbent totem of centuries of technological innovation and cultural influence. The commercial tampon as we know it has been shaped and re-shaped by a myriad of invisible forces—like genuine concern for women’s wellness, certainly, but also sexism, panic, feminism, capitalism, and secrecy. * * * There are differing accounts of the whens, wheres, and hows of the earliest tampon-like devices. Women in ancient Rome, it’s been said, fashioned their own tampons out of wool; Indonesian women are believed to have used vegetable fibers to staunch menstrual flow, while rolls of grass are said to have been used in parts of Africa. According to Nancy Friedman’s 1981 book Everything You Must Know About Tampons, Hawaiian women undertook the (presumably itchy) endeavor of using “the furry part of a native fern,” and ancient Japanese women, according to Qualifying Times: Points of Change in U.S. Women's Sport author Jaime Schultz, made tampons from paper, secured them with bandages, and changed these dressings between 10 and 12 times every day.

Some of the earliest tampons recognizable as we know them today—intra-vaginal devices made from a string and a wad of something absorbent—were documented in Europe in the 18th and 19th century. Curiously, these were more often used for purposes other than menstrual management. In some places, tampons were used as contraceptives, and Schultz cites a 1776 report from a French doctor that describes a tampon made from tightly rolled, vinegar-soaked linen that was used to stem the flow of hemorrhage and leucorrhea (non-menstrual vaginal discharge). In the late 19th century, the accomplished U.S. gynecologist Paul F. Munde’s 552-page oeuvre “Minor surgical gynecology: a treatise of uterine diagnosis” described eight distinct uses for the vaginal tampon, the first of which was as “a carrier for the application of medicinal agents to the cervix and vagina.” Only on item eight—after uses like retaining the shape of the cervix to prevent a relapse of a prolapsed ovary—was the absorption of “vaginal and uterine discharges” even mentioned, and nowhere in his section on tampons is menstruation mentioned specifically. In 1879, around the same time commercial menstrual pads were arriving in Western markets for the first time, the British Medical Journal published a report on “Dr. Aveling’s Vaginal Tampon-Tube” in its section on the latest innovations in medicine. It described an applicator contraption that today seems alarmingly complex, complete with a “small unsilvered glass vaginal speculum, with a wooden rod.”

The “kite-tail” tampon that went inside the applicator was made “by tying three or four pledges of cotton-wool in a row with a piece of fine string or stout thread,” which were then saturated with glycerine (!) and smushed into the beveled end of the speculum, using the wooden rod. Then: This is then to be gently inserted into the vagina, until it reaches the neck of the womb, when the tube may be withdrawn over the rod which is retained to hold the tampon in its place. Lastly, the rod is withdrawn. BMJ It’s unclear whether the tampon-tube was primarily intended for use by doctors (or midwives), or by women themselves: The BMJ took care to note that “in cases of erosion or congestion, this little operation can generally be managed by the patient,” but “in cases of uterine displacement, further adjustment by the medical man will be necessary.” There’s not much known about whether women of this era bought products like Dr. Aveling’s Tampon-Tube for at-home use, or whether they used them for managing their periods. But around the turn of the century, it seems tampons were still—in medical circles, at least—best known as devices for treatment or non-menstrual absorption within the vagina. A 1900 entry in the British edition of the Nurse's Dictionary of Medical Terms and Nursing Treatment Compiled for the Use of Nurses, unearthed by the Museum of Menstruation website, defined “tampons” as plugs of antiseptic wool enclosed in gauze, and used for introducing into the vagina, &c. Sometimes a capsule containing carbolic, thymol, &c., is enclosed in the middle of the tampon, and is broken just before use, so that the antiseptic permeates the whole plug. A string is usually attached to the plug to aid in its withdrawal. “Tampons can be bought,” the entry continued, “but in hospitals are generally made by the nurses.”

Of course, that was about to change. * * * Legend has it, Schultz writes in Qualifying Times, that in the early 1920s, a Kimberly-Clark employee named John Williamson poked some holes in a condom, stuffed it with the fluffy, absorbent filling used in commercial Kotex pads, and pitched it to his dad, a Kimberly-Clark medical consultant, as a menstrual solution. “Never would I put any such strange article inside a woman!” the elder Williamson is said to have exclaimed, thus swiftly shooting down what might have been the origin story of the modern commercial menstrual tampon. Related Story Don't Let Them See Your Tampons But the tampon would get its creation myth nonetheless, though about a decade later. As Tampax tells it, a Colorado-based general practitioner named Earle Cleveland Haas introduced the first commercial applicator tampon. A friend of Haas’s mentioned to him that she had taken to wearing a piece of sponge intra-vaginally to absorb menstrual flow. Thinking of his wife (by some accounts a ballerina) and her struggles with the bulky menstrual pads of that era, Haas developed a variation made of compressed cotton. And because Haas wanted to ensure that the tampon could be inserted and removed without having to be touched directly, he designed an applicator from telescoping paper tubes. Haas obtained a patent in 1933, and combining the terms “tampon” and “vaginal packs,” he called his product Tampax.

Tampax arrived on shelves in the mid-1930s—and was one of the great game-changers in 20th-century periods. “For many people, there was a lot of discomfort with the idea of women touching themselves in any way in their vaginal or labia area, especially young girls,” says Sharra Vostral, the author of Under Wraps: A History of Menstrual Hygiene Technology. “A lot of people argued that [tampon use] was not only inappropriate because it might break the hymen, but it might be also pleasurable and might be a way for girls to experience orgasmic pleasure.” Tampax’s telescoping applicator made it possible to insert a tampon without the dreaded self-touching—though it didn’t do much to assuage fears of accidental virginity loss, which, despite evidence that the hymen doesn’t necessarily break as a result of sex or tampon use, still persist in some parts of the world today. Earle C. Haas / USPTO Especially in the United States, the spike in women’s physical activity during World War II made tampons a staple of the American menstrual period. Tampax, available for 35 cents and often delivered by mail, came in discreet, plain paper-wrapped boxes of 10, and it had imitators within a year of its debut. The Tampax model didn’t immediately eclipse other tampon designs. In 1942, Schultz writes, a survey found that 37 percent of tampon users still used homemade remedies, like strips of doctor’s-office cotton or cut-up store-bought sponges. Frequently, these DIY solutions were employed by women with active lifestyles (like dancers) and, as Friedman points out, women in “dubious professions” of the era like acting, modeling, prostitution—and sports. But in 1945, the magazine Consumer Reports noted that while tampons still were only a fraction as popular as pads, “there can be no question about [the tampon’s] rapid growth, as more women take advantage of the greater comfort of internally worn protection.” Indeed, sales of tampons had increased by five times from 1937 to 1943. One survey taken in 1940 and 1944 found approximately one-quarter of women regularly used them.

Shortly after, in 1945, The Journal of the American Medical Association published its first substantial research on tampons. Some of the newly popular applicator tampons were made of absorbent cotton, explained the study author Robert L. Dickinson, while one was made from cotton linters, and one was crepe paper held together with a net of threads. All had a strand of waterproof string and “a light inserter for placement at any depth by means of a cardboard tube.” In Germany, around the same time, the gynecologist Judith Esser-Mittag was developing a digital (that is to say, non-applicator) tampon that would come to be called the O.B. tampon—and it would go on to enjoy massive popularity in many parts of the world. Even as scientific research on tampons began in earnest, Friedman explains that “medical opinion was divided on tampons, with ‘forward-thinking’ physicians recommending them wholeheartedly while more conservative doctors waxed eloquent in condemning them.” Dickinson also found that tampon usage was most common among young, educated women; “the higher the income bracket the greater being the employment of the tampon,” he wrote. (It’s been noted, however, that Dickinson also wrote training materials for Tampax. Much of the existing research on tampon safety was sponsored and published by feminine-hygiene product manufacturers themselves—a notable asterisk on the medical information on tampons from that era.)

* * * In the years following, companies continued to tweak their products in hopes of further simplifying the modern menstrual period. New innovations like Kotex’s Kotams Stick—a hybrid between a digital and applicator tampon that looked something like a tampon on the end of a lollipop stick—emerged in the 1960s, and 1970 brought the advent of a tampon with two withdrawal strings. Many of the new products seemed to emphasize the secrecy they could offer a woman on her period. For example, popular brands of tampons in the 1940s had included Lillettes, Meds, Pursettes, and digital Kotex tampons called Fibs; as Schultz points out, “The names are telling in that they emphasize that the products are feminine and diminutive, of medical origins, or allow women a ‘little white lie’ that conceals menstruation.” Dickinson noted in the 1945 JAMA study that yet another method of period concealment had started to show up on store shelves: tampons with fragrances. Playtex later adopted that same strategy, marketing “deodorant” tampons with what was advertised as a “fresh, delicate scent” starting in 1971. To some women, the notion of “deodorant” tampons seemed too far a stretch. Friedman wrote that some women developed allergic reactions to the fragrances—and besides, as she pointed out, “Menstrual fluid has no odor until it’s exposed to air, which doesn’t happen with any tampon until it’s removed.” Alternative products—like the Tassaway, a disposable menstrual cup introduced in 1970—entered the market, and as the University of Massachusetts Boston professor Chris Bobel noted in an article for Health Care for Women International, a small feminist movement had begun to publicly question why women should feel pressured to hide or staunch their menstruation in the first place. What was so shocking or gross or shameful, after all, about something that happened to half the world’s adult population every month? Related Story There Has to Be a Better Way to Sell Tampons Still, tampons continued to flourish—even the deodorant ones, despite growing allergy-related concerns from physicians. And by the time Playtex introduced the plastic, dome-tipped applicator in 1973, the tampon was a common technology—according to Vostral, it was included in more than 70 percent of U.S. women’s hygiene routines.

* * * But the momentum was about to carry the tampon industry too far. In 1975, Procter & Gamble began test marketing its first feminine-hygiene product—a distinctive, futuristic new tampon called Rely. Rely was shaped like a tea bag, engineered to expand both widthwise and lengthwise, and made of entirely synthetic materials. One of these was carboxymethylcellulose, or CMC—an edible, hydrophilic ingredient used in manufactured products from ice cream to detergent. Chips of CMC inside the tampon made it hyper-absorbent; some women, it’s been said, could wear it for an entire period. It’s startling, in hindsight, that Rely made it into consumers’ hands, let alone their vaginas. Perhaps U.S. manufacturers should have sensed something was amiss when regulators in Japan forbade the import and sale of Rely tampons because of its chemical composition, as Vostral and the New York University microbiologist Philip Tierno note. And in 1976, new legislation in Congress imposed stricter regulations on American-made tampons by switching their categorization under the Food, Drug, and Cosmetic Act from cosmetics to medical devices. But because Rely had been testing a small sample of products before the law changed, the Rely tampon escaped what Vostral describes as “a whole new battery of tests” before arriving in stores. (Ironically, as Friedman notes, the year after tampons were reclassified from the “cosmetics” category of FDA regulation to “medical devices,” new legislation began requiring cosmetics manufacturers to list ingredients on their packaging—but not medical devices. To this day, a tube of mascara or a bottle of shampoo has to come with a list of ingredients, but not a box of tampons.)

So Rely made it to the markets—and initially, it was a sensation. “Rely was pretty fantastic, actually,” Vostral says. “Some women, especially if they had heavy periods, thought it was a great product.” She adds, though, that the Rely tampon could absorb so much fluid that it looked “kind of mushroom-like” when it was removed after use. Some women—particularly young women who had never given birth—found Rely tampons to be painful to remove “because they would absorb so much that they would stick to the vaginal walls.” To this day, a tube of mascara or a bottle of shampoo has to come with a list of ingredients, but not a box of tampons. In 1978, faint alarm bells began to sound. The Berkeley Women’s Health Collective accused manufacturers of withholding information about the substances used in tampons even after repeated requests for a list of ingredients. Circulating their grievances via pamphlet, the collective also blamed manufacturers for ignoring the risks of shredded fibers being left behind inside the body and over-drying of the vagina. Nevertheless, Tierno estimates that by 1980, nearly a quarter of tampon users were using Rely. Competitors had rapidly introduced their own hyper-absorbent, synthetic tampons; by mid-1980, Tierno says, “there was not one tampon manufacturer on the market with a product that did not contain [synthetic ingredients],” and Friedman points out that almost every tampon for sale at the time contained some sort of “modified superabsorbent cellulose.”

Then, between October of 1979 and May of 1980, 55 cases of toxic-shock syndrome were reported to the Centers for Disease Control and Prevention—seven of them fatal. TSS, a rare staphylococcal illness characterized by vomiting, diarrhea, fever, and rashes, had been identified just two years earlier after a minor outbreak in Denver, Colorado. When young, menstruating women began exhibiting some of the same symptoms as the Denver patients, many people began to suspect a link between tampon use and TSS. Related Story Why No One Can Design a Better Speculum In July of 1980, CDC investigators issued a report linking tampons to TSS. That September, its study of TSS cases in Minnesota, Wisconsin, and Iowa found that the absorbency of the tampon and the use of Rely tampons specifically “were the only variables that significantly increased the relative risk of TSS.” Tierno adds that three-quarters of the women who reported tampon-related TSS were found to be using Rely tampons specifically. P&G, after a tense standoff with the Food and Drug Administration, withdrew Rely from shelves just weeks after the CDC’s September report. In 1980, a total of 812 menstruation-related TSS cases were reported—38 fatal. Every major manufacturer of tampons at the time faced lawsuits. But P&G faced more than a thousand. In 1982, the family of Patricia Kehm, a 25-year-old who had died of TSS while using Rely, successfully sued P&G for $300,000 in nonpunitive damages. “Pat Kehm died because Procter & Gamble let her die,” the plaintiff’s attorney, Tom Riley, said in his final remarks. “They were more concerned about their product than warning their customers.” (Proctor & Gamble did not respond to requests for comment.)

By June of 1983, more than 2,200 total cases of TSS had been reported to the CDC. More than 80 percent were menstruating women using tampons. * * * It took years after the outbreak for scientists to figure out how tampons caused TSS. In 1989, Tierno, along with Bruce Hanna, published research that found a link between synthetic materials—specifically CMC, polyester, polyacrylate rayon, and viscose rayon—and toxic-shock syndrome. The synthetic ingredients, they wrote, provided a fertile environment for the amplification of the toxigenic bacterium Staphylococcus aureus, causing disease. In other words, Rely and other tampons made with synthetics were “kind of like a petri dish,” Vostral explains. “When a woman would change Rely, it would squeeze some of the bacteria into the vagina, then you’d put in another tampon and it just provided a whole new set of food.” Fortunately, only a small portion of women have TSST-1, the particular strain of Staphylococcus aureus that causes toxic shock, in their vaginas—a 2005 Journal of Clinical Microbiology study of North American women between 13 and 40 found 1 percent of its subjects carried TSST-1 vaginally. “Fifteen to 20 percent of women can carry staph aureus—maybe even 25 percent carry staph aureus, and that’s not necessarily toxigenic,” Tierno explains. Less than three percent of staph aureus strains are toxigenic with TSST-1. (Younger women who carry this particular bacteria in their vaginal cavities are more susceptible to TSS because their immune systems aren’t as developed, which is why many cases of tampon-related TSS occur among teenagers and young women.)

As Karen Houppert noted in a 1995 Village Voice exposé on the feminine-hygiene industry, once scientists discovered that the bacteria necessary to cause TSS lived in only a small percentage of women’s bodies (and was usually dormant), the scare seemed to be over—so, according to Houppert, “the FDA relaxed.” The government “left further research on causes and effects of toxic shock syndrome to tampon manufacturers,” she wrote, “and the industry continued to escape any serious regulation.” * * * In 1983, tampons went to space. When Sally Ride became the first American woman in space, NASA engineers asked her whether 100 tampons would be enough for her weeklong journey on the space shuttle Challenger—arguably helping cement the tampon’s reputation as both a fixture of modern womanhood and a complete mystery to men. (The first tampons in space, The American Prospect notes, “were packed with their strings connecting them, like a strip of sausages, so they wouldn’t float away.”) Perhaps this feat contributed to a 1986 Consumer Reports article naming the tampon, despite its recent, gruesome spate of bad publicity, one of the “50 small wonders and big deals that revolutionized the lives of consumers”—right alongside air conditioning and running shoes. When Sally Ride became the first American woman in space, NASA engineers asked her whether 100 tampons would be enough for a weeklong journey. Back on Earth, meanwhile, tampons were evolving: Toxic-shock warning labels were added to tampon boxes to recommend using the minimum absorbency needed, and in late 1989, after a decade-long campaign effort (in which advocacy and feminist health groups like Public Citizen and Women’s Health International were instrumental), the FDA ordered tampon manufacturers to implement a standardized system of “junior,” “regular,” “super,” and “super-plus” absorbency ratings, on a scale from six to 15 grams’ absorbency. (At the height of the TSS scare, more than 40 percent of women were using tampons with absorbencies of 15.4 grams or more.) To this end, the FDA implemented a fascinating contraption called a “syngyna,” which simulated all the physical conditions of tampon use, as the industry’s standard method of testing tampon absorbency. But the most dramatic changes to the post-TSS tampon were virtually invisible to consumers.

Tierno recalls writing a letter in 1980 to the CDC, the FDA, and P&G identifying four popular tampon ingredients that could amplify bacteria growth: carboxymethylcellulose, polyester, polyacrylate rayon, and viscose rayon. At the time, “of course, I was laughed at,” he says—and Tierno’s research, it’s worth noting, has remained controversial, especially among tampon manufacturers and scientists they sponsor. But according to Tierno (and the CDC), manufacturers abandoned the use of CMC and polyester after Rely was pulled from shelves, and tampons containing polyacrylates were withdrawn from markets in 1985. (Tampax, Friedman notes, even revived a line of all-cotton tampons it had discontinued in 1978.) Viscose rayon is still commonly used in tampons; a representative for Kotex confirmed to me that viscose rayon is the only one of these ingredients still in use in its products. (Representatives for Procter & Gamble, now the owner of Tampax, did not respond to requests for comment on their ingredients, and Playtex declined to comment on theirs.) While the tampon had been cylindrical for more than a century, the human vagina is not. After Rely, consumers began to realize just how little they knew about what was actually in tampons. In 1981, Friedman’s book pointed out that, at the time of publication, only Playtex listed its basic ingredients in its packaging, and it didn’t specify whether fibers had been bleached or chemically modified to enhance absorbency. Several groups, like the Boston Women’s Health Book Collective (the publishers of Our Bodies, Ourselves) and Women’s Health International pushed for manufacturers to reveal full lists of tampons’ ingredients. None of these groups were successful.

The CDC has stopped actively tracking the TSS epidemic, but a report from 1996 shows a dramatic decrease in reported menstrual cases of TSS after the mid-1980s. In fact, according to the CDC, no U.S. women died of tampon-related TSS at all in 1988 or 1989. Still, between 1987 and 1996, 636 cases of menstrual TSS were reported, 51 of them fatal. * * * In 1997, Procter & Gamble acquired Tampax’s parent company, Tambrands—and its feminine-hygiene division promptly got to work on designing a new and improved tampon. Jim Keighley, a section head of engineering at P&G at the time, remembers that the new product was to have a “premium applicator” (that is, a plastic applicator), so that P&G’s newly acquired Tampax brand could move away from the “tampon my mother uses” reputation its cardboard applicator was earning it. And, importantly, the product that would come to be called Tampax Pearl was to have nothing in common with the ill-fated Rely experiment. “We were very intentional about completely starting over,” recalls Keighley, who worked in the Tampax division of P&G until 2007. “We did not want Pearl to be Rely II.” Related Story The AIDS-Fighting Tampon And with good reason. Research by the Association of Schools of Public Health indicates that by 1990, information about TSS had caused “a significant decrease in use of tampons in all racial-ethnic groups.” In the ASPH’s survey of current or past tampon users, more than 40 percent reported that their use of tampons had decreased after learning about TSS—and in a larger survey, just over half of the women reported using pads exclusively. But throughout the industry, the new urgency of developing a better tampon—and, undoubtedly, the heightened scrutiny—resulted in a number of breakthrough discoveries. Among them: While the tampon had been cylindrical for more than a century, the human vagina is not.

Developers at Tampax studied wax molds of real women’s vaginal cavities (“I was never really quite clear on how they did that,” Keighley remembers, “but they did get some people to agree to do it”) and had what he describes as an “a-ha!” moment. “Intuitively, we all think that cavity is round,” he explains. And it is—but only at the vaginal opening. The cavity widens and flattens the farther up you go—it’s “more the shape of a mummy sleeping bag,” Keighley explains, “and that’s because of the weight of the internal organs around it.” Users of applicator tampons, P&G’s team found, tended to insert tampons deeper into the cavity than users of digital tampons. Radical re-engineering ensued. Today, while digital tampons like O.B. are cylindrical when they expand, some applicator tampons expand into blossom or upside-down umbrella shapes, while others, like Tampax, expand into shapes reminiscent of stingrays or kites. Keighley’s team at Tampax also tried a number of methods to improve the withdrawal cord of tampons. At first, “We could come up with stuff that worked, but we couldn’t come up with stuff that looked good,” he admits. Finally, though, Tampax settled on the Pearl’s vaunted leakguard braid—made of a yarn-like substance to enhance its wicking ability and sewn into the tampon for maximum security and comfort upon removal. Tampax Pearl was a hit when it went on sale in 2001—especially with young women. “My sons were teenagers back then,” Keighley remembers. “They would bring girlfriends home to the house, and if they found out I made Pearl, they would say, ‘Oh, I love Pearl!’ My sons would just go nuts.”

* * * Of course, not everybody fell back in love with tampons. A feminist backlash against tampons had a moment in the late 1990s, as Houppert’s widely read Village Voice exposé and subsequent book The Curse—Confronting the Last Unmentionable Taboo: Menstruation called out the industry for selling tampons containing dioxin, a “likely carcinogen” found in bleached rayon, and a 2006 article by Bobel in the research journal Sex Roles describes a group of young activists called the Student Environmental Action Coalition starting a “Dioxin Out of Tampons” campaign in 1999. In 2000, James Madison University hosted the first Anti-Tampon conference. In the late 1990s, major commercial tampon brands switched from dioxin-producing chlorine gas bleaching methods to either elemental “chlorine-free” or “totally chlorine free” bleaching processes—which, it’s worth noting, don’t necessarily eliminate dioxin so much as diminish its presence to trace levels. (Even trace levels of dioxin remain controversial; the FDA recommends that manufacturers list any possible chemical residue on their labeling, but says trace amounts of dioxin shouldn’t be considered a hazard, while biologists like Tierno note that the vagina's lining is super-permeable to chemicals and that small exposures to toxins can accumulate over time.) In 2000, James Madison University hosted the first Anti-Tampon conference. Today, Tierno estimates that 80 percent of U.S. women of menstruating age use tampons. But as Keighley notes, it’s a mistake to assume consumer habits are the same everywhere. For example: Outside North America, digital tampons have outsold applicator tampons for decades. “If you interview women in Europe and ask why they like digital tampons, they’ll tell you about [environmental] concerns. They’ll also tell you that it’s a hygienic concern—that they don’t trust the applicator being inserted inside their bodies,” Keighley says. Conversely, tampon users in the U.S., who largely prefer applicators, “will tell you it’s a hygienic thing—they don’t want to gunk up their fingers,” he explains. “Consumers develop very strong opinions on usage habits—polar opposites, for the same reason.” * * *

It’s been a weird century thus far for commercial tampons. Few products in modern history have been quite as scandal-ridden—or as quietly so. But the future of tampons looks bright, if potentially a little bizarre. A few hours into Reddit’s marathon “I design tampons” AMA in 2011, Redditors began asking what the next generation of tampons might look like. Multilobal fibers were being experimented with, the host disclosed (for “increased capillary action,” or better distribution of fluid throughout the tampon). Biodegradable tampons were “hard mainly because the materials tend to be expensive and fragile,” but: “I'm sure that Playtex, Tampay [sic], and Kotex are all probably working on it, though.” “How about a Bluetooth-enabled buzzer for when your phone is on silent?” one user joked. “Ah, who am I trying to kid. How about a built-in vibrator?” “Already patented,” karnim responded, “though I don’t know if it’s being produced.” Indeed, in the last five years, the U.S. Patent Office has fielded patent proposals for new innovations including—but not limited to—a tampon with a saturation indicator, a reusable tampon applicator, a beveled tampon shaped sort of like a spool of thread to help stop leaks, and, yes, a vibrating tampon. In the last five years, the U.S. Patent Office has fielded proposals for a tampon with a saturation indicator, a reusable applicator, and, yes, a vibrating tampon. And if activists and legislators have a say, the tampon of tomorrow could have a less murky relationship with human consumers. Though manufacturers like Tampax, Playtex, and Kotex now list their tampons’ basic ingredients on their packaging voluntarily, many still urge manufacturers to list more complete inventories of the chemical substances and processes used. Earlier this year, Representative Carolyn Maloney of New York reintroduced a bill to Congress calling for more research on feminine-hygiene-product safety. Named for Robin Danielson, a woman who died of TSS in 1998, the bill calls for the FDA to investigate whether “dioxins, synthetic fibers, chlorine, and other components (including contaminants and substances used as fragrances, colorants, dyes, and preservatives)” pose health risks to sanitary-product users or their biological children. It also calls for the FDA to require independent testing to verify the data tampon and other sanitary-product manufacturers provide. The Robin Danielson Act, originally known as the Tampon Safety and Research Act aims to create more transparency between manufacturers and consumers. It was first introduced to Congress in 1997. “I will tell you,” maintains Tierno, who advised Maloney in drafting early versions of the bill, “if Congress’ men had [vaginas], they would have passed this act the first time around.” Alas: This latest go-round marks the 10th time such a bill will have been considered in Congress. The government-transparency website GovTrack gives the Robin Danielson Act a 2 percent chance of being enacted.