The modern commercial tampon was invented in 1929 by Dr. Earle Haas, a Colorado physician who designed an applicator-style tampon with a removal cord, then sold the patent to a woman named Gertrude Tendrich, who built it into the Tampax brand. But the story of internal menstrual absorption stretches back thousands of years before Haas filed his patent, and what happened after the tampon hit the market involves public health crises, cultural battles over women’s bodies, and policy fights that continue today.
Ancient Predecessors
People who menstruate have used some form of internal absorption for millennia, though the historical record is spotty and often filtered through male historians who rarely bothered to document menstrual practices. Ancient Egyptian papyrus references are frequently cited as evidence of early tampons, though scholars debate whether these descriptions refer to contraceptive pessaries rather than menstrual devices. What is clear is that various cultures independently arrived at the idea of inserting absorbent material, whether softened papyrus, wool, grass, or rolled cloth, to manage menstrual flow.
By the nineteenth century, menstrual management in Western countries mostly meant external pads, rags, or homemade cloth diapers. Internal devices existed but were not widely commercialized. Patent records show that inventors in the United States were filing designs for menstrual products as early as the mid-1800s, reflecting a growing market awareness that women needed better options than what they were cobbling together at home.
Earle Haas and the Birth of the Applicator Tampon
In 1929, Dr. Earle Haas designed what would become the prototype for the modern tampon. His innovation had two key features that set it apart from earlier internal devices: a cardboard applicator tube that allowed insertion without directly touching the absorbent material, and a removal string that made extraction straightforward. Haas received a patent for his design and trademarked the name “Tampax.”1Clinical Microbiology Newsletter. The History of Tampons: from Ancient Times to an FDA-Regulated Medical Device
Haas was a general practitioner, not a gynecologist, and he struggled to find backers for his invention. The medical establishment was largely indifferent, and cultural squeamishness about menstruation made investors skittish. Unable to commercialize the product himself, Haas sold his patent to Gertrude Tendrich, a German immigrant and businesswoman. Tendrich founded the Tampax Company and began manufacturing tampons from her home, hand-sewing the early products with a compression machine. She was the person who actually brought the tampon to market and built it into a viable consumer product, a contribution that often gets buried under Haas’s name in popular retellings.
Tampax’s early marketing had to walk a delicate line. The product was genuinely liberating for women who wanted to swim, exercise, and go about daily life without bulky pads, but advertising it meant talking about menstruation in a culture that treated the subject as unspeakable. Early Tampax ads emphasized cleanliness, discretion, and freedom, often using euphemisms so heavy that a reader unfamiliar with the product might not immediately grasp what it was for.
The Digital Tampon and Competing Designs
Haas’s applicator tampon was not the only design that took hold. Dr. Judith Esser-Mittag, a German gynecologist, developed a different type known as the digital tampon, meaning it was inserted with the fingers rather than an applicator. This design, marketed under the o.b. brand, expanded widthwise during use rather than lengthwise like applicator tampons. The two designs represent fundamentally different engineering approaches to the same problem: applicator tampons compress into a narrow cylinder and elongate as they absorb fluid, while digital tampons are denser and expand radially.1Clinical Microbiology Newsletter. The History of Tampons: from Ancient Times to an FDA-Regulated Medical Device
The split between the two designs became partly geographic and partly cultural. Applicator tampons dominated the American market, where the idea of not touching oneself during insertion was a selling point in a society uncomfortable with women’s bodies. Digital tampons gained stronger footing in parts of Europe, where the applicator was seen as wasteful packaging. That geographic divide persists to this day, though both types are now available in most countries.
The Virginity Myth and Cultural Resistance
One of the biggest obstacles to tampon adoption was not engineering but cultural anxiety. The so-called “beginner myth” held that tampon use could compromise a young woman’s virginity by stretching or tearing the hymen. This belief was not a fringe concern. It shaped how tampons were marketed, discussed by physicians, and permitted or forbidden by parents for decades. Research into tampon advertising found that manufacturers addressed this myth with considerable deftness, simultaneously working to dispel it while also sustaining it to the degree that it justified a market for smaller “beginner” or “slim” tampons.2PubMed. Virginity and tampons: the beginner myth as a case of alteration
The myth has no medical basis. Virginity is a social concept, not a physical condition that can be detected or “lost” by inserting a medical device. The hymen varies enormously in shape and elasticity from person to person, and plenty of activities unrelated to sexual intercourse can stretch or change it. But the persistence of this belief reveals how deeply menstrual products are entangled with ideas about female purity and sexuality. In some communities and families, the myth continues to discourage tampon use among adolescents, sometimes pushing them toward less effective or less comfortable alternatives.
The Toxic Shock Syndrome Crisis
The darkest chapter in tampon history arrived in the late 1970s and early 1980s, when a cluster of severe and sometimes fatal infections in young women was traced to tampon use. The condition, toxic shock syndrome (TSS), was linked to the bacterium Staphylococcus aureus and specifically identified in association with tampon use in 1978.3PubMed Central. Rely and Toxic Shock Syndrome: a technological health crisis Symptoms included sudden high fever, a sunburn-like rash, dangerously low blood pressure, and multi-organ involvement. The mortality rate was alarming.
The crisis centered on a product called Rely, manufactured by Procter & Gamble. Rely tampons used synthetic materials, including polyester foam and carboxymethylcellulose, designed for superabsorbency. The marketing pitch was that Rely could absorb an entire period. The problem was that these synthetic materials created what researchers later described as a biologically incompatible technology: the tampon’s composition and structure converged with normal vaginal bacteria and the menstrual environment to create ideal conditions for S. aureus to flourish and produce its toxin.3PubMed Central. Rely and Toxic Shock Syndrome: a technological health crisis
Research demonstrated that tampons provided increased surface area for staphylococci to colonize and trapped enough oxygen inside the vaginal canal for the bacteria to produce toxic shock syndrome toxin 1 (TSST-1).4PubMed Central. Production of toxic shock syndrome toxin 1 by Staphylococcus aureus restricted to endogenous air in tampons The tampon itself was not carrying the bacteria; rather, it was reshaping the local environment in ways that turned a common, usually harmless skin bacterium into a lethal threat. Rely was voluntarily recalled in 1980, and the episode forced a fundamental reckoning across the entire menstrual product industry.
What Changed After the Crisis
The TSS epidemic transformed tampon regulation overnight. Before 1980, tampons were loosely regulated consumer goods. In the aftermath, the U.S. Food and Drug Administration classified tampons as Class II medical devices, subjecting them to standardized absorbency labeling, mandatory safety testing, and required package inserts warning about TSS. The absorbency labeling system that now appears on every box of tampons, with standardized terms like “regular,” “super,” and “super plus” tied to specific gram ranges, is a direct legacy of the Rely disaster.
Manufacturers also moved away from the synthetic materials implicated in TSS. The superabsorbent designs vanished from the market. Modern tampons are typically made from cotton, rayon, or a blend of the two, materials that have a much longer safety track record than the polyester foam and carboxymethylcellulose that made Rely so dangerous. TSS still occurs in rare cases, and it is not exclusively associated with tampon use, but the incidence dropped sharply after the regulatory and material changes of the early 1980s.
Modern Safety Research
Even with the post-TSS reforms, questions about what tampons are made of and what they might release into the body have never fully gone away. One recurring concern involves dioxins and furans, toxic compounds that can be byproducts of the chlorine-bleaching process used to whiten cotton and rayon. Testing of commercially available tampons found that the total toxic equivalence of dioxins and furans in tampon samples was not statistically different from the background levels at the limit of detection, meaning the amounts were essentially at or below the threshold of measurement.5PubMed. Dioxin and furan levels found in tampons Modern manufacturing processes use elemental chlorine-free or totally chlorine-free bleaching methods, which has reduced dioxin contamination to trace levels.
A more recent line of research has examined nanoparticles shed by tampons during use. Chemical characterization of several brands found that some released polyethylene plastic nanoparticles primarily from the tampon’s outer cover, while cellulose-based nanoparticles made of cotton or rayon came from both the cover and the absorbent core. In laboratory testing, these tampon-derived nanoparticles increased activation of a blood-clotting factor by up to six-fold and reduced another clotting marker by up to 40 percent relative to normal levels.6American Chemical Society (ACS Publications). Characterization and Coagulation Effects of Nanoparticles Shed from Tampons These are lab findings, not clinical outcomes in living people, so it is too early to say whether nanoparticle shedding poses a real health risk. But the research highlights that even familiar, long-established products can yield surprises when examined with modern analytical tools.
The Rise of Alternatives
The tampon’s dominance over the menstrual product market has eroded in recent years as reusable and non-disposable options have gained popularity. Menstrual cups, typically made of medical-grade silicone, collect rather than absorb fluid and can be reused for years. Period underwear uses layered absorbent fabrics to replace both pads and tampons for lighter flow days. Menstrual discs sit higher in the vaginal canal than cups and have gained a following partly because they can be worn during intercourse.
These alternatives are driven by a mix of environmental, health, and economic motivations. A single person who menstruates may use thousands of disposable tampons over a lifetime, and the environmental cost of all that cotton, rayon, plastic applicators, and packaging has become harder to ignore. Reusable products also sidestep some of the lingering material concerns discussed above, since silicone and fabric do not shed the same nanoparticles or carry the same TSS risk profile as absorbent fiber tampons. That said, every product comes with its own learning curve and potential drawbacks, and tampons remain the most widely used internal menstrual product worldwide.
Menstrual Product Taxes and Period Poverty
The history of the tampon is not only a story about materials science and medicine. It is also a story about money and access. Menstrual products, including tampons, are taxed as general consumer goods in many jurisdictions, even though menstruation is an involuntary biological process. The taxation of these products has been identified as a contributor to menstrual poverty, a term describing the inability to afford or access adequate menstrual supplies.7PubMed Central. Taxing women’s bodies: the state of menstrual product taxes in the Americas
Campaigns to eliminate the so-called “tampon tax” have gained significant traction. Several U.S. states, as well as countries including the United Kingdom, Australia, India, and Kenya, have removed sales taxes or value-added taxes from menstrual products. Advocates argue that taxing tampons and pads amounts to penalizing people for a biological function they did not choose, while opponents of repeal typically frame it as a general tax-policy issue rather than a gendered one. A comprehensive review of menstrual product tax policies across the Americas found that the academic literature had largely neglected the issue even as governments debated it, suggesting that the policy conversation has outpaced the research.7PubMed Central. Taxing women’s bodies: the state of menstrual product taxes in the Americas
Period poverty is not limited to low-income countries. Surveys in the United States, the United Kingdom, and other wealthy nations have found that meaningful percentages of menstruating people, especially students and those experiencing homelessness, report going without adequate menstrual products due to cost. Some miss school or work as a result. Providing free menstrual products in schools and public restrooms has become an increasingly common policy response, with Scotland becoming the first country to mandate universal free access in 2022.
How Tampon Design Keeps Evolving
Despite being nearly a century old in its basic form, the tampon is still being redesigned. Organic cotton tampons, which skip the rayon blends and synthetic covers used in conventional products, have become a fast-growing category driven by consumer demand for transparency about what goes into the body. Some newer designs have moved away from traditional applicators entirely, using compact or collapsible applicators that reduce plastic waste while still offering a hands-free insertion experience.
Researchers have also explored tampons as diagnostic tools rather than just absorbent devices. Because the tampon sits in contact with vaginal and cervical fluid for hours, it collects biological material that can be analyzed after removal. Small studies have investigated using worn tampons to screen for endometrial cancer, detect sexually transmitted infections, and monitor vaginal microbiome composition. None of these applications are anywhere near routine clinical use, but they represent an intriguing second life for a device that Earle Haas designed nearly a hundred years ago for a much simpler purpose.