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the look on your face when inserting a tampon is painful
Illustration by Josh Christensen
As Ashley Broadwater was researching an article she was writing for the website Giddy on the vasovagal repsonse and why inserting a tampon is painful, she reached out to me for my opinions on the causes of and solutions for this common issue. Here is a brief synopsis of the article along with a link to the full article below.

Heather Jeffcoat, DPT

Find Out Why Inserting a Tampon is Painful

Feeling dizzy and nauseous after putting in a hygiene product? Doctors have some theories.

As mentioned throughout our website, there are a multitude of potential causes of painful penetration, some with overlapping symptoms. A proper diagnosis will always include a deep dive into the background issues that led to the condition, including both physical and emotional causes. And when these issues coincide they can lead to what is called a "vasovagal response":

A vasovagal response is when a bodily trigger causes you to faint.

For people with a sensitive cervix, this reaction is caused by the tampon touching the cervix," said Somi Javaid, M.D., a board-certified OB-GYN in Ohio and one of three founders of HerMD, a female-founded healthcare startup.

Symptoms of this type of episode include paleness, nausea, sweating and, yes, fainting. Treatment for a vasovagal episode can include trigger avoidance or medication.

If any of the above rings true, you may have what is known as a "friable cervix". Causes may include:

  • Sexually transmitted diseases (STDs)
  • Vaginal atrophy
  • Hormonal imbalance

Firast things first of course, consult with your physician or gynecologist if you suspect any of the above to be the case.

Your sympathetic nervous system was engaged

When faced with imminent physical danger, the human body’s sympathetic nervous system triggers our "fight-or-flight" response. The sympathetic nervous system is a normally harmonized network of brain structures, nerves and hormones that, if thrown off balance, can result in serious complications. Click here for a full explanation of the sympathetic nervous system at LiveScience.com.

If your body perceives inserting a tampon as a threat, it will engage our sympathetic nervous system, which may produce the physical effects. Putting something inside you—especially in your vagina, where you may have experienced trauma, pain or shame around penetration—could feel foreign or nerve-wracking.

People who experience chronic pelvic pain or high levels of depression and/or anxiety are more likely to have sensitive nervous systems, too. In other words, inserting a tampon may be perceived as painful, even though it is a non-painful stimuli.

You have toxic shock syndrome

Toxic shock syndrome (TSS) is a less likely cause, but it's best to ascertain if you have it.

Although more rare these days than when it first hit the news in the 1980s, toxic shock syndrome is still one possible reason why inserting a tampon is painful. It has been linked to everything from glyphosate in the (non-organic) cotton used to make tampons, to exposure to dioxins and other manmade chemicals including fragrances.

It's also important to rule out toxic shock syndrome with your physician, as that can also make you feel hot due to a fever but has other potentially life-threatening symptoms of diarrhea, widespread sunburn-like rash, dizziness or fainting, headaches and bloodshot eyes.

How to keep tampon insertion from disrupting your life

Once TSS has been ruled out, to get at the root of what can help you avoid the effects of the nervous system, a team of providers may be necessary. If you experience pain, a pelvic floor therapist, pain management physician and/or acupuncturist may need to be on your team to reduce or get you out of your pain cycle. If you don't feel pain, a psychotherapist or pelvic floor physical therapist can help with anxiety and nervous system regulation.

Change the tampon you use and how you insert it

Trying different brands and/or sizes may give better results, and you might also try switching up how you insert the tampon.

We recommend inserting the tampon in a different position; for instance, laying down or sitting on the toilet and bearing down to try to make the dizziness go away. Having a fan blowing nearby may help, too.

Try 'rainbow breathing'

One essential function that can help reduce your feelings of anxiety or other unregulated nervous system effects is deep, lateral breathing, sometimes called 'rainbow breathing' in the pediatric population.

To use this breathing technique:

  • Get into a comfortable position.
  • Inhale as deeply as is comfortable for you. Feel your rib cage expand forward, to the sides and back.
  • As you inhale, reach your arms overhead, then bring them down to your sides as though you're making a rainbow with your arms.

Hopefully this article has shed some light on the causes of painful penetration and why inserting tampon is painful. Click here to read the original article at Giddy.com, and use this simple contact form if you'd like to make an appointment at one of our offices.

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Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by S.S., age 54

Heather is the best! I saw her today for terrible hip/groin pain. I was so impressed with the safety measures in place and felt completely safe . Thanks for the healing hands.

S.S., age 54

Testimonial by A.M.

Months after giving birth, it was difficult for me to go from a sitting or lying position up to a full standing position without feeling that I had to remain hunched over until a bit of time had passed to get fully upright. However, after taking Heather’s course, I learned exercises to get my body back to normal. She also showed me correct ways to lift and carry my son as well as put him in/take him out of the carseat and stroller. This class was really beneficial and Heather is a wonderful teacher who made me feel very comfortable.

-- A.M.

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