Period products
The practical differences between the options, and straight answers to the safety questions that come up most often.
The options
| Product | Where it sits | Typical wear time | Notes |
|---|---|---|---|
| External pads | Outside the body, in underwear | Change every few hours | Simple, no insertion, can cause irritation if fragranced or worn damp |
| Tampons | Inside the vagina | Up to eight hours, no longer | Discreet, must not be left in; lowest suitable absorbency reduces risk |
| Menstrual cup | Inside the vagina, forming a seal | Commonly up to twelve hours | Reusable, needs washing between uses and sterilising between cycles |
| Menstrual disc | Higher, sitting behind the pubic bone | Commonly up to twelve hours | Different fit; some can be worn during penetrative sex |
| Period underwear | Worn as underwear | Varies with absorbency | Reusable, washable, useful alone or as a backup |
| Reusable cloth pads | Outside the body | Change every few hours | Washable alternative to disposable pads |
Absorbency and how much bleeding is normal
Period products are rated by how much they absorb, and the useful principle is to use the lowest absorbency that gets through the interval comfortably, changing to a higher one only for the heaviest days.
Bleeding that soaks through a pad or tampon every hour or two for several hours, that requires double protection, that includes clots larger than a small coin, or that regularly floods bedding is heavy menstrual bleeding. It is common, it is treatable, and it is worth an appointment, particularly because it causes iron deficiency. Treatments include medication that reduces bleeding and hormonal methods such as the hormonal intrauterine system, which is used for this purpose as well as for contraception. See the contraception overview.
Toxic shock syndrome
The question that generates the most anxiety, so it is worth being precise. Toxic shock syndrome is a rare illness caused by toxins produced by certain bacteria. It is associated with tampon use, particularly higher absorbency tampons left in for long periods, though it also occurs in people who have never used a tampon and in men and children.
It is very rare. Practical precautions are straightforward: use the lowest absorbency that is adequate, change every four to eight hours, never leave a tampon in overnight beyond eight hours, use an external product for part of the day if periods are long, wash hands before and after insertion, and remove the last tampon at the end of a period.
The symptoms to know are a sudden high fever, a widespread rash resembling sunburn, vomiting or diarrhoea, dizziness, muscle aches and confusion. Anyone who becomes suddenly and severely unwell while using a tampon should remove it and seek urgent medical help, mentioning the tampon.
Menstrual cups have been associated with rare cases too, so the same principle of cleaning and reasonable wear time applies.
Cups and discs in practice
Both take a few cycles to get used to, and a first attempt that fails is not a verdict. Insertion involves folding, and finding a fold that works is individual. A cup must open fully to seal, and rotating it slightly after insertion usually confirms this. Removal involves releasing the seal by pinching the base, not by pulling on the stem.
Practical points: they hold more than most tampons, which suits heavy days and long stretches away from a lavatory; they can be worn overnight within the recommended time; they need rinsing between uses and sterilising in boiling water between cycles; and removing one in a public lavatory takes a little planning. Anyone with an intrauterine device should discuss cup use with the clinician who fitted it, since releasing the seal carelessly can theoretically disturb the threads.
Period underwear
Absorbent layers built into underwear, washed and reused. They work well on lighter days, as overnight protection, and as a backup alongside a tampon or cup on heavy days. Capacity varies considerably between styles, and the stated absorbency is worth checking against actual flow rather than assumed.
Questions have been raised about chemical treatments used in some absorbent textiles. This is an area where testing and regulation continue to develop, and choosing products from manufacturers who publish testing information is a reasonable response.
Irritation
Fragranced pads and liners are a common cause of vulval irritation, and there is no reason to use them: the smell they mask is normal. Pads worn for a long time in warm weather create a damp environment that irritates skin. Anyone with a vulval skin condition should choose unfragranced products and change them frequently. See vulval hygiene.
Tampons can cause dryness and discomfort if the absorbency is higher than the flow requires, and removing a dry tampon is uncomfortable and can cause small abrasions.
Practical choice
Most people settle on a combination: a cup or tampons during the day, an external product or period underwear at night, and something reusable for light days. The best product is the one that gets through the required interval without leaking and without discomfort, and comparing them over two or three cycles is more informative than any list.
Where this information comes from
This page follows public guidance and patient information published by the National Health Service, the National Institute for Health and Care Excellence, and the World Health Organization.
Last reviewed: September 2026