A Staff Report from the Straight Dope Science Advisory Board

Who invented tampons?

June 6, 2006

Dear Straight Dope:

I was wondering--who invented tampons and maxi pads and how did they use them?

Tampons go way back. The word tampon is probably derived from the Old French word tampion, meaning "a plug or cover for the muzzle of a cannon or gun to keep out dust and moisture." Some sources describe the two words as etymological twins, both derived from the word tapon. The word tampon is translated into several languages here.

The tampon itself is often referred to in the scientific literature as a pledget, the part of the applicator that goes into a woman's body is called the penetrator or barrel, and the part that pushes the tampon through the penetrator is called the inserter or the plunger. A tampon without an applicator is called a digital tampon. Around 97% of European women prefer digital tampons, while only 3-4% of American women do, according to Elizabeth Kissling in her book Capitalizing on the Curse: The Business of Menstruation (2006). Now that we've covered the terminology, we can talk about the history.

Women have crafted tampons and pads for their own use for thousands of years. In her book Everything You Must Know About Tampons (1981), Nancy Friedman says:

[T]here is evidence of tampon use throughout history in a multitude of cultures. The oldest printed medical document, papyrus ebers, refers to the use of soft papyrus tampons by Egyptian women in the fifteenth century B.C. Roman women used wool tampons. Women in ancient Japan fashioned tampons out of paper, held them in place with a bandage, and changed them 10 to 12 times a day. Traditional Hawaiian women used the furry part of a native fern called hapu'u; and grasses, mosses and other plants are still used by women in parts of Asia and Africa.

Apparently, as time passed, tampons went underground. By the 1930s, when commercial tampons became available, some women were already making their own "out of surgical cotton, cutting strips to size and rolling them tightly for insertion, or they bought natural sea sponges at cosmetics or art supply stores and trimmed them into reusable tampons," Friedman writes. "But these women belonged to an exclusive margin of society; they tended to be actresses, athletes, or prostitutes--all dubious professions, in the eyes of 'respectable' women."

The more common choice was a pad or napkin. According to Janice Delaney and her co-authors in The Curse: A Cultural History of Menstruation (1988), until 1925 American women "wore a diaper made of bird's eye or outing flannel, which they were obliged to wash and reuse." Burners were available for disposal during travel as early as the 1890s.

The first commercial sanitary pad was Lister's Towels, first manufactured in 1896 by Johnson & Johnson. They failed because advertising for such things was thought improper--few women heard about the product. During World War I, Delaney and company write, French nurses figured out that "the cellulose material used for bandaging wounds absorbed menstrual blood better than cloth diapers." After first calling the product Cellucotton and Cellu-Naps, Kimberly-Clark settled on Kotex (a combination of "cotton" and "texture") in 1920 or 1921. "For $.60 a customer received 12 napkins packaged in a 'hospital blue' box," says Toiletpaperworld.com. Marketing these products was difficult because of society's squeamishness. In 1920, Kimberly-Clark, worried about its image, organized a separate firm called the Cellucotton Products Company to market Kotex. Stores wouldn't carry the product, magazines wouldn't advertise it, and sales unsurprisingly weren't so hot. But the company persevered. "By 1925 the product was beginning to gain acceptance," Toiletpaperworld tells us. "In 1926 Montgomery Ward advertised Kotex in its catalogue and millions of women began to use and accept sanitary napkins as a way of life."

One of Kotex's marketing innovations was meant to help women avoid the embarrassment of asking a male clerk for the product. According to Thomas Heinrich and Bob Batchelor in Kotex, Kleenex, Huggies: Kimberly-Clark and the Consumer Revolution in American Business (2004):

To make the product available to the woman who was loathe to ask a clerk at a drugstore counter to hand her a box of Kotex from the shelf behind him, Kimberly-Clark encouraged merchants to display the product on countertops, enabling the customer to take a box and pay for it with minimal communicative action. Thus Kotex became one of the first self-service items in the history of American retailing.

Women took a box and put their money into a container--the clerk was removed from the transaction.

Kotex took off and was followed by Modess, made by Johnson & Johnson's Personal Products Company. According to Robert Spector in Shared Values: A History of Kimberly-Clark (1997):

After having built the market virtually all by itself, Cellucotton Products faced almost 300 rivals by the late 1920s. Women shopping for Kotex sometimes returned home to discover their retailer had substituted an unknown brand. (Because of the nature of the product, they seldom voiced complaint.) To thwart this retailing malpractice . . . [an ad campaign] warned against substitutions, and asserted that there was only one Kotex. Despite the crowded field, Kotex recorded sales in 1927 in excess of $11 million and was available in 57 countries.

All early sanitary napkins required a belt. It wasn't until 1970 that the Personal Products Company introduced Stayfree and Kimberly-Clark introduced New Freedom pads, both featuring an adhesive backing that made belts unnecessary.

Commercial tampons were probably available by the late 1920s or early 1930s, but they didn't gain mainstream acceptance until Tampax appeared on the market in 1936. None of the early tampons had applicators. They had names like Fax, Fibs, Holly-Pax, Moderne Women, Nappons, Nunap, Slim-pax, and Wix. Some claim Fax was the first.

Kimberly-Clark considered entering the tampon market several times. According to Spector:

In the early 1920s, John Williamson, a young K-C employee who worked on the development of Kotex, rigged up a condom, punctured it with holes and filled it with the creped wadding material that went into Kotex pads.

Williamson's father was the first medical consultant for the development of Kotex. When Williamson showed his invention to his father, the older man was "aghast."

"Never would I put any such strange article inside a woman!" said the senior Williamson. "You'd be so loaded with legal problems that you'd never get out of court. Don't discuss this with anyone because some damn fool will want to put it on the market and you'll be in trouble." That ended the experiment.

In 1935, Kimberly-Clark was offered the patent rights for a "different method of taking care of menstrual needs," according to Spector, but declined, taking the view that the $7,200 price would be "just like throwing money out the window." Bad call. The product would eventually become Tampax, the first tampon with an applicator. It was patented by Dr. Earl Haas, who didn't get anywhere with it. According to Harry Finley of the Museum of Menstruation and Women's Health, "After failing to get people interested in his invention (including the Johnson & Johnson company), on October 16, 1933 he finally sold the patent and trademark to a Denver businesswoman, Gertrude Tenderich, for $32,000. She started the Tampax company and was its first president. Tenderich was an ambitious German immigrant who made the first Tampax tampons at her home using a sewing machine and Dr. Haas's compression machine." Finley continues, "After selling the rights to the tampon, [Haas] continued with his doctor's practice and various business enterprises. He regretted later selling the rights, but was glad it was successful, and died at 96 in 1981. Up to right before his death he continued to try to improve the tampon."

Church groups and even gynecologists expressed reservations about tampons. For doctors, this was a "curious reversal," Dr. Robert Dickinson wrote in the Journal of the American Medical Association in 1945. Doctors had been providing female patients with medical tampons for years. As Dickinson put it, "the tampon used to pay office rent."

Playtex introduced the first deodorant tampon in 1971. By this time manufacturers were advertising in the mass media. In 1972, the National Association of Broadcasters lifted its ban on television advertising of sanitary napkins, tampons, and douches. While some manufacturers were slow to join the fray, ultimately they all did.

Tampons aren't as popular in other countries as they are in the U.S. According to Karen Houppert in The Curse: Confronting the Last Unmentionable Taboo: Menstruation (1999):

While 70 percent of American women use tampons, only 100 million of the world's 1.7 billion menstruating women do. In Asia and Latin America, two of the most populous parts of the world, only 3 percent of all women use tampons.

Seeing an opportunity, Procter & Gamble is trying to change cultural biases. In Latin America the company sponsors "bonding sessions," which are said to resemble Tupperware parties. In some countries you can't find tampons at all. When journalist Susan Hack searched for tampons in Sana'a, Yemen, she was told, "in Yemen we don't insert."

Tampons and other menstrual products continue to be controversial. The [London] Times Online ran a story on May 7, 2006 entitled "Celebrities Back Tampon Rebels of Zimbabwe," which tells of Thabitha Khumalo, who "has been arrested 22 times, tortured so badly that her front teeth were knocked into her nose and had an AK-47 thrust up her vagina until she bled." Her crime? Protesting the critical shortage of tampons and pads in Zimbabwe. When economic problems there caused tampon maker Johnson & Johnson to leave, the price of tampons skyrocketed. A box of twenty currently costs about $16 U.S. in a country where the minimum monthly wage is $32. The article's author, Christina Lamb, tells us:

So desperate is the situation that women are being forced to use rolled-up pieces of newspaper. Zimbabwe already has the world's lowest life expectancy for women--34--and Khumalo believes these unhygienic practices could make it drop to as low as 20 because infections will make them more vulnerable to HIV. "It's a time bomb," she said. The shortage is forcing schoolgirls to stay at home when they start menstruating.

Back in the developed world, the problem isn't the scarcity of manufactured tampons and pads but their omnipresence, some women feel. They choose alternatives such as sea sponge tampons, soft foam tampons, and reusable and disposable menstrual cups. Few of these items are new--reusable menstrual cups were introduced around the same time as Tampax tampons--but environmental concerns have spurred renewed interest. For example, the Student Environmental Action Coalition has organized a Tampaction campaign, which

aims to eradicate the use of unhealthy, unsustainable tampons and pads, institutionalize sustainable alternatives into our schools and communities, and infuse healthy attitudes surrounding menstruation into our culture's consciousness.

Others take a different tack--they want to eliminate the need for tampons and pads altogether. To relieve medical problems or sometimes just to avoid the inconvenience and expense, some women suppress menstruation with hormone treatments like those used for birth control. Brazilian gynecology professor Elsimar Coutinho, in his book Is Menstruation Obsolete? (1999), suggests that for many women it is. Coutinho claims that women menstruated a lot less in the past because of pregnancy, poor nutrition, nursing, and so on, and says menstruation has no proven benefit to those not trying to conceive a child. He advocates use of the injectable contraceptive Depo-Provera or birth control pills to suppress monthly periods.

Opponents say menstrual suppression has been inadequately studied and that menstruation may serve unknown functions. For one thing, menstrual blood differs from other blood: it contains macrophages and has 30 times more stem cells than bone marrow, according to a recent report. Others suggest that menstruation gives the body a break from estrogen. The recently approved birth control pill Seasonale offers a possible compromise, reducing the number of periods from 13 a year to 4.  

Meanwhile, inventors continue to tinker with traditional menstrual products. For example, in her book Tampons and Other Catamenial Devices, which "details processes for improving the properties and construction of both tampons and insertion devices," Marcia Gutcho cites patent #3,948,257 held by William Bossak for a tampon with a deodorant tag attached to the end of the string. Mr. Bossak explains:

To enhance the morale of the wearer, such as during the menstrual period or other instances of occasional depression, the tag is preferably in the form of an adornment, the esthetic appearance of which frequently has the desired effect. In particular, the tag may have a floral configuration[.]

It'd take more than a floral configuration to enhance my morale, but whatever works.

References

Chesler, Giovanna (director), Period: The End of Menstruation, motion picture, 2006:

www.periodthemovie.com

Coutinho, Elsimar & Segal, Sheldon, Is Menstruation Obsolete? (1999): www.amazon.com/gp/product/0195130219/sr=8-1/qid=1149039858/ref=pd_bbs_1/002-9105220 -2490469?%5Fencoding=UTF8

Delaney, Janice, Lupton, Mary Jane & Toth, Emily, The Curse: A Cultural History of Menstruation (2d ed. 1988): www.amazon.com/gp/product/0252014529/qid=1149039901/sr=2-1/ref=pd_bbs_b_2_1/002-910 5220-2490469

Freidman, Nancy, Everything You Must Know About Tampons (1981): www.amazon.com/gp/product/0425051404/qid=1149039959/sr=1-1/ref=sr_1_1/002-9105220-24 90469

"Fun Facts," Toiletpaperworld.com: www.toiletpaperworld.com/tpw/encyclopedia/navigation/funfacts.htm

Gutcho, Marcia, Tampons and Other Catamenial Receptors, Chemical Technology Review No. 129 (1979): www.amazon.com/gp/product/0815507534/qid=1149040062/sr=1-1/ref=sr_1_1/002-9105220-24 90469

Habiger, Petra, Menstruation, Menstrual Hygiene and Woman's Health in Ancient Egypt (1998), Museum of Menstruation and Women's Health: www.mum.org/germnt5.htm

Hack, Susan, "Tampax Nightmares," July 22, 1998, Salon.com: www.salon.com/wlust/feature/1998/07/22feature.html

Heinrich, Thomas & Batchelor, Bob, Kotex, Kleenex, Huggies: Kimberly-Clark And The Consumer Revolution In American Business (Historical Perspective on Business Enterprise)

(2004): www.amazon.com/gp/product/0814209769/qid=1149040114/sr=1-1/ref=sr_1_1/002-9105220-24 90469

Houppert, Karen, The Curse: Confronting the Last Unmentionable Taboo: Menstruation (1999): www.amazon.com/gp/product/B000C4SHN6/qid=1149040182/sr=2-2/ref=pd_bbs_b_2_2/002-9 105220-2490469

Kaunitz, Andrew, "Choosing whether--and when--to menstruate," Journal of the American Academy of Physician Assistants March 2004, 17: www.jaapa.com/issues/j20040301/articles/w0304menstruate.html

Kerr, Martha, "Menstrual Blood Yields Stem Cells," ABC News, March 14, 2006: www.abc.net.au/science/news/health/HealthRepublish_1590861.htm

Kissling, Elizabeth, Capitalizing on the Curse: The Business of Menstruation (2004): www.amazon.com/gp/product/158826310X/002-9105220-2490469

Lamb, Christina, "Celebrities Back Tampon Rebels of Zimbabwe," Times Online, May 7, 2006: www.timesonline.co.uk/article/0,,2089-2168451,00.html

Spector, Robert, Shared Values: A History of Kimberly-Clark (1997): www.amazon.com/gp/product/0944641245/qid=1149036742/sr=1-3/ref=sr_1_3/002-9105220-24 90469

Strauss, Steven, The Big Idea: How Business Innovators Get Gread Ideas to Market (2002): www.amazon.com/gp/product/0793148375/sr=8-1/qid=1145136254/ref=sr_1_1/103-6048292-78 99813?%5Fencoding=UTF8

"Tampax Patent and History," Museum of Menstruation and Women's Health: www.mum.org/Tampaxpatent.htm

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