Bacterial Vaginosis (BV) is a vaginal condition resulting from an imbalance in the natural vaginal flora. This occurs when certain anaerobic bacteria overgrow, leading to a decrease in protective, acid-producing Lactobacilli species. The shift often results in noticeable symptoms, most commonly a thin, grayish-white discharge accompanied by a distinct, sometimes “fishy,” odor.
Why Tampon Use is Discouraged During BV
Healthcare providers generally recommend avoiding tampons during an active BV infection because they interfere with the vaginal environment. Tampons absorb fluid, which can inadvertently trap discharge and harmful bacteria high in the vaginal canal.
This trapping effect can worsen the infection. A saturated tampon may also provide a steady source of nutrients for the anaerobic bacteria responsible for BV. Menstrual blood has a higher, more alkaline pH than the naturally acidic vaginal environment.
Holding this less acidic mixture against the vaginal walls can neutralize the already-disrupted vaginal pH. Maintaining a low pH is a defense mechanism, as Lactobacilli thrive in acidic conditions. Avoiding internal absorbents supports the return to a healthy, acidic state.
Interference with Topical Treatments
Tampon use is discouraged if you are undergoing treatment for BV with topical medication. Common treatments, such as metronidazole gel or clindamycin cream, are designed to coat the vaginal walls to deliver antibiotic ingredients directly to the infection site.
A tampon will absorb the medication along with menstrual fluid and discharge. This absorption reduces the antibiotic concentration at the tissue level, significantly lowering treatment efficacy. A decreased concentration increases the risk that the infection will not be fully eradicated or may recur.
Internal menstrual products must be avoided for the entire duration of the treatment course. Medical professionals advise continuing treatment even if menstruation begins, substituting the tampon for an external option to allow the medicine to work properly.
Safer Menstrual Hygiene Options During BV
The safest option for managing menstruation during an active BV infection is external protection, primarily sanitary pads. Pads collect menstrual fluid outside the vaginal canal, preventing interference with the internal vaginal environment or topical medications. This external collection allows for better airflow and does not trap discharge or blood internally, reducing the risk of bacterial overgrowth.
When choosing pads, select unscented, breathable varieties, ideally made with cotton or hypoallergenic materials. Scented products contain chemicals that can cause irritation and disrupt the sensitive vaginal area. Wearing breathable cotton underwear also helps prevent moisture buildup, which creates a favorable environment for bacteria.
Menstrual cups and discs, while non-absorbent, require careful consideration. Some studies suggest cups may help maintain a healthy vaginal microbiome by not absorbing Lactobacilli. However, their insertion and removal carry a risk of introducing external bacteria or physically irritating inflamed tissues. External pads remain the most universally recommended option for comfort and supporting infection resolution.