Sue K. Goebel

Date of Award


Document Type


Degree Name

Master of Science (MS)




Today the majority of females fifteen years and older have used tampons. Since their introduction in 1933, tampons have changed greatly in composition: more absorbent synthetic fibers have replaced natural fibers, plastic applicators have joined cardboard, and some contain a fragrance. While changes in vaginal mucosa including inflammatory changes, lacerations, and micro-ulcerations as a result of tampon use have been documented, no research examining the use of menstrual hygiene products and their effect on cervical cytology was located.

The purpose of this study was to examine the association between menstrual hygiene product use and the incidence of abnormal Pap smear results, specifically that of benign cellular inflammatory changes and/or atypical squamous cell of undetermined significance (ASCUS). The Theory of Nursing as Human Science and Human Care as proposed by Jean Watson (1979) was the theoretical framework for this study.

Data were collected by chart audit review of 250 women, ages 14 to 36, who sought Pap smear screening at a Midwestern family planning clinic. The data collection instrument was designed by the researcher. Data were analyzed using the Statistical Package for the Social Sciences (SPSS-X).

The association in Pap smear result by tampon applicator use, analyzed using Pearson Chi square, was . . 2 found to be statistically significant (X =18.53; df=4; p=0.003). The difference in Pap smear result by type of 2 tampon was also statistically significant (X =48.06; df=3; p=0.000). Reported use of plastic and/or deodorized tampon use by those subjects with inflammatory changes and/or ASCUS Pap results was three times that of those reporting cardboard applicator, non-deodorized tampon or sanitary pad use.