John Charles McQuaid and tampons

Published in 20th Century Social Perspectives, 20th-century / Contemporary History, Issue 2 (Mar/Apr 2008), Letters, Volume 16

Sir,

—Margaret Ó hÓgartaigh, in her account of the trials of sportswomen in mid-twentieth-century Ireland (‘Internal tamponage, hockey parturition and mixed athletics’, HI 15.6, Nov./Dec. 2007), ridicules the opinions of the late John Charles McQuaid, Catholic archbishop of Dublin, and of Dr Stafford Johnson on the subject of menstrual tampons. Dr McQuaid in particular seems so easily to attract denigration from many quarters that it may not have occurred to anyone that his critical remarks and those of his medical adviser could have any sense in them.
Another look at the historical background can suggest otherwise. Menstrual tampons, developed in America in the 1930s, were not widely used in Europe before the 1950s. There was a strong folk belief, not by any means restricted to Catholics or to Ireland, that they represented possible damage to the hymen and vagina of the wearer—it seemed to be ‘interfering with nature’, and, in a sense, it was. Women who saw themselves as progressive and modern naturally took a different view. Menstruation—commonly referred to as ‘the curse’—was perceived by some as a female disability, which the tampon, if a somewhat intrusive form of sanitary protection, helped to conceal, and perhaps even to deny. Tampons became popular, especially with those involved in active sports and competitive swimming.
Those who, like myself, were nursing in the 1950s and ’60s saw another aspect. Women who were mentally confused, mentally ill or just more absent-minded than usual could suffer highly unpleasant consequences from leaving tampons in for too long. We sometimes had to remove such retained tampons, and help treat the resulting ulceration. Towards the end of the 1970s we began to hear about Toxic Shock Syndrome (TSS), a serious and potentially fatal condition associated with tampon use. In a TSS epidemic in America in 1979–80, the known deaths were mainly of women too young to have developed much resistance to the bacteria responsible—Staphylococcus aureus. TSS symptoms, which in the early stages strongly resemble those of ’flu and in consequence can mislead, are produced when certain strains of Staphylococcus aureus enter the bloodstream. The actual detailed mechanism of the infection is not yet clear, but the material of which high-absorbency tampons were made at the time is considered to have been a major factor. And it is evident, from discreet but firm warnings given on the reference websites, that TSS cases still occur.
Details of the present situation can be found on the three websites—American, Canadian and Irish—below. Their writers are very careful to avoid condemning tampon use, because it is clearly unwise to seem to challenge what has become big business, but at the same time they stress a continuing risk element and the need for user choice to be fully informed. While reading their pieces, I could not help being reminded of the recent lively interest in non-essential cosmetic surgery, presented in some journals as modern, life-enhancing and, of course, risk-free, for little or nothing is said about risks. Even in the far-away 1950s, not everybody thought that everything new must be beyond criticism on that account.

—Yours etc.,
HELEN KAHN
Killeagh
Co. Cork
http://www.fda.gov/fdac/features/2000/200_tss.html
http://www.hc-sc.ge.ca/iyh-vsv/prod/tampons_e.html
http://www2.vhi.ie/topic100587581

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