Yes, your thoughts are irrational. A tampon can give you freedom. Lucky for us ladies, we have choices. We can even go with the environmentally friendly menstruating devices and buy cloth! Yes, cloth! Think about all those pads in the landfills that take 500+ years to break down. I digress.
Some women actually *need*to wear both a tampon and a pad on heavy days! Some women wear tampons when they are menstruating because they think panty lines with big maxi pad lines are unattractive! Well, there is always a skirt, right? But then on days when the temp is 100+ and you have a large, wet pad nestled in an area where there is minimal air, that can feel pretty grotesque too, to some that prefer a clean and dry feeling.
So I have been on both sides of the coin. Personally, I don't find either a huge pleasantry in my life and really, a tampon is actually more sanitary feeling because you don't have to worry about the odor and excessive moisture. On warm days, that excessive moisture can actually cause yeast !
So how often? Read the instructions. That is why they are in the box. But typically, if you give it a gentle tug and it feels dry and thus uncomfortable, it is not full. Conversely, if you give it that gentle tug and it feels slippery, it is likely full. If it isn't full, change it on the same schedule you would change your maxi-pad.