The Day I Explained to My Friend Where Her Tampon Went

I twirled the Pap smear brush in my good friend/patient’s cervix, placed it into the small plastic container with solution for the laboratory, gently closed the metal speculum and removed it from her vagina. “That’s it all done, you want to go to Zaziki’s for dinner tonight, I could kill some hummus?” I asked, as I pushed my stool back from the exam table. She closed her knees and sat up from the table, her naturally turned up lips started to curve downward with hesitation, and her well-shaped eyebrows arched even further up her fair forehead. “What is it?” I asked. “Okay it’s not really a big deal, but I’ve been meaning to ask you…before I started coming to you, a couple of years ago, I had to see my gyno because I thought I had gotten a tampon stuck! But it was so embarrassing because when he checked, it wasn’t in there!” she exclaimed. I smiled and soothingly responded, “Yeah that actually happens all of the time.”

“But the weirdest thing was…What my real question is..” she continued. “Yes?” I encouraged. “Before I came into see him I was at home with my leg up trying to get it out and I felt something. I kept grabbing it and pulling at the edge but it wouldn’t come out! It was so weird because I was sure that was the tampon!” she confessed, her face now more relaxed staring at me bright eyed looking for the answer to her conundrum. “It was your cervix,” I answered. “What?” she shuddered with horror, “I was yanking on my cervix?” “Yeah, probably, sounds like it. You wouldn’t be the first.” I responded.

In order to fully explain, I think I have to first give a quick anatomy lesson. Your uterus, which fills up with blood each month, which is also the organ that will also house a baby, narrows into your cervix. The cervix is essentially like the neck of the uterus, and it is also the portion of it that is sitting in the vagina. It is round and bulbous, approximately an inch or so in diameter. Much like the circumference of an expanded tampon. Therefore, in times of confusion it is also easily mistaken for one. The cervix has a pin point hole that allows the blood from the uterus to come out into your vagina.

A tampon, sits in the vagina, to catch the blood. A tampon also expands in your vagina as it soaks the blood. As you can see from the illustration that if you are unable to pull it out there are only several options; It fell out, it is crammed back so far into your vagina along with it’s attached strings that you cannot reach it, or you took it out and forgot doing so. It is impossible for it to travel anywhere else. The vagina is closed around the cervix creating a dead end cul-de-sac and the cervix hole not dilated (like it is in labor) is way too small for the tampon to pass through. So the theory that it could travel and get lost somewhere in your body besides your vagina is completely false.

As known, tampons come in a variety of sizes designed for a variety of flow amount. From slim and light to super and heavy. No matter what the size, you should not leave a tampon in longer than eight hours. Leaving a tampon in longer than that has been associated with Toxic Shock Syndrome, an illness cased by a bacteria. The first time I heard about Toxic Shock Syndrome, was from my mother, soon after I started my period. It was up on the top of her list of reasons that I was forbid to use a tampon. Of course, I  just borrowed them from my friends and was inserting them sans applicator by the age of twelve.

Although real, Toxic Shock Syndrome, is a rare illness. I have seen dozens of retained tampons in my time as a gynecologist. Some knowingly and some unknowingly i.e. a woman comes in for a regular annual visit, I place the speculum in and I see that it is sitting in the back of her vagina, usually at this point smelling a bit foul. This often occurs when a woman believes she has removed it and then engages in intercourse. This scenario is most common at the end of her cycle so she is no longer bleeding and not soaking the tampon, therefore not bleeding through, signaling her to change it. The force of the penis during sex pushes the retained tampon further and further back into her vagina often into the corner of the cul- de- sac I described. In the event that Toxic Shock Syndrome does occur, fever, a rash that looks like a sunburn (especially on the hands and feet) and diarrhea will develop. So if you know or are unsure if you have left a tampon in longer than recommended, look for these symptoms.

Even without these symptoms, if you have left a tampon in and can’t reach it or you are unsure, it is always best to check with your physician. So many people, like my dear friend, come in mortified about this, but I promise we are not judging you and we have likely forgotten if we have put one in at some point in our lives as well. I myself remember one day in busy residency, rushing into the hospital bathroom to quickly change my tampon, only to be confused on removing it when I felt an additional set of strings. I had put in two tampons unknowingly, one on top of the other.

An alternative to a tampon besides a pad is a menstrual cup. Menstrual cups are made of plastic or rubber. They are inserted into the vagina to catch the menstrual flow. You remove and empty the cup every eight to twelve hours. Menstrual cups can be bought in stores or online. Some cups are used only once and thrown away. Others can be washed and reused. Therefore, this has become all the rage with the Go Green girls since reusable and is therefore not contributing to waste products and damaging the environment. It may take some practice to use a menstrual cup and often a few menstrual periods are needed to get used to it. There may also be less of a risk of getting toxic shock syndrome with menstrual cups compared with tampons. So besides being environmentally safe it has that advantage. I also believe they are easier to retrieve so less likely to get stuck.

“Do you think I hurt myself?…I mean when I was grabbing on it?” she asked, her eyes slightly saddened with worry.   “Nope, I just looked at it and everything looked great!” I said. “ Thanks Dr. Pari, now let’s go kill that hummus, now that I know I won’t mistakenly kill my cervix!”