Toxic shock syndrome, infections: What if I leave a tampon in for too long?

Mary Bowerman USA TODAY Network Published 8:19 AM EDT Jun 3, 2017

Have you ever panicked and thought you might have left a tampon in? Or even lost one?

Leaving a tampon in for too long can lead to infections and rarely cause life-threatening toxic shock syndrome (TSS). TSS is typically caused by an overgrowth of bacteria called Staphylococcus aureus. Each year toxic shock syndrome affects about 1 in 100,000 women. While the instructions on the tampon box encourage women to change their tampon every eight hours, sometimes people forget to change them or occasionally may lose them.

Leaving a tampon in for longer than 8-12 hours, can increase risk of infection or possibly TSS, according to Jessica Shepherd, a gynecologist.

Tampons. Loic Venance, AFP/Getty Images

“In general, if you leave a tampon in for too long it can create a breeding ground for bacteria and can increase risk of yeast infections, bacterial vaginosis or possibly TSS,” Shepherd said. “For some women it comes down to a hygienic issue of making sure you change as often as possible.”

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If a woman believes she’s left a tampon in for too long, she should do a self-check or ask her partner to help see if the tampon may have gotten lost in her vagina. If she is unable to find it, but has vaginal discharge or a strange vaginal odor, it’s important to seek medical attention, Jennifer Wu, OBGYN, Lenox Hill Hospital in NYC said.

“People go to the ER all the time for lost tampons,” Wu said. “Patients are always upset and worried about TSS, but it’s very rare and most of the patients have been fine.”

Wu said TSS symptoms include fever, rash and feeling extremely ill. She said the overall message is to avoid leaving the tampon in for too long and to remember that a bigger tampon doesn’t mean it can be left in longer.

And as for the often-asked question of whether it’s ok to leave a tampon in over night?

“Usually they can put a tampon in before bed and change in the middle of the night, but it’s best to use the smallest tampon possible, Wu said. “Sometimes the tendency is to use a super tampon and leave it in a super long time, but better off changing it.”

Follow Mary Bowerman on Twitter: @MaryBowerman.

Published 8:19 AM EDT Jun 3, 2017

What if I forget to remove my tampon?

If you forget to remove your tampon (for example, at the end of your period), it can become compressed at the top of your vagina.

This can make it difficult for you to feel the tampon or pull it out.

Don’t panic if a tampon gets stuck inside you. It’s not possible for a tampon to get lost inside you and it’ll stay in your vagina after you have inserted it.

Try using your fingers to grab the string of the tampon or the tampon itself.

If you still can’t get the tampon out, go to your GP practice or nearest sexual health clinic as soon as possible. Healthcare staff will be able to remove it for you.

If you can’t get to your GP or a sexual health clinic, ring NHS 111 for advice.

Tampon manufacturers advise that a tampon shouldn’t be left in for more than 8 hours.

It’s particularly important to get the tampon removed quickly if you:

  • notice an unpleasant smell or vaginal discharge
  • have pelvic pain
  • have a high temperature (fever)

Occasionally, a rare but life-threatening bacterial infection called toxic shock syndrome has been linked to women using tampons.

Most women are aware that the recommended duration for leaving a tampon in is less than eight hours, but what happens if you leave it in longer?

Redbook interviewed Mary Jane Minkin, a professor of obstetrics, to find out the science behind it. The results may surprised you…

RELATED: What The Colour Of Your Period Is Trying To Tell You

1. Toxic Shock Syndrome

This is the infection that you may have heard horror stories about – it is caused by a buildup of bacteria from leaving a tampon in too long. However Playtex reports that this is extremely rare – only one to 17 cases are reported for every 100,000 women who use tampons. The symptoms include high fever, low blood pressure, and hot, scalded skin. If you have any of those symptoms, it’s time to see a doctor.

2. Dryness

The vaginal tissue surrounding the tampon can react with dryness, which can be uncomfortable. You can fix this by switching a tampon for pads for a while, or using a bit of lube.

3. A Bad Smell

When blood from your period reacts to bacteria from wearing a tampon, it can cause a bad smell. The longer you wear a tampon, the more bacteria will gather and the worse the smell.

Our periods are as unique and different as we are. If you’ve been blessed with a lighter flow, then finding the right tampon for your light period is important. You shouldn’t use the regulars if you don’t have to! To help you narrow down your search, we’ve compiled a list of 5 of the best tampons for you light flow ladies.

Besides those of us with a lighter flow, girls just starting out in the world of menstruation might find lighter tampons useful as well. Using a light tampon could help newbies get used to the insertion ritual. Tampons designed for a lighter flow are usually thinner in size, therefore first-time tampon users might find them less daunting to use in comparison to a regular-sized tampon.

Light tampons can also come in handy for women who experience occasional spotting throughout the month. Panty liners can usually do the trick when it comes to spotting. But for those of us who like a bit more leak protection, light tampons are great back-up security.

Are you ready to meet your light flow’s new best friend? Let us introduce you to the 5 top light/lite tampons that will make your period a breeze.

Whether you’re a beginner or just a stickler for a classic plastic applicator tampon, Tampas Pearl might be your best ally. Their applicators are super easy and comfortable to use. Plus, their lite tampons provide just enough protection for someone with a generally lighter flow or for women experiencing spotting or the tail end of their period.

2Veeda Lite Tampons

If you’re looking to go organic and stick to basic cotton tampons, Veeda is a drugstore brand that delivers. Made with 100% cotton and free from chemicals, dyes, and synthetics, Veeda Lites provide great protection from leaks and give you peace of mind that you’re doing something beneficial for your body and the environment.

3o.b. ProComfort Lite Days

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For those of you who aren’t about that applicator life, these o.b. ProComfort tampons might be right up your alley. Free from cardboard or plastic applicators, these tampons employ “Silk Touch” technology for easy insertion.

4Tampax Pearl Active Lites

For girls on the go, these Tampax Active Lites assure you that you’ll stay leak-free throughout practice or a gym session. Similar to their Tampax Pearl sisters, these Tampax Actives come with easy-to-use plastic applicators that make life a little bit easier and a lot more comfortable.

5Cora Organic Tampons Light

Cora is another brand that boasts the use of 100% organic cotton to make their tampons. These tampons are highly-absorbent, chlorine-free, fragrance-free, and Non-GMO. Plus, with every box of Cora tampons bought, the company donates pads to a girl in need in a developing country.

Tackle your lighter days or lighter flow with light tampons from of these brands. Those regulars might just become a thing of the past.

Tampons, Pads, and Other Period Supplies

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When you get your period, you’ll need to use something to soak up the menstrual blood. There are lots of different products out there. It might take some experimenting to find what’s right for you.

Most girls use on or more of these:

  • pads (or sanitary napkins)
  • tampons
  • menstrual cups

What Are Pads?

Pads are rectangles of absorbent material that attach to the inside of a girl’s underwear and catch menstrual blood. They’re sometimes also called sanitary pads or sanitary napkins. Some pads have extra material on the sides. These “wings” fold over the edges of your underwear to help hold the pad in place and prevent leaking.

There are many different types of pads, including:

  • super
  • slender
  • overnight
  • scented
  • maxi
  • mini

Some girls have heavier bleeding with their periods and others have lighter bleeding. And most girls have a light days and heavier days. Pads can vary by size or by absorbency. You want to try to find a pad that is big enough that you don’t worry about leaking through, but is small enough to be comfortable. It might take a little bit of experimenting to find the right pad for the different times of your period.

Some pads are scented or come with a deodorant in them. But these can irritate the vagina or cause an allergic reaction in some girls.

How Do You Use Pads?

Pads should be changed every 3–4 hours, even if you have a light flow. Regular changing prevents buildup of bacteria and stops odor. If you have a heavier flow, you might need to change pads more often to make sure you don’t leak.

There are two types of pads that do the same job, but are used a little bit differently.

  • Disposable pads. Most pads have a sticky strip along the bottom. You peel off the paper strip that covers the adhesive and press the pad into the crotch of your underwear. If the pad has wings, you wrap these around the bottom of the crotch.
    To remove the pad, unstick it from your underwear and wrap it in toilet paper. Put it in the trash can or in the special disposal box that’s found in most bathroom stalls. Don’t try to flush a pad down the toilet because the toilet can become clogged and make a big mess.
  • Reusable pads. These pads are washed after each time you wear them. They’re sold in natural health stores and online. These kinds of pads snap or clip onto a girl’s underwear. Girls might use these pads because they feel they’re better for the environment or to save money. It’s all a matter of personal preference.

What Are Tampons?

Tampons absorb blood from inside the vagina. A tampon is also made of absorbent material, but it’s compressed into a small tube. Tampons come in different sizes and absorbencies for heavier and lighter periods.

Tampons also can come with or without deodorant. There’s no need for deodorant in a tampon, though, because changing tampons regularly usually gets rid of any odor. The deodorant in tampons can irritate the vagina, and could cause an allergic reaction in some girls.

Some tampons come with an applicator. An applicator is a plastic or cardboard tube that guides the tampon into the vagina. Other tampons are inserted using a finger.

Some girls find that a slender size, applicator-style tampon is easier to use when they first start their periods. An applicator with a rounded top can be especially helpful for beginners. The first time you use a tampon, try to do so on a heavier flow day. This will make the tampon slip in easier.

How Do You Use Tampons?

A tampon is put into the vagina using an applicator or a finger. After washing your hands, follow the directions that come with the tampons carefully and be sure to relax.

It’s very important to change tampons every few hours and that you wear the absorbency type that is right for you. Change a tampon every 4–6 hours or when it’s saturated with blood.

Tampons have a string attached to one end that stays outside a girl’s body. To remove the tampon, pull gently on the string until the tampon comes out. Wrap it in toilet paper and throw it in the trash.

Don’t flush a tampon down the toilet. Even when the box says a tampon is flushable, tampons can still cause problems in some plumbing systems.

Because you can’t see a tampon, you’ll need to remember when it’s time to change. If you forget to change it, you may get spotting or leakage on your underwear or clothing.

If it’s time to change your tampon and you can’t find the string, don’t worry! The tampon is still there. Reach in with your fingers to find the string. It may take a minute to do because the string might be a bit hard to grab.

Some girls worry that tampons can get lost inside their bodies. But there is no way for this to happen. The vagina holds a tampon in place and the opening of the cervix (located at the top of the vagina) is too tiny for a tampon to get through.

It’s important to change tampons often. A tampon that’s left in too long won’t get lost. But a girl may get a discharge, odor, or an infection. And never put a tampon in and leave it in all day or all night, even if you have a light period. Doing this puts girls at risk for a rare but very dangerous disease called toxic shock syndrome (TSS).

What Is a Menstrual Cup?

Like a tampon, a menstrual cup is inserted into the vagina. Instead of absorbing blood, the cup catches it before it flows out of the vagina. Menstrual cups are made of flexible materials, like rubber or silicone.

You can’t see when the cup is full, so empty it (or, in the case of disposable cups, throw it away) several times a day. Instructions that come with the cup explain how to do this.

Because some menstrual cups look like a diaphragm, girls might wonder if a menstrual cup could be used as birth control. But a menstrual cup does not prevent pregnancy.

How Do I Decide What to Use?

Choosing a type of period protection is up to you. Some girls like tampons because they’re easy to store in a purse or pocket. Tampons and cups are also helpful for girls who do sports like swimming, since you can’t wear a pad in the water.

Some girls prefer pads because they’re easy to use and it’s easier to remember when to change them because you can see them getting soaked with blood. And some girls with heavy periods use tampons together with pads or pantiliners for added protection against leaking.

Many girls switch back and forth depending on:

  • their situation
  • where they’re going to be
  • their menstrual flow
  • time of day (day or night coverage)

Reviewed by: Amy W. Anzilotti, MD Date reviewed: October 2019

What Happens if I Keep a Tampon in For Longer Than 8 Hours?

The Scenario: It’s a summer evening, you’re rocking out with your most cherished companions at an outdoor music fest. It’s remote, the scenery is divine, and the music is killer. Smells of nature fill the air accompanied by an occasional whiff of the overwhelmed port-a-potties. You could stay here forever.

Until you realize your buddy is bleeding. Not because they’ve been shot or stabbed, but because every 28 days or so, blood, mucus, and dead endometrial tissues come tumbling out of their genitals. Fortunately, god (or someone shortly after her) invented tampons. Since pre-sunrise, your friend has had a wad of cotton shoved up there, and that insertion is well beyond the box-recommended eight-hour mark.

“How long can I realistically leave a tampon in?” your friend asks. You get it—no one wants to visit a bathroom stall (especially one without sinks) at a music festival more often than they need to.

The Concern: The box says eight hours, the directions say eight hours, my middle school hygiene teacher said, “eight hours!” Do tampons self-destruct after eight hours?

I still haven’t determined where that eight-hour timeline originated, but manufacturers warn that wearing a tampon for longer than eight hours, increases the risk of toxic shock syndrome . I clearly remember learning about toxic shock syndrome in my early tampon education. Perhaps it was my mom or maybe the school nurse, but “It can kill you,” I was told. For a long time, I was afraid to anywhere near a tampon.

Even now decades later, with every monthly cycle, those three little letters still boggle my mind: TSS–just how dangerous is it?

Worst Case Scenario: TSS can be fatal, so the worst case scenario is death. Breathe, though: TSS is extremely rare. Each year, less than 1 out of every 100,000 people contracts toxic shock syndrome, and not all of those cases are related to menstruation. Many of the recorded TSS cases are complications of burns or wound care.

So, death by forgotten tampon is theoretically possible but highly unlikely. Still, let’s say your friend is one of the few unlucky folks who develop menstrual-related TSS. You might be relieved to hear that the infection usually progresses fairly slowly. This means they’ll probably have time to pursue life-saving antibiotic treatment after the festival.

But seriously, anyone showing symptoms of TSS should immediately go to the emergency room. TSS usually begins with a sudden fever, sore throat, muscle pains, and a rash that looks like sunburn. Symptoms like diarrhea, nausea, vomiting, and peeling of the skin can also pop up. If untreated, the patient will experience a drop in blood pressure, multiple organ failure, and will eventually kick the can.

A forgotten tampon, “can be a breeding ground for bacteria just like any other foreign object that’s left in the body too long,” says Zoe Rodriguez, assistant professor of obstetrics, gynecology, and reproductive science at Icahn School of Medicine at Mount Sinai in New York. Rodriguez explains that not all bacteria causes TSS but, “if the bacteria that does flourish is of the staph aureus variety of the strain that has that particular toxin then that’s what could put the patient at risk.”

And while Rodriguez acknowledges that leaving a tampon in for too long does increase the risk of TSS, she also emphasizes, “it’s super rare.”

What’ll Probably Happen: Most of the time nothing happens if you leave a tampon in for too long. Some people do experience complications, but those complications aren’t as dangerous as TSS. For example, if a person uses a tampon too absorbent for their menstrual flow, they might experience excessive drying of the internal mucus membranes. Rodriguez says that this could cause discomfort and even internal abrasions when it’s time to yank that sucker out. But if the individual has adequate internal lubrication, removal shouldn’t be an issue.

Rodriguez encourages patients to “try to use products that are less absorbent on lighter days…because it’s the super absorbent products that can put one at risk for TSS.” For those who’ve left a tampon in for longer than the recommended time, Rodriguez advises to “just remove it and go on about their business and typically nothing will happen.”

Of course, the longer a tampon stays in, the higher the risk of complications. And forgetting tampons or “losing” them is not uncommon. Individuals frequently need medical assistance to retrieve internally misplaced tampons. Don’t be embarrassed if it happens to you. Reach out and ask for a helping hand (ha). Just make sure that hand is attached to a licensed medical professional.

As for the health effects of retained tampons, Rodriguez explains, “The most common consequence of leaving a tampon in for too long or forgetting a tampon inside, is a very foul-smelling discharge and irregular spotting.” She describes the experience as a “mild or minor condition” and elaborated that it often only develops after leaving a tampon inside the body for days or even weeks.

Advice for Your Friend: As long as your friend is healthy and symptom-free, it’s probably okay to wait for adequate bathroom facilities before diving-in to retrieve that bloody wad of cotton. Most likely they won’t suffer any serious health effects.

But if at any point, during or after, your friend begins to notice a discharge or discomfort, they should head to the doctor, because Rodriguez adds, “In my patients who do present with a foul smelling discharge because they’ve left a tampon in too long, I will treat them empirically with antibiotics.”

Knowledge is important—know the symptoms of TSS, but if you can’t avoid leaving a tampon in for more than eight hours, don’t freak out. Just don’t forget about the damn thing altogether and you should be fine.

Read This Next: Why Do I Sweat a Puddle Every Night?

6 best, easy-to-use tampons for beginners

Image zoom Getty Images / Emilija Manevska

To pad or to tampon? That is the ultimate female question. Choosing a staple period product is a personal decision and there’s absolutely no wrong answer. If you’ve chosen to take the tampon route, these beginner tampons will make life on your period a lot easier.

To a beginner, using a tampon may seem like a daunting task. But we assure you that once you get the hang of it, inserting a tampon is no big deal. Just so you know — the first time you try a tampon, you’ll probably go through a trial and error process in which you’ll waste a few tampons along the way. Don’t get frustrated. Just take a few deep breaths and carry on.

Perhaps the best thing about using a tampon is that fact that when inserted correctly you can’t even tell it’s there. Tampons are less bulky and less messy than pads, which are the biggest selling points for those who use them.

Beginners should start with slender tampons that come in plastic applicators. Cardboard applicator tampons, or tampons with no applicators at all, are usually less expensive and can be more environmentally friendly. But these varieties tend to be uncomfortable and difficult to use.

To help guide you through the process of choosing a first tampon, check out our suggestions below.

Image zoom Tampax

Tampax brand tampons are great for beginners. They have a simple design that makes for comfortable insertion. We recommend practicing with the Lite version because they’re thinner. But once you have the hang of it, upgrade to regular and then to super, if necessary.

2U by Kotex Sleek Regulars

Image zoom U by Kotex

These Regular-sized tampons are great for newbies due to their smooth, easy-grip applicator design that ensures perfect placement.

3Playtex Gentle Glide 360°

Image zoom Playtex

If you’re one for simplicity, the Playtex Gentle Glide tampons might be your perfect match. They are comfortable to use and their 360° absorbent tampon keeps you leak-free and dry.

4Tampax Radiant Regular

Image zoom Tampax

With a sleek and easy-to-use applicator, Tampax Radiant promises that you’ll remain 100% leak-free. These guys are similar to the above U by Kotex Sleek with their easy-grip design.

5U by Kotex Fitness

Image zoom U by Kotex

If you play sports, these tampons will score high on your leaderboard. Not only will they give you great protection from leaks, but these U by Kotex Fitness tampons come with their own FitPak so you can discretely bring three with you to the gym or to practice.

6Seventh Generation Free & Clear

Image zoom Seventh Generation

For girls with ultra sensitive skin or concerns about chemicals and fragrances, Seventh Generation’s Free & Clear tampons have a BPA-free smooth applicator made with 95% plant-based materials. The actual tampons are made with organic, hypoallergenic cotton and are fragrance free.

Test a new product every month to find the perfect tampon for you. Good luck, ladies! You’ve totally got this.

  • By Olivia Harvey

As if we needed life to be any more difficult when it comes to menstruation, getting your period when you’re planning a beach day can be a serious bummer. If you’ve managed to get your cramps under control (a feat in and of itself worth celebrating), the last thing you want to worry about is leakage.

Related Story
Here are seven editor-approved tampons you can rely on for your poolside needs, whenever:

For picking up on the go

Tampax Pearl Tampons

Pearl Plastic Tampons Tampax amazon.com $18.72

You know ’em, you love ’em, you’ve definitely tried ’em, and the good news is that they’re so popular, they’re most likely available in any drugstore you can hop into on your way to the beach or pool.

For when you’re traveling on an exotic beach vacation

Cora Organic Tampons With Compact Applicator

Organic Cotton Tampons Cora amazon.com $15.99

Fun fact: If you’re traveling to certain Asian countries, you might not be able to find tampons very easily. This is something I learned firsthand and something I wish I would’ve planned for in advance. Next time, I’ll be bringing these Cora Organic Tampons with me. They have compact applicators, so they take up less real estate in your luggage and you can pack extra for peace of mind. Calculating the exact number of tampons you’ll need ≠ something fun you want to do before a vacation.

For swimming laps

Playtex Sport Tampons

Amazon.com $8.68

These are my personal OG tampons. They are comfortable, never slip out of place, are easy to insert, and are good for any level of activity—whether that means thrashing about in the waves nonstop or taking a warm and sunny beach nap (just don’t forget your SPF).

For stashing in your beach bag

Lola Compact Plastic Tampons

MyLola.com $10.00

These little blue tampons from Lola have a lot going for them. For starters, they’re made from 100 percent organic cotton, and the plastic applicator is totally BPA-free. And they’re super compact, so they won’t take up valuable real estate in your beach bag that should be devoted to sunscreen, beach snacks, and cans of rosé.

You can order just one box from Lola’s website. Or you can be prepared and set up a personalized subscription for the rest of the summer. Lola’s boxes are super customizable—you can decide exactly how many light, regular, super, and super+ tampons you want and how often you want them. Might as well have them shipped straight to the beach.

For beaches with no bathroom

U by Kotex Super-Plus Tampons

Target.com $4.69

Going pee in the ocean is one thing. But changing your tampon in the ocean isn’t advisable (for hygienic and environmental reasons). If your summer plans include going to one of the beautiful remote beaches where you literally can’t spot another sunbather, much less a bathroom, you need a tampon that’s up to task. Or in other words: You need a high-absorbency tampon.

These U by Kotex super-plus tampons can absorb a whopping 12 to 15 grams of blood. Considering you lose about 30 to 40 grams of blood on an average period, these little guys should be able to handle even your heaviest days.

For keeping the beach beautiful

O.B. Pro Comfort Tampons

Amazon.com $9.63

Think of how many little plastic or cardboard tampon applicators you’ve thrown away in your lifetime. It’s so many! If you find yourself enjoying the soft sound of the waves and the warm feeling of sun on your skin and thinking, Wow, it would be a shame if this were totally ruined, maybe it’s time to give applicator-free tampons a try.

These classic tampons from o.b. are highly reviewed on Amazon and come in multipacks to accommodate all the days of your period. They’re easy to insert (although it may take a bit of getting used to), and having no applicator means they’re teeny-tiny and easy to pack.

For when you don’t want a tampon

Amazon.com $24.13

Public beach and pool bathrooms aren’t usually the cleanest places, and spotting a wet tampon string sticking out of your swimsuit isn’t the best. If you want another non-tampon option, a menstrual cup may be your best bet.

There are loads of options, but this compact, collapsible version from Intimina is great for keeping in a beach or pool bag because it’s so small and transportable—it even comes with its own little case! Plus, it carries the benefit of being waste-free. Do your vagina and the earth a little good.

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Hannah Smothers Hannah writes about health, sex, and relationships for Cosmopolitan, and you can follow her on Twitter and Instagram. Carina Hsieh Sex & Relationships Editor Carina Hsieh lives in NYC with her French Bulldog Bao Bao — follow her on Instagram and Twitter • Candace Bushnell once called her the Samantha Jones of Tinder • She enjoys hanging out in the candle aisle of TJ Maxx and getting lost in Amazon spirals.

Treatment

Heavy Menstrual Periods (Menorrhagia)

Women of child bearing age have monthly bleeding called menstruation. It is also called menses or a period. During menstruation, the lining of the uterus (the womb) is shed along with some blood. Most women with bleeding disorders have very heavy periods that last longer than normal. The medical name for this is menorrhagia.

Women who have been diagnosed with a bleeding disorder often dread their monthly periods because of a large amount of bleeding that can occur during this time. It is not uncommon to have to change a pad/tampon every hour or so for the first day or two of the cycle. The bleeding can also last longer than a week and interfere with activities of daily living.

It can be embarrassing, annoying, and inconvenient to be bleeding heavily for several days. Many women fear they will leak through their clothing while in public and choose to stay home for the first day or two of their cycle. This means missing days of work or school which can create problems with employers or teachers. Fortunately, there are products available to help control the bleeding and avoid soiling clothing.

In the past, doctors had difficulty defining the normal amount of bleeding that should happen during a woman’s period. It is hard to measure. Women in a family with a bleeding disorder may think their periods are normal because they bleed just like their mothers and grandmothers did. Your doctor may give you a chart to mark how many tampons or pads you use each day of your period. A normal period lasts less than eight days.

Bleeding during your period is considered heavy if:

  • Your bleeding soaks through the pad or tampon in less than two hours.
  • Your clothes are often stained from leaking menstrual blood.
  • Your bleeding gets in the way of your doing your daily activities.
  • You pass large blood clots (bigger than one inch).

How to treat menorrhagia:

  • Treatment for menorrhagia depends on the type of bleeding disorder. Amicar®, Cyklokapron®, desmopressin, or even platelet transfusion may be used.
  • Stimate® nasal spray, if effective, may be used on the first day of the period.
  • Birth control pills or hormones can be used to control the periods. They also raise the clotting factor levels in some women with bleeding disorders.

Some women with menorrhagia are treated with hormones. They receive a combination of estrogen and progesterone. This causes thinning of the lining of the uterus (womb) so that there is less lining to shed during the monthly period. The longer you take the hormonal medication, the lighter and shorter your period becomes.

There are several forms of hormone medicine. You and your health care provider can decide which will work the best for you. Hormones can be taken in a daily pill or as an injection (shot) that is given every three months. Your health care provider can put a device in your uterus. This intrauterine device releases a hormone that helps control the bleeding. It can be left in place for up to five years.

There are several options of pills available. There are monthly packs so that you have a period once a month. There are three month packs so you have a period four times a year. There is a form that you take every day of the year. With this last option you don’t have a regular period but may have unscheduled and unexpected breakthrough bleeding. The unexpected bleeding is usually spotting. The option of unexpected spotting is inconvenient but it may be easier to live with than heavy bleeding. You know your body and your lifestyle better than anyone else and can choose what option will work for you.

When you desire to become pregnant you stop using the hormone medication. The length of time you are on the pills or intrauterine system will not affect the length of time it may take you to become pregnant. It is recommended to stop the injection form of the medication 18 months before you want to become pregnant. The injection form may take up to that amount of time to clear your body.
Menorrhagia may also be treated with surgery. One type of surgery that is used is endometrial ablation. The doctor uses heat, a laser, or radiowaves to remove the lining inside the uterus. This lining is called the endometrium. After it is removed, the menstrual flow usually decreases or even stops. Most women are not able to have children after endometrial ablation.

Removal of the uterus (hysterectomy) will stop menstrual bleeding completely, but it is a drastic step. Make sure you have discussed all other treatment options with your doctor.

Coping with menorrhagia

Products are available to help avoid blood leaking through your clothing. One can be found in the incontinence aisle at most discount and drug stores. This product is called Poise® Panties and it can be discreetly worn under clothing. Unlike the common perception of adult diapers, these are thin and worn as panties so there are no sticky tabs at the sides as found in some products. They are made to absorb a considerable amount of fluid and they are disposable. They can be worn in addition to a tampon to give you extra security when you are having heavy bleeding. They do not rustle when you walk or add bulk to your clothing. The top of the panty can be folded down to fit under low rise pants. They are a great option for your heavier flow days. If you have questions or need help locating products to manage your heavy periods, talk to the nurse at your hemophilia treatment center (HTC).

Teenage girls can often be embarrassed by the heavy flow and may not participate in sports or other activities for fear of having an accident. Physical exercise is an excellent way to overcome menstrual cramps if you suffer from those. It also improves muscle strength and can keep your heart healthy. Using super tampons in combination with the Poise® Panties will help prevent accidents while participating in sports or other physical activities.

Sometimes teachers will not allow girls to go to the bathroom as often as they need to when having their periods. Your bleeding disorder nurse can help educate the teachers by doing an educational in-service at your school. Once the teachers understand about your bleeding disorder and why you may need to make several trips to the bathroom during the day, they are more likely to excuse you from class to take care of your hygiene needs.

A woman with menorrhagia can lose a great deal of blood each month. She may become anemic. This means her blood has less than the normal amount of red blood cells. She can feel weak and tired. A simple blood test can check for anemia.

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