What you should do when you discover a retained tampon

Retained tampons are fairly common, and at Women’s Health Practice we recommend coming in for evaluation if you find one. Maybe it got to be a late day of your period, or you changed during the night, and sleepiness took over; and you simply forgot to remove the tampon. Tampons that have been in place for more than a few hours, are technically ‘retained’, but it’s tampons that have been in place for days or longer that we considered a potential adverse condition.

1. Remove the tampon when discovered.
2. If the tampon has shredded, get a gyno exam.
3. If you suspect you did not remove one of your tampons, go to the gyno to see if you either have a retained tampon, or rarely women have more than one retained tampon, especially if they were slim.
4. If you have had sex and discover a retained tampon you are more likely to notice odor, but statistics don’t say that you are more likely to have had an infection.
5. If you have had a retained tampon and you have burning with urination, see your gyno to see if you have a bladder infection.
6. If you know you have herpes and have had a retained tampon you may want to get checked for any spread to the cervix.
7. If you have an odor, you should be checked for a gyn infection. Tampons are designed to absorb a lot of moisture, although not as much as they actually used to absorb a couple of decades ago, so the moisture begins to change the flora of the vagina and causes odors. It’s often not apparent for a long time that something is a bit amiss. In general the patients we find to have a retained tampon have no actual pain, and often they don’t have much discharge, but complain most dramatically of odor.
8. Discharge that is bloody should be checked right away and most likely is not due to the retained tampon at all, but any discharge should mean you need to be seen. Occasionally there is a significant amount of discharge, depending upon the type of tampon and long it has been there. The discharge a woman develops with a retained tampon usually is dark brown, it can even be black.  
9. The treatment could be as simple as removing the tampon. Actually our ability to normalize the bacteria in the vagina is so great that many physicians will just treat with removing the ‘lost’ or ‘forgotten’ tampon and often antibiotics aren’t necessary unless the odor and discharge doesn’t resolve for a few days. Serious side effects such as Toxic Shock Syndrome even if the tampon has been there very long, are very uncommon, and if no fever or pain this is highly unlikely to be the result even from a very long retained tampon. It’s important to have your gyno do a vaginal exam if you suspect a retained tampon, as it is not always possible to detect it or remove it yourself.
10. Generally these guidelines would apply to a retained condom as well!