Sleeping With a Tampon in 'Is' Safe

Turns out tampon removal before bed isn't really necessary.

During your six to eight days of monthly bloody hell, taking out your tampon has probably become a sort of nighttime ritual, as habitual and mandatory as washing your face and brushing your teeth before finally snuggling down into your happy place. And you probably are not about to get out of bed halfway through your already too-short precious hours of sleep to change a tampon.

But if you're quick to get your (period-proof) panties in a twist fretting over your chances of toxic shock syndrome (TSS), you might take some comfort in the fact that this potentially serious complication of a bacterial infection is really rare. Your chances of TSS are somewhere around one in 100,000, said Raquel Dardik, MD, a gynecologist at NYU Langone Health.

You're not wrong about not leaving a tampon in too long. Keeping a tampon in for longer than recommended by the manufacturer does seem to increase your risk of landing in TSS trouble. But nobody really knows how long is too long. "There is no data determining how long they should stay in," Dr. Dardik said.

Tonya Callender, a doctor of nursing practice specializing in women's health care at the University of Texas Medical Branch at Galveston, advised that "too long" is probably a lot longer than you'd ever think to leave a tampon in any way: twenty. four. hours.

That's a far cry from the four to eight hours recommended by most manufacturers, not to mention a heck of a lot longer than you're probably waiting to change your tampon. Callender recognized that; she didn't advise not changing your tampon for an entire day. Rather, if you are bleeding lightly and happen to forget about a tampon you inserted yesterday, you're probably fine.

But if you're bleeding more heavily, you're obviously going to want to change your tampon a lot more than once a day—more like every three to four hours. The longest you should wait before changing a tampon is probably around eight hours, Callender said.

Whether those eight hours fall during the day or at night doesn't make any difference. "There is no risk of sleeping with a tampon in," Callender noted. "Just the fact that it's at night doesn't make any impact [on TSS risk]."

At one time, the absorbency level of a tampon may have been a risk factor. "When TSS was first identified in the 1970s and '80s, the cases seemed to be associated with more absorbent tampons," Dr. Dardik said.

According to "The Palgrave Handbook of Critical Menstruation Studies," synthetic materials that gave the products their super-absorbency (including rayon and polyester) seemed to increase the chances of TSS, as research later revealed. But the brands that were mixed up in that long ago mess have long since been pulled from the shelves, Dr. Dardik said. So, current high-absorbency tampon options are much, much safer.

If you've got a lazy Saturday or Sunday ahead and you're (blissfully) anticipating spending way more than eight hours snoozing, be on the safe side and reach for a pad, menstrual cup, or a pair of extra-absorbent period panties. Save the tampons for earlier mornings.

Naturally, you'll always want to remember to switch things up first thing in the morning. However, forgetful sleepyheads don't necessarily need to panic about a later-than-usual change. Ob-gyns promise they've had patients who have forgotten they had a tampon in for days or even weeks—and they have been totally fine.

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