When Can I Wear Tampons Again Miscarriage
Howdy! I recently learned (unfortunately) that it'due south recommended women don't apply tampons during miscarriage bleeding, due to chance of infection. As the friend who told me this pointed out, it makes an already unpleasant and uncomfortable experience all the more unpleasant and uncomfortable. I was wondering if that'southward truthful, and (this is what I couldn't detect anywhere online) if that'southward less true for early on miscarriages, like those in the start 6 weeks.
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Short Take
Avoiding tampons for two weeks after a miscarriage is the recommendation. This is canonical conventional wisdom based on a theoretical risk of infection with tampons, just there is no supporting research.
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This appears to exist one of those medical recommendations that someone wrote in a textbook decades ago, but perchance even a hundred years or more, and it has stayed effectually since.
The hypothesis is a tampon could increment the risk of infection every bit the neck is open to pass tissue. Inserting anything into the vagina, be it a tampon, a sex activity toy, or a penis, could possibly introduce bacteria that would at present take an easier pathway into the uterus. A tampon in the vagina could as well provide a site for leaner that is already present to grow.
Bacteria can definitely enter the uterus from the vagina and cause infection. Gonorrhea is one example people might be familiar with, but even the typical bacteria in the vagina tin can cause impairment in this way. One that tin can crusade catastrophic infections with a loftier rate of mortality later on miscarriage, induced abortion, and even pregnancy is Clostridium perfringens. I've seen this once and I hope I never encounter it once again. Thankfully, it is a rare infection, but that besides means what we know about information technology is based on example reports. I read vi case reports for this piece, but none of them mentioned if tampons were involved or not. There is besides the risk of toxic shock syndrome with tampons (caused by a toxin produced by the leaner Staph aureus), although it is believed that the toxin typically enters the claret stream from the vagina not via the uterus. Currently, the risk of menstrual toxic shock syndrome is 1 in 100,000 women per year. How tampons after miscarriage might affect that gamble is unknown.
Many people miscarry before they know they are pregnant, especially as bleeding before half dozen weeks is often lighter than a regular period. This means that many people might be unaware they are miscarrying and so are using tampons. Ane report that looked at menstrual blood loss versus claret loss from a miscarriage before half-dozen weeks appears not to have instructed participants to avert tampons in case they were pregnant, every bit they used pad and tampon counts to estimate blood loss.
I accept not been able to discover any clinical trials or even observational studies to back up the recommendation to avoid tampons after a miscarriage. I asked multiple OB/GYNs if they knew of whatever studies that I was missing, and each ane said no.
My own personal theory is this is an older recommendation from before the discovery of antibiotics, when infection in the uterus was disastrous and objects in the vagina, such as pessaries, were believed to play a role. Some objects actually did crusade infections, for example stem pessaries, a contraceptive with a metallic rod that went into the cervix with a metallic cap on the outside covering the neck (imagine a giant thumb tack in the cervix). Infections related to miscarriage would have been more mutual, even taking unsafe abortion out of the flick. There was no treatment for gonorrhea, then that resulted in catastrophic infections for many. There is also incomplete abortion, a miscarriage that starts just doesn't complete. The tissue that stays behind combined with an open cervix trying to expel the tissue increases the chance of infection. Today nosotros tin exercise a dilation and curettage in a clean operating room with sterile equipment and administer antibiotics. This was non always the case.
I take some textbooks from the late 1800s and treatment for infection of the uterus (then typically called inflammation or metritis) amounted to little more than torture, and most of it ineffective at that. For example hot water douches, carbolic acid douches, and scarification of the cervix (cutting the cervix to scar it), so obsession about preventing infections is, um, understandable in that context.
I suspect this legacy of catastrophic infections informed a lot of textbooks in the 1920s and 30s and the information about avoiding anything that might theoretically raise the infection adventure stuck. Septic unsafe abortions would only had added to the business. I am confident that there is more than a whiff of purity civilization equally well. Information technology is easier to tell someone they should keep a penis out of their vagina if you tell them tampons are risky.
The hypothesis that tampons after miscarriage or abortion might raise the risk of infection is not an unsound one, it's just that it unencumbered with data so nosotros don't know if information technology is valid or if it'southward dogma. It'south also nearly impossible to written report. The charge per unit of infection after a showtime trimester miscarriage and after a first trimester ballgame is so low that a massive study would probable be required to testify a risk from tampons.
In 1 report, 77% of second trimester miscarriages were associated with infection. This means there is more likely to be bacteria in the haemorrhage that follows. Could this leaner attach to a tampon and abound and and so travel back into the uterus or enter the bloodstream? Mayhap. The neck also stays open up for longer after a second trimester miscarriage, so this might further increase the chance. In addition, any second trimester procedure that involves laminaria, seaweed sticks that are placed in the cervix the day earlier to open the cervix for dilation and evacuation, increases the risk of infection. In the absenteeism of other information, information technology seems a solid recommendation to avoid tampons for two weeks later on a second trimester miscarriage or abortion.
Given the gamble of infection is lower overall with a first trimester miscarriage and that many people probably use tampons with early miscarriages not realizing they are significant, the gamble of tampon-related infection is likely low, just that is also a hypothesis. Information technology is but not possibly to quantify the infection risk related to tampons in this state of affairs. When infections do occur, even with modernistic antibiotics, they tin exist catastrophic.
The American Higher of OB/GYN (ACOG) and handouts from multiple institutions recommend avoiding tampons for two weeks after a miscarriage or a pregnancy termination, and this is what nearly practitioners recommend. Based on the lack of data, it is hard for them to recommend anything else. I appreciate this is a deeply unsatisfying respond.
Source: https://vajenda.substack.com/p/is-it-safe-to-wear-a-tampon-during
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