It happens to more people than you’d think. You’re busy, you’re rushing, and suddenly you realize you can’t remember if you actually took that last one out before putting a new one in. Or maybe your period ended three days ago, but something feels... off. Honestly, the "lost tampon" panic is a rite of passage for many, but how to know if you left a tampon in isn't always as obvious as a dangling string.
Sometimes there is no string.
The vagina is a collapsed muscular tube, roughly three to four inches long, though it stretches. It’s not a bottomless abyss. A tampon can’t travel into your abdomen or get lost in your "insides" because the cervix—the opening to your uterus—is far too small to let it through. But it can get tucked into the fornix, the little pockets of space around the cervix, where it sits and, well, begins to collect bacteria.
The Smell is Usually the Dead Giveaway
If you’ve left a tampon in for more than a day or two, your nose will likely tell you before your brain does. This isn't just a "period smell." It’s an unmistakable, pungent, often rotting odor. It happens because the blood trapped in the tampon begins to decompose, and the natural bacteria in your vaginal flora start to overgrow in the stagnant environment.
Dr. Jennifer Gunter, a board-certified OB-GYN and author of The Vagina Bible, has noted that a retained foreign body (the medical term for a forgotten tampon) is one of the most common causes of a sudden, foul vaginal odor. If you notice a smell that reminds you of something decaying, and no amount of showering fixes it, you need to check.
Don't be embarrassed. Doctors see this all the time. Seriously.
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Check for These Physical Red Flags
Aside from the scent, your body might start reacting to the presence of an old tampon through discharge or discomfort. You might notice a watery, brownish, or even greenish discharge. It’s often heavier than your usual spotting. This is your body trying to flush out the irritant.
Then there’s the pelvic pressure.
A tampon that’s been in for a while can swell as it absorbs more moisture, leading to a dull ache or a feeling of fullness in the pelvic floor. Some people experience sharp pains during sex or when sitting down. Others might see localized redness or feel an itch that mimics a yeast infection, but without the "cottage cheese" discharge typical of Candida.
The Myth of the Vanishing String
Strings can get tucked behind the tampon itself or pushed up toward the cervix during bowel movements or intercourse. Just because you don't see a string doesn't mean the tampon is gone. Conversely, if you do see a string but it feels stuck, do not yank it with excessive force. It might be tangled or caught against the vaginal wall.
How to Do a Self-Check (The "Hook" Method)
If you’re spiraling and need to know right now, you can perform a self-exam. Wash your hands thoroughly first. Long nails are not your friend here.
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Squat low or put one foot up on the bathtub. This shortens the vaginal canal. Use your longest finger—usually the middle one—and insert it as far as you can. Sweep in a circular motion, feeling for something firm, cylindrical, or "squishy" like wet cotton. You are looking for the cervix, which feels like the tip of a nose, and checking the spaces around it.
If you feel something but can’t grab it, try bearing down as if you’re having a bowel movement. This uses your pelvic muscles to push the object lower.
When It Becomes an Emergency: Toxic Shock Syndrome (TSS)
We can't talk about how to know if you left a tampon in without mentioning Toxic Shock Syndrome. It’s rare. Very rare. According to the NORD (National Organization for Rare Disorders), it affects about 1 in 100,000 people in the U.S. annually. But when it happens, it moves fast.
TSS is caused by a buildup of Staphylococcus aureus or Streptococcus pyogenes bacteria. If you have a forgotten tampon and suddenly feel like you have the worst flu of your life, stop reading and go to the ER.
Watch for these specific, "red alert" symptoms:
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- A sudden, high fever (usually over 102°F).
- A flat, red rash that looks like a sunburn, specifically on your palms or soles.
- Extreme dizziness or fainting (a sign of dropping blood pressure).
- Vomiting or profuse diarrhea.
- Severe muscle aches.
If you have these symptoms and suspect a tampon is still inside, tell the triage nurse immediately. Time is the most important factor in treating TSS with intravenous antibiotics and fluids.
Why You Shouldn't Just "Wait and See"
Leaving a tampon in for an extra few hours isn't a crisis. But leaving one for days or weeks increases the risk of pelvic inflammatory disease (PID) or severe bacterial vaginosis. The longer it stays, the more the vaginal pH is disrupted.
Also, it gets harder to remove. Over time, the cotton fibers can start to break down or become "dry" against the vaginal walls, making the removal process uncomfortable or even causing small abrasions.
If you find it and it’s been there for a while, remove it slowly. If it’s stuck or you can only feel a piece of it, see a healthcare provider. They have specific tools—like a speculum and long forceps—that can retrieve it in about thirty seconds.
Actionable Steps for Peace of Mind
If you are currently worried, follow this sequence:
- Wash your hands and perform the manual sweep. Be thorough. Use a lubricant if you are feeling dry or irritated to avoid causing micro-tears.
- If you find it but can’t reach it, try the "squat and bear down" technique. If that fails after five minutes, stop. You don't want to irritate the tissue further.
- Book an appointment with an urgent care or your OB-GYN. Tell them exactly what you suspect. It is a routine procedure for them, and they will likely perform a quick swab to ensure no infection has started.
- Monitor your temperature for the next 24 to 48 hours. Even after removal, keep an eye out for fever or a rash.
- Give your vagina a break. After a retained tampon is removed, avoid using another tampon or a menstrual cup for at least one full cycle to let the vaginal flora rebalance. Use pads or period underwear instead.
- Consider a "double-check" habit. If you’re prone to forgetting, use a period tracking app that sends "change tampon" reminders, or make it a rule to only use tampons during the day and pads at night.
The human body is resilient, and while the "forgotten tampon" scenario is stressful, it is almost always easily resolved once you identify the signs. Trust your nose, trust your physical sensations, and never feel too "silly" to seek professional medical help.