Help! I forgot to remove a tampon

Q:

Last night I noticed an off odor, and I discovered a tampon I’d forgotten for several days. I had a hard time getting it out, but I finally did. The smell is gone and I feel fine, but I’m horrified that I left it in so long, and I’m wondering if I need to worry about toxic shock syndrome.

A:

Please don’t stress—forgetting to take out a tampon is far more common than you might think. Women who’ve removed them vigilantly for decades can lapse and leave one in, especially at the end of their cycle when bleeding slows and leaks (which serve as a removal reminder) are less likely. But even when tampons are left in for more than eight hours (which is the maximum time most manufacturers recommend), toxic shock syndrome—a condition marked by nausea, vomiting, fever and rash—is very rare. Still, I suggest calling your doctor for peace of mind. She may want to examine you to rule out an early case of vaginitis and ensure there are no remaining pieces of the tampon in your vaginal canal.

Q I’m nearly three

years past menopause, but I still have cramps and mood swings a few days each month. What’s

going on?

A You’re not alone: I’ve had many postmenopausal patients describe similar “PMS” symptoms, which are typically caused by hormone imbalances that can persist for several years after menopause. In such cases, I suggest taking 40 mg. of black cohosh daily. This herb can restore hormonal balance to alleviate mood swings and cramps.

That said, I also advise seeing your doctor so she can examine you to rule out other possible culprits, such as fibroids or polyps. And if you’re on hormone replacement therapy (HRT), ask your doctor if that may be a factor. Taking hormones that alternate between estrogen and progesterone (which mimics premenopausal hormone fluxes) can cause “PMS” symptoms, so your doctor may advise switching to continuous cycle HRT to keep your hormone levels steadier.