Though there isn’t conclusive research supporting the recommendation to avoid tampons, to err on the side of caution, it’s best to choose pads for miscarriage-related bleeding.Here’s why it’s a good idea to follow your physician’s advice before inserting tampons after an early pregnancy loss.
Overview of Early Pregnancy Loss
The risk of infection may vary based on your individual situation. For instance, after a chemical pregnancy, any added risk of tampon use is probably quite low, especially considering that most chemical pregnancies go unnoticed. Usually, the first sign of an early pregnancy loss is bleeding and cramping. To diagnose a miscarriage, your doctor will start with a physical exam. An ultrasound to check for a heartbeat and a blood test to measure levels of human chorionic gonadotropin (hCG) can help confirm the miscarriage. Once a miscarriage is confirmed, further treatment may be required to remove remaining fetal tissue. Infection and excessive bleeding are risks of treatment, although serious complications are unlikely. Surgical and nonsurgical options are available in most cases.
Uterine Infections
The technical term for the uterus is the endometrium. Uterine infections are called endometritis (not to be confused with endometriosis). Multiple strains of bacteria may be responsible for uterine infections, including:
ChlamydiaGonorrheaNormal vaginal bacteriaTuberculosis
Bacteria can travel from the vagina to the uterus during a miscarriage, childbirth, or the placement of an intrauterine device (IUD). After a miscarriage, any pregnancy tissue left behind can be a breeding ground for bacteria. Tampons potentially trap this bacteria, creating an environment for it to grow and spread. To diagnose a uterine infection, your doctor may do a biopsy, measure your white blood cell counts, or use a microscope to examine discharge. When left untreated, a uterine infection can lead to more serious complications, such as sepsis or infertility. If you notice the following symptoms after a miscarriage, you should let your doctor know right away:
Abdominal swellingConstipation or changes in bowel movementsExcessive bleeding or dischargeFeverNausea
Treatment for uterine infections may include antibiotics, intravenous fluids, and rest.
Toxic Shock Syndrome
Besides infection, the main concern with using tampons after a miscarriage is the risk of toxic shock syndrome (TSS), a serious condition related to prolonged tampon use. In TSS, bacteria enter the bloodstream and spread to other organs throughout the body. In severe cases, extremities may need to be amputated. Individuals with a compromised immune system, diabetes, or other chronic health issues are more vulnerable to the dangers of TSS. A recent miscarriage, childbirth, or abortion are all considered risk factors for toxic shock syndrome. Some symptoms of toxic shock syndrome include:
ConfusionDiarrheaHigh feverKidney failureLiver failureMuscle achesNauseaRash that occurs about 2 weeks after initial infection and affects the palms and soles of the feetRedness of eyes and throatVomiting
Diagnosis
To diagnose TSS, blood tests may be used to check liver function, clotting times, blood cell counts, electrolyte levels, and the presence of microorganisms. Urine tests and spinal fluid can also be checked for bacteria.
Treatment
Treatment of toxic shock syndrome occurs in the ICU. Care may include the following:
AntibioticsDialysis to treat kidney failureDrainage of any infected sitesGamma globulin (in severe cases)Intravenous fluidsRemoval of any foreign bodies (like a tampon)
A Word From Verywell
Miscarriage is a traumatic, heartbreaking experience, which can be exacerbated by the days of bleeding that follow. It’s understandable to want to use tampons to deal with this stage. However, to protect your health and prevent infection, avoid tampon use until your doctor advises that it’s safe to use them again. For support in dealing with pregnancy loss, seek counseling from a qualified therapist.
