No, you should never leave a tampon in for 20 hours; health guidelines, including from the U.S. Food and Drug Administration (FDA), recommend changing tampons every 4 to 8 hours, as leaving them in longer significantly increases the risk of serious infections, most notably the life-threatening Toxic Shock Syndrome (TSS).
Change your tampon every four to eight hours to avoid health risks. TSS symptoms include a rash, fever, and nausea, requiring immediate medical attention. Leaving a tampon in too long may disrupt the balance of vaginal microbes, leading to BV or a yeast infection.
The short answer is: Yes, you can sleep with a tampon in. But it's important to pick the tampon with the right absorbency for you and not wear any tampon for longer than eight hours. Ob/Gyn Stacie Jhaveri, MD, dives more into sleeping safely with a tampon.
There isn't a set time for when symptoms of TSS start after using a tampon. However, tampons should be removed from your vagina after eight hours to lower your risk of TSS. This doesn't mean you will get TSS if a tampon is left in your vagina longer than eight hours.
Other symptoms may include pain at the site of a wound, vomiting and diarrhea, signs of shock including low blood pressure and light-headedness, shortness of breath and a sunburn-like rash. In general, TSS symptoms can develop as soon as 12 hours after a surgical procedure.
The earliest signs of TSS begin abruptly and can present with flu-like symptoms including fever, headache, vomiting, diarrhea and sore muscles.
What are the symptoms of toxic shock syndrome?
Reducing the risk of toxic shock syndrome
Given the number of women worldwide who regularly use tampons, TSS is a very rare condition. Suggestions to reduce the risk include: Change tampons regularly (at least every four hours). Avoid using super-absorbent tampons.
TSS is a severe toxin-mediated illness with sudden onset of high fever, vomiting, profuse watery diarrhea, and myalgia, followed by hypotension and potentially shock. During the acute phase of the illness, a “sunburn-like” rash is present.
Heavy periods aren't usually life-threatening, but they can be if you lose too much blood. Bleeding through two or more tampons or pads each hour for two to three hours in a row is a sign that you should see your provider or seek emergency care.
You can go about your day, sleep comfortably at night, or even exercise, knowing your blood flow is absorbed and secure. Another reason is comfort. Many people say wearing regular underwear with pads feels bulky or awkward, whereas period pants feel just like everyday undies — but with hidden leak protection.
Because it's best to change tampons every few hours, choose pads instead of tampons for overnight wear. Special overnight pads are available too. That way, you can be sure you're wearing one that's absorbent enough to get you through until the morning.
You know your tampon is full when you feel resistance pulling the string, notice blood on the string or in your underwear, or feel it inside you; however, for hygiene, you should change it every 4-8 hours regardless, as a "dry" tampon (not full) can be uncomfortable to remove, and a full one will leak. The best signs of fullness are leaking (blood on underwear) or the string appearing bloody, indicating it's saturated and needs changing soon.
vomiting and diarrhoea. severe pain in your arms or legs, or all over your body. a rash that feels rough like sandpaper – the rash may look red, which can be harder to see on brown or black skin. the palms of your hands, soles of your feet, tongue and the whites of your eyes turn bright red.
Vaginal discharge that is a yellow-green colour is not normal. It can indicate an infection in your body, and you should get treatment as soon as possible. The infection could be due to a sexually transmitted infection (STI). These can lead to complications, especially in pregnancy.
Irritation: Using a high-absorbency tampon or leaving it in for too long may cause irritation or minor inflammation in the vaginal area, which could, in some cases, make it easier for bacteria to travel closer to the urethra. However, this has not been conclusively linked to UTI onset in studies.
The main concern with a lost tampon is toxic shock syndrome (TSS). This is very rare but can cause death. You should change your tampon regularly — around every 4 to 6 hours depending on your flow. Most tampon manufacturers advise that a tampon shouldn't be left in for more than 8 hours.
Common signs and symptoms include fever, muscle aches, vomiting and diarrhea, and a sunburn-like rash that later peels. Low blood pressure, shock, multi-organ failure, and death can occur. How soon after exposure do symptoms appear? TSS can develop within 12 hours in some cases.
Symptoms of shock
The incidence of TSS is estimated to be around 0.8 to 3.4 per 100,000 in the United States.
Symptoms
Key points. Periods that last for more than 7 days are considered heavy. Periods that require a new tampon or pad after less than 2 hours or involve passing large clots are considered heavy. Your healthcare provider can determine if you might need testing for a possible bleeding disorder.
Symptoms of sepsis
Sweating for no clear reason. Feeling lightheaded. Shivering. Symptoms specific to the type of infection, such as painful urination from a urinary tract infection or worsening cough from pneumonia.
If you cannot simply pull the string to remove the tampon, or the string is inside and you feel comfortable exploring your own vagina, you can try to "gently sweep it out" on your own.
To reduce your risk of TSS, use the lowest absorbency tampon necessary, wear a tampon for no more than 8 hours and then throw it away, and use tampons only when you have your period.