Can You Sleep With a Tampon In?

Managing your menstrual cycle is just a fact of life — at least until menopause decides to make its appearance. The good news is we’ve come a long way since moss and buffalo skins. (1) And while tampons and pads top the list of feminine hygiene products, they’re not without issue. (2) Pads come with the looming threat of shifting and leaks, and while tampons sidestep those issues, they have their own usage considerations. For starters, it’s unclear to many women if they can sleep with a tampon — and if so, for how long? Turns out, you can sleep with a tampon in, but before you skip off to the bathroom, there are some things you need to know. Here’s more.

Long Story Short

• Women can sleep with a tampon for up to eight hours.
• Toxic shock syndrome (TSS) is a bacterial infection commonly associated with tampon use.
• To minimize the risk of spreading bacteria and exposing yourself to TSS, don’t exceed an eight-hour wear time, wash your hands, and put in a fresh tampon right before bedtime.

Can You Sleep With a Tampon in Overnight? 

Laura Purdy, M.D., MBA, and board-certified family medicine physician, tells Sleepopolis that you can sleep with a tampon overnight — provided you follow some important safety guidelines. (3)

Mind the Timing

First and foremost, Purdy says sleep duration is key. “Changing your tampon every 4 to 8 hours is recommended, so if you’re sleeping less than 8 hours, wearing a tampon should be fine.” (3) However, if you’re planning to sleep in, she cautions that could increase your risk of developing toxic shock syndrome (more on that later). 

How Long Can You Sleep With a Tampon in?

Safety guidelines from the FDA suggest changing your tampon every four to eight hours. This means you can technically sleep with a tampon for a maximum of eight hours. If you plan to sleep for a longer stretch, consider setting an alarm so you don’t wear a tampon for longer than you should. (3)

Set an Alarm

If you think your forty winks may exceed the time stamp on your tampon, consider setting an alarm to help you stay within your eight-hour window. If you’re a heavy sleeper or hate sleep disruptions, it may be best to skip the tampon and sleep with a pad instead. 

Put a Fresh Tampon in Just Before You Go to Bed

If you use a tampon at night, be sure to put a fresh one in right before hitting the sack. If you go to sleep with whatever you have in place, you’re adding more time onto the tampon and are likely increasing your risk of exceeding your time limit. Also, remember to remove your tampon immediately upon waking.

Wash Your Hands

Even if you think your hands are clean, be sure to wash your hands before and after handling a tampon. This may help reduce the spread of bacteria. (3) 

Pick the Right Absorbency

While it may sound strange, choosing the right absorbency for your flow matters. By using a higher absorbency than what’s needed for your flow, you may be tempted to stretch the time between tampon changeouts and needlessly increase your risk for Toxic shock syndrome (TSS). With this in mind, the FDA cautions women to use the lowest absorbency needed. (3)

What Is Toxic Shock Syndrome? 

Toxic shock syndrome (TSS) is a medical condition caused by a bacterial infection. TSS is a rare but serious illness that requires immediate medical attention as it can be life-threatening.

Symptoms of Toxic Shock Syndrome

The symptoms of toxic shock syndrome vary from person to person, and Linda Khoshaba, N.M.D. and founder of Natural Endocrinology Specialists (NES), warns that they can develop rapidly as well. 

Symptoms of TSS can develop rapidly and may include: (4)

• Sudden high fever (above 102°F or 38.9°C)
• Low blood pressure (hypotension)
• Vomiting or diarrhea
• A sunburn-like rash, often on the palms and soles
• Muscle aches
• Redness of the eyes, mouth, and throat
• Confusion or disorientation
• Headaches

With some words of caution, Khoshaba says, “If any of these symptoms occur, especially in the context of recent tampon use, it is crucial to seek immediate medical attention.” 

Regarding treatment, Khoshaba tells us that “toxic shock syndrome is typically treated with antibiotics to fight the bacterial infection and supportive care, such as fluids, to stabilize blood pressure and address other symptoms. In severe cases, hospitalization may be required for intensive care.” (4)

Why Do Tampons Cause Toxic Shock Syndrome? 

Khoshaba says, “Toxic Shock Syndrome is often associated with Staphylococcus aureus (staph) and sometimes Streptococcus pyogenes (strep).” (4) While she notes that TSS can occur in anyone, she says, “It is most commonly linked to tampon use, particularly when tampons are left in for extended periods or if super-absorbent tampons are used.” (4)

What to do if You Have Toxic Shock Syndrome

Khoshaba says TSS is an actual “medical emergency.” If you suspect you have TSS, she suggests the following:

Remove the Tampon or Menstrual Product: If you’re still using a tampon, remove it immediately and switch to a pad. (5)

Seek Immediate Medical Attention: Go to the nearest emergency room or call emergency services. Khoshaba notes that “TSS can progress rapidly, so prompt treatment is crucial.” (5)

Be Prepared With Information: You or someone close to you should be able to inform healthcare providers about your symptoms, tampon use, and any recent illnesses or surgeries, as these can help with diagnosis and treatment. (5)

Alternatives to Sleeping with Tampons

Tampons aren’t the only way to protect your sleep — and your sheets. Safe alternatives for overnight menstrual protection include pads, period underwear, menstrual cups, and menstrual discs. 

Pads

Pads are always a good non-invasive fail-safe for period protection. If you’re concerned about overnight protection and heavier flows, overnight pads may be worth a closer look. Khoshaba notes, “Overnight pads are designed to offer extra absorbency and coverage during the night, reducing the risk of leaks without the need for internal products.” 

Menstrual Cups

Menstrual Cups are funnel-shaped cups (usually made of medical-grade silicon or latex) that collect menstrual blood instead of absorbing it like pads or tampons. They are reusable, and one cup can be used for the entire duration of your period. Khoshaba notes that menstrual cups can be worn for up to 12 hours, making them a good option for overnight use. (6)

Period Underwear

Period Underwear is “specially designed underwear with built-in absorbent layers that can be worn alone or as a backup to other products,” says Khoshaba, who adds that they’re comfortable and provide protection without the risk of TSS. (7)

Menstrual Discs

Menstrual Discs are similar to menstrual cups, they collect menstrual blood instead of absorbing it. Like menstrual cups, the discs can be worn for up to 12 hours, making them a solid option for overnight use. (6)

Though there isn’t a link between menstrual discs and TSS at this time, we should note that, like tampons, menstrual cups have also been linked with toxic shock syndrome. One research study even found that menstrual cups may have higher levels of Staphylococcus aureus (staph) growth than tampons. (8) So, while these reusable options are good alternatives for women who prefer not to sleep with a pad overnight, they may not necessarily sidestep the toxic shock syndrome conundrum. 

FAQs

The Last Word From Sleepopolis 

You should be able to sleep with a tampon in as long as you keep it under eight hours. While toxic shock syndrome is most commonly associated with tampon use, it’s not a given. Your risk of TSS is greatly reduced if you mind some best practices associated with tampon use.

Sources

1. Sanitary suspenders to Mooncups: A brief history of menstrual products · V&A. Victoria and Albert Museum. (n.d.). https://www.vam.ac.uk/articles/a-brief-history-of-menstrual-products 
2. Menstrual hygiene products: Pads and tampons are the go-to choice. Apple Women’s Health Study. (2023, May 18). https://www.hsph.harvard.edu/applewomenshealthstudy/updates/menstrualhygieneproducts/ 
3. Commissioner, O. of the. (n.d.). The facts on tampons and how to use them safely. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/facts-tampons-and-how-use-them-safely 
4. Ross A, Shoff HW. Toxic Shock Syndrome. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459345/
5. NHS. (n.d.). NHS choices. https://www.nhs.uk/conditions/toxic-shock-syndrome/ 
6. How to use Flex Cup: Insertion & Removal. The Flex Company. (n.d.). https://flexfits.com/pages/how-to-use-flex-period-cup 
7. The Super Absorbent. Super Comfortable. super safe. super sustainable. The Period Company. (n.d.). https://period.co/collections/all 
8. Nonfoux L, Chiaruzzi M, Badiou C, Baude J, Tristan AThioulouse J, Muller D, Prigent-Combaret C, Lina G 2018. Impact of Currently Marketed Tampons and Menstrual Cups on Staphylococcus aureus Growth and Toxic Shock Syndrome Toxin 1 Production In Vitro. Appl Environ Microbiol 84:e00351-18.
9. https://doi.org/10.1128/AEM.00351-18

Khoshaba, Linda. Author Interview. August 6, 2024. 

Purdy, Laura. Author Interview. August 7, 2024.