Tampon use in patients with anorexia nervosa can cause persistent vaginal bleeding: A case series
Article first published online: 5 NOV 2010
Copyright © 2010 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 44, Issue 8, pages 752–755, December 2011
How to Cite
Gaudiani, J. L., Heinrichs, G., Narayanan, V. and Mehler, P. S. (2011), Tampon use in patients with anorexia nervosa can cause persistent vaginal bleeding: A case series. Int. J. Eat. Disord., 44: 752–755. doi: 10.1002/eat.20861
- Issue published online: 9 NOV 2011
- Article first published online: 5 NOV 2010
- Manuscript Accepted: 27 JUN 2010
- vaginal bleeding;
To describe the phenomenon of persistent vaginal bleeding intwo patients with severe anorexia nervosa.
We report two cases of young women with severe anorexia nervosa reporting vaginal bleeding that persisted for months despite trials of topical and systemic conjugated estrogen therapy.
A speculum exam by a gynecologist ultimately revealed the source of the bleeding to be tampon-induced vaginal ulcers. These resolved, along with the vaginal bleeding, with vaginal estrogen cream and cessation of tampon use.
Most patients with anorexia nervosa are amenorrheic due to reversion of the hypothalamic-pituitary-ovarian axis to a prepubertal state. Vaginal bleeding in patients with anorexia nervosa may trigger needless systemic hormonal treatments, radiographic studies, and multiple physician visits. A careful exam is warranted to evaluate for the presence of tampon-induced vaginal ulcer in patients with anorexia nervosa who have persistent vaginal bleeding. © 2010 by Wiley Periodicals, Inc. (Int J Eat Disord 2010)