You made it to your CrossFit class, despite your horrible period cramps. You even wore your period underwear just in case your tampon leaks. And yet, in the middle of squatting with a barbell on your back, you feel like your tampon slips out a little bit. But wait, is that a thing that can happen? In short, it is possible for your tampon to escape, at least "from a pressure perspective," says Carrie Pagliano, PT, DPT, spokesperson for the American Physical Therapy Association (APTA).
There's actually a very simple explanation as to how this could happen, and it involves physics. "If the downward intra-abdominal pressure forces during a lift are greater than the ability of the rest of the abdominal canister to counteract them, then the outcome is more pressure down on the tampon," Dr. Pagliano says. "Thus pushing it out." In other words, if you exhale or brace too hard before a lift, and your pelvic floor, abdominals, and deep back muscles aren't strong enough to withstand that pressure, a tampon could come out.
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For most people, this isn't really something you have to worry about. The vagina is a "closed unit," meaning the three-to-five inch vaginal canal where a tampon sits is pretty much secluded, Nicole Bullock, DO, FACOG, an Ob/Gyn in Abilene, TX told Refinery29. That's a good thing, because it means your tampon can't get lost in your body or travel up through your cervix. But it also means that your tampon could theoretically come out in a circumstance like this.
If you're someone who doesn't have a very strong core or pelvic floor, then you might be more susceptible to runaway tampons during certain exercises, like lifts or even squats. People who have been pregnant or given birth tend to have weaker pelvic floors, for example. If nothing else, this unique situation might be a reminder that you need to strengthen your core muscles. A strong core obviously does more than just keep you from slipping tampons during lifts: it helps prevent back pain and improves posture.
Of course, if you notice that you have concerns about this happening, or anything else related to your pelvic health, it's a great idea to see a women's health physical therapist, Dr. Pagliano says. "They help treat many conditions related to pelvic pain," she says. (You can find a physical therapist by using the APTA "find a PT" tool.) And, hey, adding kegels to your workout routine probably wouldn't hurt.