Tampon use in patients with anorexia nervosa can cause persistent vaginal bleeding: A case series
✍ Scribed by Gaudiani, Jennifer L. ;Heinrichs, Gretchen ;Narayanan, Vignesh ;Mehler, Philip S.
- Publisher
- Wiley (John Wiley & Sons)
- Year
- 2010
- Tongue
- English
- Weight
- 61 KB
- Volume
- 44
- Category
- Article
- ISSN
- 0276-3478
No coin nor oath required. For personal study only.
✦ Synopsis
Objective:
To describe the phenomenon of persistent vaginal bleeding in two patients with severe anorexia nervosa.
Method:
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.
Result:
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.
Discussion:
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.