What’s the story with vaginal foreign bodies?

Dear Cecil: Years ago you answered a question about gay men getting gerbils and other items stuck up in their anal canals. But what about vaginas? A good friend of mine, who is also a paramedic and EMT instructor, informed me of several women he has treated with a variety of items stuck helplessly up their own little “tunnels of love.” One case allowed a hot dog to rot and fester for several weeks before finally becoming concerned with the pain, pus, and, of course, the smell. What more information can you provide? royjwood, via the Straight Dope Message Board

Cecil replies:

This is a topic we’ve shamefully neglected, and it’s time to put matters right. Here’s a partial list of “vaginal foreign bodies” drawn from the medical journals. Warning — if you’re the type with a queasy stomach, don’t read this on a crowded bus:

An orange, an eggplant, a flashlight bulb, a screw, a crayon, a pencil, the metal top from a lead pencil (remained in place 20 years), a wax candle, the broken-off heel of a wooden shoe tree (remained in place 53 years), a pessary (57 years), another pessary with a two-and-three-quarter-inch base (a pessary is a device inserted in the vagina to support internal organs; it’s supposed to be checked periodically), tampons, “lost” IUDs (string no longer visible), thermometers, a drinking glass (measuring 5 by 7 by 8.5 centimeters), a metal speculum mistakenly left in place following a gynecological exam (she didn’t get far), a cucumber (14 inches), a salt cellar (8 by 4 centimeters), what appears on the X ray to be a Coca-Cola bottle, a brandy bottle (0.35 liters), carrots, a dead housefly, a bag of cocaine wrapped in a condom (1 by 10 by 16 centimeters), two 85-gram bags of cocaine (discovered posthumously), a cylindrical tin container (3 by 6 centimeters; remained in place two years, during which time it became encased in a giant calculus or stone), a jade bracelet (65 millimeters in diameter, hidden during a communist uprising, remained in place more than 40 years, discovered at autopsy), a bottle cap (3.7 by 3.8 centimeters) encased in a cauliflowerlike mass (4 by 5 centimeters), an aerosol deodorant cap, a hairspray can cap, miscellaneous other caps, a plastic cup (3 by 3 by 4 centimeters), an oxidized iron rod that protruded 2 centimeters out of the vagina (“identified by X-ray examination as one handle of an iron forceps often used for cutting metal wires”), a completely calcified plastic stopper, surgical gauze, “avian pulmonary tissue which was artfully introduced in the vagina of [a two-year-old] girl by her schizophrenic mother,” plus a lot more in Dutch, Japanese, Hungarian, etc., that I didn’t feel like translating. But you get the general idea.

In some cases the victim inserted the VFB for sexual purposes, only to have pieces or occasionally the entire thing get lost inside. Often the woman was too embarrassed to seek help and the object remained inside for years, as with the shoe-tree heel. Frequently the object became encysted or calcified, eroded the vaginal wall, or resulted in other complications you don’t really want to hear about. Sometimes the women were “packers” (drug couriers); in other cases they inserted the objects as children. Some were mentally incapacitated; others wouldn’t talk or feigned ignorance. Sometimes the explanations make no sense. In the case of one four-year-old, “the parents recognized the tubular foreign body as the shell of a suppository that had been mistakenly placed in the vagina by a layman during a febrile upper respiratory infection two years ago.” Huh?

In quite a few cases the woman was the victim of sexual or other abuse. The Coke bottle above had been kicked into the woman’s vagina by four rapists; she subsequently died. The candle had been inserted in a 20-month-old infant. In one investigation of 12 girls brought to a clinic for VFBs, 8 definitely and 3 possibly had been sexually abused. Even in cases of accidental VFBs the victim’s troubles were often prolonged by medical incompetence. I found several reports of women who had been repeatedly examined over a period of years before somebody found the object. (Granted, a small plastic cap can be tough to spot on an X ray.)

Thermometers often get stuck when some quack tells a woman to take her temperature vaginally for purposes of contraception, ignoring repeated injunctions by experts that taking your temperature orally works just as well. I have here an X ray of one such woman showing that the thermometer — a conventional glass job — has gotten stuck inside her crosswise. Girls are told to be careful about what they let into their vaginas; the advice applies to inanimate objects too.

“A FEW MINOR STICKING POINTS,” SHE SAYS

Dear Cecil: As a professional sex educator and sex writer, I thought I’d mention a few minor sticking points in your recent column about vaginal foreign bodies. I have gotten the can’t things get stuck up there? question quite frequently, often from young women who are afraid of irrevocably losing a tampon inside themselves, so I’ve answered the general question a time or six thousand myself. In your answer, you overlooked two things. The most important is that in fact it’s quite difficult for something to get lost or stuck in the vagina. The main reason is that the woman was too damned squeamish to stick a finger or two up her own coochie and pull it out. The vagina, as you undoubtedly know, man of the world that you are, is a cul-de-sac, not a thoroughfare. The os, the opening that runs between the vagina and the uterus through the cervix, is extremely narrow — in its normal state, about as wide as a pencil lead. Generally speaking, objects inserted into the vagina cannot fit through the os and get into the cervix or uterus (to insert objects into the uterus, like IUDs, the cervix and os have to be manually dilated or opened). Therefore, what we’re talking about is, if you’ll forgive the analogy, something like a pocket with a hole the size of a pencil lead in the bottom of it. Loose change is not going to fall through that tiny hole and get lost down your pants leg. Neither are sex toys, tampons, marbles, candles, tubes of lip gloss, hairbrush handles, fruits and vegetables, or any of the other myriad things people frequently stick in their vaginas in the spirit of exploration or eroticism. Any object that does go in but doesn’t seem to want to come back out can be retrieved by simply reaching in with a finger or two and gently tugging it out (a woman can do this herself or have a partner do it for her). If that doesn’t work, as sometimes happens with large objects that are hard to get a grip on, it’s likely because the woman is afraid or tense and is reflexively tightening the pubococcygeal muscles, effectively narrowing the vaginal opening. The solution is to squat and bear down and push it out, just as if one were straining with a bowel movement. One can also use a finger or two to help direct the object out of the vagina while doing this. It might be a little uncomfortable, but in this case, the corollary to what goes up must come down is what went in can certainly come out again. If a woman has inserted an object while masturbating and finds it difficult to remove after she has orgasmed, it usually helps to wait 15-20 minutes for all of the tissues to indilate before trying again to remove it. Vasocongestion during arousal causes swelling of many portions of the vulva, including the entrance to the vagina. Once that blood has had a chance to drain and the tissues have gone back to normal, it’ll be easier to remove the object. (Relax. Read a few Straight Dope columns. It’s not going anywhere, I promise. Then try again.) So, basically, there’s no good reason that a woman would EVER need to make an embarrassing visit to the ER for most types of objects people commonly insert into their own vaginas. There are two cases where an ER visit is warranted, though. If a woman has got something sharp up there, or something that has broken (don’t be stupid: light bulbs and fragile glass and plastic objects are not good sex toys!) or which has already caused an injury, the ER is the best bet. Same goes if she has been sexually assaulted with an object that has been left inside her vagina: medical intervention is the best bet, not only for safe extraction of the object but for documentation of the assault. The second thing I wanted to mention in regard to your things-stuck-up-the-hoochie column is that not all the objects you mentioned are actually stuck up the hoochie at all. IUDs, particularly, are inserted via the vagina, but actually are inserted into the uterus (as I mentioned above). The uterus is not the vagina, it’s a separate organ. And, as I mentioned, it’s a hell of a lot more difficult to insert something into the uterus than it is to insert something into the vagina. I daresay that no one is likely to manage to insert an object into their uterus accidentally — the undilated os simply won’t accommodate it. IUDs are inserted by health care professionals who dilate the cervix to do it. One is supposed to check for the string periodically to make sure the placement is still correct. But sometimes the string (a tiny bit of monofilament thread usually) gets retracted back into the os so that it can’t be felt by inserting a finger into the vagina and touching the cervix at the os. I dare say that doesn’t count as a lost object, even so. Provided both the woman and her health care provider(s) remember that an IUD was inserted, they can still arrange to keep track of it and make sure it’s still doing its job and not causing problems. And even if it were lost, there’s not far for it to go. A lost IUD can’t exactly go drifting around the body like the Flying Dalkon Dutchman, it’s going to stay inside the uterus. That’s it. Perhaps that’s more information about girly innards than your column can really bear, but I thought it might be helpful to you (and I know from years of experience that the info is helpful to women who are panicky about the possibility of something becoming lost inside them). Thanks for all the fun reading over the years. –Hanne Blank, author, Big Big Love: A Sourcebook on Sex for People of Size and Those Who Love Them (Greenery Press)

I don’t quarrel with your observation about IUDs. I simply observe that “lost” IUDs — the quotation marks are in the original — are commonly cited in discussions of vaginal foreign bodies. It’s safe to say gynecologists, and one hopes their patients, know where they really are.

On the same subject, I’ve been taken to task on the Straight Dope Message Board for the following comment:

Sometimes the explanations make no sense. In the case of one four-year-old, the parents recognized the tubular foreign body as the shell of a suppository that had been mistakenly placed in the vagina by a layman during a febrile upper respiratory infection two years ago. Huh?

SDMB user Raritan writes:

See, some kids don’t like taking medicine. . . . So, some medicines that are meant to improve general body symptoms come in forms that don’t need to be swallowed. Acetaminophen (sold under the brand name Tylenol, among others) is one such drug, sold [in] the usual pills and in a per rectum form as well. So when the kid had a fever, mom and dad gave her a Tylenol suppository, didn’t unwrap it all the way, and put it in slightly off-target. Clumsy, but understandable.

Understandable? Let’s review. The kid’s got a fever, and the feckless parents can’t get medicine into her even with an eyedropper. So they scour the countryside looking for someone as awash in ignorance as themselves, which certainly must have taken some doing, and having succeeded against all odds let this person (a) force a suppository still in its plastic shell (b) into the wrong aperture in their two-year-old daughter, and (c) proceed to forget about it for two years until the kid’s got major urinary tract problems. Maybe “huh?” isn’t the right response. Maybe “duh,” but even that’s too mild. How about THESE TWO BIRDBRAINS COULDN’T BE TRUSTED TO WATER THE GRASS MUCH LESS CARE FOR A HUMAN BEING, which still doesn’t do the subject justice, but it’s all I can think of for now.

Cecil Adams

Send questions to Cecil via cecil@straightdope.com.