Although exceedingly rare, toxic shock syndrome is a serious, life-threatening, condition that has a higher occurrence during menstruation, particularly among teens and young adults. It isn't always associated with menstruation, but it can also occur in men, women and children, especially if there is any type of skin injury or wound. But, TSS became really well known in the 1970s after a surge in cases was tied to a super absorbent tampon called Rely which was quickly removed from the market. But TSS, being more well-recognized, was found to occur with other brands of tampons, and to date, has even been reported with the use of pads and a menstrual cup. 

TSS is not caused by tampons or other menstrual devices; it’s caused by a toxin that is released by some strains of staph or streptococcus bacteria. When ANYTHING is inserted into the vagina during menstruation, small pockets of air trapped by the menstrual products can allow the bacteria to grow and produce the deadly toxin. Since tampons are the most commonly used menstrual hygiene product inserted into the vagina - they have obviously been implicated the most in menstrual TSS. 

What about organic tampons? Many women have been convinced that organic 100% cotton tampons will eliminate the risk of TSS. Unfortunately, that’s not true, and that notion was recently disproven by microbiologists in France. Their study showed that bacterial growth and toxin production is similar with organic cotton fibers as well as with traditional synthetic fibers (which are also made from cotton or wood pulp). 

And mentrual cups? Same. TSS has been reported with the use of a menstrual cup, and the same French study showed that the bacteria that cause TSS can form a “biofilm” of the bacteria on the cup, making it hard to sterilize.

But remember, TSS is very rare, so let’s put it in perspective and make a game plan for reducing the risk for it.

Perspective:  You are more likely to be struck by lightening than to get TSS while using a tampon. The latest statistics put the occurrence of menstrual TSS  at less than 1 case per million people. 

Reduce Your Risk:  However, just like you follow safety precautions to avoid being struck by lightening (don’t stand in an open field holding a golf club in the air!), there are safety precautions you should take to reduce your risk of TSS. Knowing the facts and knowing what to do if you have symptoms can be protective and even life saving.

  1. Do not wear a tampon or menstrual cup for more than 6-8 hours.
  2. Do not wear tampons 24-7. This is particularly important for young menstruators because the vaginal immunity (yes, your vagina has it’s own immune system) is not fully mature until several years into menstruation. Using a tampon absorbs some of the protective bacteria, so give your vagina time to restore the normal bacteria by alternating pads with tampons when you can. 
  3. Use the tampon with the lowest absorbency that will manage your flow. If you remove a tampon and it is still dry in some areas, use a lower absorbency.
  4. If you use a menstrual cup, wash it with soap and hot water between uses, and boil at least after every cycle or even after a few days.
  5. Know the symptoms of TSS: high fever, flu-like symptoms including high fever, body aches, chills, weakness, rash. 
  6. If you are menstruating and develop these symptoms, remove your tampon or menstrual cup and go immediately to the nearest Emergency Room. Make sure you or someone with you tells them you may have TSS. Early recognition and treatment is very effective with simple antibiotics, but delayed treatment can result in life threatening sepsis and complications.

Remember that millions of tampons are safely used every day and TSS is extremely rare. To reduce your risks, know the facts, and be smart about how you use menstrual products.

For more myth busting and safety information on menstrual products, download this one-page guide to tampon & pad safety & smarts!

menstruation, tampon, menstrual cup, toxic shock

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