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What everyone should know about toxic shock syndrome (TSS)?

What everyone should know about toxic shock syndrome (TSS)?

By Dr Melisa Holmes, OB-GYN & Founder of Girlology

When I talk about tampons in my gynaecology practice, I find some patients are terrified of Toxic Shock Syndrome (TSS), while others have never even heard of it. Toxic Shock Syndrome is serious, so it’s important to understand, but there’s no need to panic. Let’s get to the facts so you can know (and share) the truth!

What is Toxic Shock Syndrome (TSS)?

Toxic Shock Syndrome, also known as TSS, is a rare, but serious infection that is caused by a specific strain of Staphylococcus aureus bacteria. Interestingly, these bacteria are commonly found on the skin, in the nose, armpits, and vagina without causing any problems. However, under certain circumstances, especially when the body has not developed immunity to this strain of bacteria, it can grow out of control and release a toxin, which is like a poison. The toxin enters the blood stream and can rapidly cause a severe illness that affects the entire body (shock).

Toxic Shock Syndrome is not caused by tampons

Toxic Shock Syndrome is caused by bacteria – specifically Staphylococcus aureus – not tampons. In the 1980s, TSS became more well-known because it was associated with highly absorbent tampons (those highly absorbent tampons were quickly taken off the market). However, you don’t need a tampon to get TSS. You can get it while using pads or menstrual cups, or no period protection at all. Anyone can get TSS. Even men and children can get TSS, and only about half of TSS infections are related to menstruation. Some other ways people develop TSS include insect bites, skin infections, or surgery.

It’s rare

Fortunately, Toxic Shock Syndrome is rare. To put it into perspective, you are more likely to die from being struck by lightning than you are from Toxic Shock Syndrome. There are also things you can do to reduce your risk further. In a storm, we take cover and shelter indoors. Similarly, there are things you can do to reduce your risk of TSS (keep reading to learn more).

It’s treatable

Although TSS is serious, it’s very treatable – especially when treated early. One of the biggest mistakes people make about their health is ignoring symptoms and waiting too long to seek medical attention. Early treatment is especially important for TSS. If you have any concern that you might have TSS while using a tampon, you should remove your tampon, get immediate medical attention, and tell the healthcare provider that you’re worried you might have TSS.

Know the Toxic Shock Syndrome symptoms

TSS can feel a lot like the flu, and symptoms can vary from person to person, but most commonly, the symptoms of TSS are:

  • High fever (over 102° F or 38.9° C)
  • Body or joint aches
  • Nausea and/or vomiting
  • Diarrhoea
  • Dizziness or fainting or confusion
  • Sometimes there is a red rash

If you are using a tampon and feel very ill with some of the symptoms above, it’s important to remove your tampon right away, get immediate medical attention, and tell the person you’re with or the healthcare provider you’re worried about Toxic Shock Syndrome.

Reduce your risk

TSS is rare, but you can reduce your risk even more by following a few recommendations:

  • Always use the lowest absorbency tampon that will manage your flow. If it hurts to remove after a few hours, go down a size.
  • Know the symptoms of TSS mentioned above and get immediate medical attention if you are worried you may have it.
  • The risk of tampon-related TSS can also be reduced by interrupting tampon use with pads from time to time.

Will organic tampons reduce my risk of TSS?

Nope. What you use is a personal choice, but the risk of getting Toxic Shock Syndrome is the same for organic or non-organic tampons, and it’s also the same for cotton, rayon, or a blend of the two. The only difference in tampons that can increase the risk of TSS is the absorbency. A higher absorbency tampon can increase the risk of TSS and a lower absorbency can have a lower risk. That’s why you should always use the lowest absorbency tampon that will manage your flow – and it doesn’t matter if it’s organic or conventional.

Is it possible to get TSS more than once?

Unfortunately, yes. If you’ve had tampon-related Toxic Shock Syndrome in the past, you should consult your doctor before using tampons. Most doctors recommend not using tampons if you’ve had TSS before.

How long can I wear a tampon safely and not get TSS?

There’s no exact answer to this, but there are recommendations. You should never wear a tampon more than eight hours for hygiene purposes. Most gynaecologists also recommend you change your tampon every 4-8 hours for vaginal health reasons. We know that the risk of TSS increases with absorbency, and there is no precise time limit supported by research. It’s always healthiest and safest to use the smallest tampon that will manage your flow and to change your tampon regularly.

Let’s recap

I know that was a lot of information about Toxic Shock Syndrome to take on board, so here’s a quick review:

  • Toxic Shock Syndrome is a rare but serious infection
  • TSS is treatable, especially if it’s caught early
  • You can reduce your risk of TSS
  • Use the lowest absorbency tampon you can to manage your flow
  • Break up your tampon usage with pads. Know the symptoms! If you’re using a tampon and you experience any flu-like symptoms, take your tampon out and seek immediate medical attention, letting the medical professional know you’re worried you might have TSS.

Now that you have the facts, you don’t need to be afraid. Tampax responsibly!

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