Toxic Shock Syndrome (TTS) is like the period bogey man, but unlike most urban legends, the risk of contracting an infection from a tampon has some truth to it. Although TSS is incredibly rare, it’s something to be taken seriously.
Chances are if you’ve used a tampon before you’ve worried about toxic shock syndrome. Or maybe you want to try tampons but you’re too scared due to possibly developing toxic shock.
So, let’s have a chat about toxic shock syndrome and it’s links to tampons…
What Is Toxic Shock Syndrome?
Toxic shock syndrome (TSS) is a rare but life-threatening condition caused by bacteria getting into the body and releasing harmful toxins.
It’s often associated with tampon use in people who menstruate, but it can affect anyone of any age – including cis men and children.
TSS gets worse very quickly and can be fatal if not treated promptly. But if it’s diagnosed and treated early, most people make a full recovery.
Toxic shock syndrome (TSS) is caused by either staphylococcus or streptococcus bacteria.
These bacteria normally live on the skin and in the nose or mouth without causing harm, but if they get deeper into the body they can release toxins that damage tissue and stop organs working.
These things can increase your risk of getting TSS:
- using tampons – particularly if you leave them in for longer than recommended or you use “super-absorbent” tampons
- using female barrier contraceptives, such as a contraceptive diaphragm or cap
- a problem with your skin, such as a cut, burn, boil, insect bite or a wound after surgery
- using nasal packing to treat a nosebleed
- having a staphylococcal infection or streptococcal infection, such as a throat infection, impetigo or cellulitis
TSS is not spread from person to person. You do not develop immunity to it once you’ve had it, so you can get it more than once.
Symptoms of toxic shock syndrome include…
- A sudden high fever
- Low blood pressure
- Vomiting or diarrhea
- A rash resembling a sunburn, particularly on your palms and soles
- Muscle aches
- Redness of your eyes, mouth and throat
Why Is Toxic Shock Syndrome Linked To Tampons?
The biggest misconception about toxic shock syndrome is that it’s caused by tampons. In reality, TSS is simply linked to tampons.
Anything left in the vaginal canal for too long can put you at risk of TSS, whether it’s a tampon or a menstrual cup – that’s why they both come with a wearing time limit.
Toxic shock syndrome is caused by the bacteria Staphylococcus aureus and Streptococcus pyogenes, commonly referred to as Staph and Strep respectively.
Staph and Strep often inhabit different parts of your body, like your throat, nostrils, vagina and rectum, without causing any issues. They’re only a threat if they multiply very quickly and produce a toxin aptly called Toxic Shock Syndrome Toxin (TSST). If TSST enters your bloodstream, it can lead to toxic shock syndrome.
It’s unclear why tampons are linked so frequently to TTS, but the theory is that when left inside your vagina for too long, tampons create the perfect breeding ground for Staph bacteria to colonise. Your vaginal canal is filled with blood vessels, so TSST has easy access to your bloodstream from your vagina.
The dry surface of tampons can also cause friction during insertion and removal, which may cause small abrasions to the vaginal mucosa and allow TSST to enter your bloodstream more rapidly.
How To Reduce The Risk
The likelihood of you developing TSS from a tampon is incredibly low. Most people produce an antibody that protects against toxic shock, and your immune system and vaginal microbiome do a pretty stellar job at fending off infections and harmful bacteria. But here are some things you can do to minimise the risk…
- Change your tampon every 4 to 8 hours or as needed. Do not leave it in any longer than 8 hours
- Use the correct tampon depending on how heavy your period is. Everyone is different. You may find that you need a regular tampon on day 1, but an extra size one for heavier days and then back down to a regular one toward the end. Figure out what’s right for you. But don’t use more absorbing tampons if you don’t need them.
- Don’t use tampons when you’re not on your period. If you’re worried about discharge use panty liners.
- wash your hands before and after inserting a tampon
- never have more than one tampon in your vagina at a time
- when using a tampon at night, insert a fresh tampon before going to bed and remove it when you wake up
- remove a tampon at the end of your period
- when using female barrier contraception, follow the manufacturer’s instructions about how long you can leave it in
Toxic shock syndrome can recur. People who’ve had it once can get it again. If you’ve had toxic shock syndrome or a prior serious staph or strep infection, don’t use tampons.
The bottom line is, you shouldn’t let the fear of TTS stop you from using tampons if you want to, although there is a risk, it is minimal if you are careful.
By changing your tampon every 4-8 hours (and remember 8 hours should be the absolute max time you leave a tampon in for) you will greatly reduce your chances of developing toxic shock from using a tampon.
You shouldn’t fear using a tampon if you wish to. If you’re still concerned about TSS please speak to your GP.