What is Toxic Shock Syndrome?
As women, we hear about toxic shock syndrome (TSS) almost exclusively in the context of warnings not to keep tampons in for too long. But dialogue typically does not progress beyond that. Opening discussions around topics like TSS is vital to dispelling stigmas and inaccurate myths that surround women’s menstrual health.
TSS is a bacterial infection that can result in amputation of extremities or death. Once you get TSS, reinfection is extremely common. The symptoms vary widely, covering everything from vomiting to chills and fever, rash, muscle pain, low blood pressure, and bruising. Menstruating women aren’t the only ones affected by TSS. Surgery and skin wounds are also risk factors for TSS for men and women.
According to the National Library of Medicine, tampon usage was determined to be a cofactor in cases of TSS in the 1970s and 80s. At the time, they weren’t sure what the connection was. Later research found that the TSS was a result of toxins released from staph (staphylococcus aureus) bacteria growth. Super absorbent tampons encourage bacterial growth when left in for long periods of time. Additionally, small microtears that occur when a tampon sticking to vaginal walls (this especially happens when a period flow is light) is removed also lead to bacterial growth.
When this was first discovered, doctors and researchers suggested that women avoid using super absorbent tampons when possible. But they encountered a problem. Tampon producers were not consistent in the absorbency labeling of their products. Women couldn’t be sure if the tampons they were using were super absorbent or not. This led to a movement to standardize absorbency labels across all period products called the Tampon Task Force.
Researchers developed a uniform system based on measurable gram weight of fluid held. As is the case with women’s health issues throughout history, this research was entirely conducted by men. A woman named Esther Rome brought up concerns that the saline-based methods that researchers were using were not a true representation of women’s periods, which often change over their cycle in fluid thickness. Her concerns were ignored, and the testing methods developed then are still in place today.
TSS is extremely rare. Only .8 to 3.4 people per 100,000 in the United States are diagnosed with the syndrome, and many of these are non menstrual related. That means that your chance of getting TSS is less than .0003%. Additionally, according to the Mayo clinic the materials and design of tampons that were associated with TSS are no longer made or sold today.
The crippling fear that I had as a young teen that I would die if I left my tampon in for longer than 8 hours was totally unnecessary. That being said, TSS is still a serious problem because of the potentially fatal effects of the syndrome. If you are want to avoid the chance of getting TSS from tampons, here are some suggestions:
Do not use tampons if you have had TSS or previous serious strep/staph infection. Reinfection is extremely common.
Use the lowest absorbency tampon you feel comfortable with when on your period.
When your flow is light, consider using pads instead of tampons.
Change tampons often. Ranges of 4 to 8 hourswere recommended on various websites such as Mayo Clinic and John Hopkins.
Don’t wear tampons overnight.
Wash your hands before and after inserting a tampon (this is important for overall hygiene!)
Don’t wear tampons when you aren’t on your period.
Avoid tampons with applicators (this can increase the rate of microtears).
Women’s periods are all different, so remember to do what works for you.
Sources:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/toxic-shock-syndrome-tss
https://www.mayoclinic.org/diseases-conditions/toxic-shock-syndrome/symptoms-causes/syc-20355384
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/toxic-shock-syndrome-tss
