Do You Ever Forget About a Tampon? Some Toxic Shock Syndrome Facts

Tampon users are most affected, but anyone can get it
toxic shock syndrome, tampons, menstruation, menstrual cycle, menstrual cup, TSS

If you’re a certain age, you may remember heavy news coverage in the early 1980s of toxic shock syndrome (TSS). This rare, serious condition, often associated with tampon use, comes from bacteria that produce toxins. Those born in the 1990s or later may never have heard of it, but tampon boxes still carry warnings about TSS.

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Ob/Gyn Jean Reinhold, MD, offers some things you should know about TSS and steps to help avoid it.

The odds of getting TSS are low

The bacteria that cause TSS normally live on your body without causing problems. But certain conditions can cause this bacteria to grow and produce toxins. Certain wounds, incisions, burns and gynecological procedures can increase your risk.

The condition can affect men, women or children, but its incidence is very rare. “I’ve only seen one case in my years of practice,” says Dr. Reinhold. However, she says that awareness about TSS and how to prevent it is still important, especially for women.

“I see patients who weren’t aware they left a tampon in or weren’t sure how long one could be left in,” she says. And forgetting to remove the last tampon during your period or going too long between changing tampons can increase the risk of TSS, she says.

Talking about the risk of TSS is important as part of a larger discussion about healthy menstruation — especially for those who have just started their periods, Dr. Reinhold says.

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Tampon users are (still) at greater risk

TSS is sometimes deadly, and the risk remains greater for women who use tampons (specifically those with higher absorbency). About half of the TSS cases today are menstruation-related. 

Manufacturers have made significant changes in how they make and label tampons since the 1980s and that has helped drive the reduction in menstrual TSS.

“One brand of super-absorbent tampons was taken off the market completely,” Dr. Reinhold says. That happened soon after a June 1980 CDC report showed a link between tampons and TSS.

Just as importantly, women opted for higher absorbency tampons less and less through the 1980s — from a high of 42% of tampon use in 1980 down to 1% in 1986. In addition to federal regulations and changes in the tampon industry, women actively helped drive the reduction as well.

You can reduce your risk (and still use tampons)

Dr. Reinhold says there are several ways in which women can reduce their risk of TSS.

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  • Change both tampons and pads frequently during your period (at least every four to eight hours).
  • If you use tampons, use the lowest absorbency possible for your flow. The bacteria that cause TSS are sometimes introduced into the bloodstream through tiny moisture droplets in the vagina caused by removing tampons that are too dry.
  • Adjust tampon size or switch to pads as your flow decreases.
  • Consider other options, including the menstrual cup. Some types of birth control can stop periods altogether. 

For those who aren’t menstruating, the best prevention is to keep wounds and surgical incisions clean to avoid infection. Change packing and bandages regularly, and see your doctor right away if you notice unusual redness or swelling.

In addition to taking these steps, it’s important to know the signs of TSS. The condition can cause organs to fail and is sometimes deadly if it’s not treated quickly.

Symptoms tend to come on suddenly. You may notice:

  • High fever (always a symptom of TSS).
  • Chills.
  • Watery diarrhea.
  • Rash resembling a bad sunburn or red dots on the skin.
  • Low blood pressure.
  • Eye redness.
  • Peeling of the skin on the soles of the feet or palms of the hands.

If you suspect you have TSS, seek help immediately. Talk to your doctor or gynecologist if you have questions about TSS or other aspects of menstruation.

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