TSS and Menstrual Products

health, menstruation, TSS

When I first started my period, I, like many other girls beginning menstruation, received practically no education on how to use a tampon. Once I reached high school, I got tired of dealing with bulky pads that I was sure everyone could see through my stirrup pants (don’t judge - I’m a 90’s kid!). Taking it upon myself to learn how to properly insert a tampon, I read the pamphlet of instructions that came tucked in next to the rows of crinkly pink plastic. Not only did I educate myself on how to use a tampon, I also found out - to my horror - about Toxic Shock Syndrome (also referred to as TSS). As terrifying as it was, I refused to revert back to wearing pads and so, for the next 10 years I proceeded to obsessively change my tampon so that I wouldn’t contract this mysterious disease. Fast forward to being a reproductive health writer and, while I’d still prefer not to have my very own case of TSS, I’m also a lot less afraid of it. Understanding exactly what it means, what the risk is, and how to prevent it helped me move from a place of fear to a place of empowerment. Hopefully, this information will help you do the same.

So, what exactly is TSS?

Basically, Toxic Shock Syndrome is an infection caused by a staph bacteria called Staphylococcus aureus or, less commonly, Streptococcus pyogenes, a strep bacteria. While the infection itself is a rare but serious one, about 20% of the adult population carry this staph bacteria on their skin or in their nose. The bacteria itself isn’t necessarily something to stress about - in order for there to be complications two things must happen. First, staph bacteria needs to be in an area where it can grow quickly (and release toxins). Secondly, the toxins must be absorbed into the bloodstream. In other words, a tampon alone isn’t enough to contract this life-threatening complication - you have to be a carrier, too.

Tampon use, in particular, has long been linked to Toxic Shock Syndrome. Especially during the 1980’s, super-absorbent tampons were among the leading culprits (due to people leaving them in the vagina longer) but, since they have started being pulled from the market the number of menstrual TSS cases (about 1 in 100,000) has declined. However, menstruation isn’t the only cause of TSS - 50% of cases are non-menstrual and 25% are found in men. These cases can come from things like complications with surgery, post-partum wounds, and even bone infections.

Don’t let these facts deter you from using caution. Last year, California model, Lauren Wasser, lost her leg due to Toxic Shock Syndrome. When she was found in her apartment with a 107-degree fever, she was taken to the hospital and the tampon inside of her tested positive for TSS. Not a tampon user? Your risk may be less but you still want to avoid keeping your menstrual cup in for more than the recommended amount of time. Though menstrual cups are a far healthier option than tampons, I wouldn’t be doing my due diligence if I didn’t tell you that there has been one confirmed case of TSS from someone who was using one. While it wasn’t directly caused by the cup (the woman caused a small abrasion in her vagina when she was inserting her cup, which led to infection), it’s important to be aware of all the risks.

Symptoms of TSS

You’ll save yourself some painful hours browsing WebMD and will be able to take action (aka go to the hospital!) if you know what the symptoms of TSS really are. if you find yourself developing any one or a combination of the following, seek medical attention immediately:

  • High fever
  • Vomiting
  • Diarrhea
  • Rashes on the hands and feet
  • Dizziness
  • Red eyes
  • Muscle aches

Reducing Your Risk

You don’t have to live in fear of TSS. Instead, be aware of the ways you can reduce your risk. By following these guidelines, you’ll do a lot to avoid any complications and stay healthy and happy:

  • Use the lowest absorbency tampon for your flow
  • Change tampons every 4 to 8 hours, even if your flow isn’t heavy
  • Switch to a menstrual cup
  • Wash your hands before and after inserting menstrual cup or tampon
  • Do not use tampons if you have a skin infection on or near your vagina
  • Trim your nails before inserting cup to avoid creating an abrasion in your vagina

You’ve got enough things to stress about

- smashing the patriarchy, climbing the corporate ladder, making it home in time for the latest episode of Pretty Little Liars. Don’t let TSS keep you up at night. Stay informed, take the necessary steps to reduce your risk, and flow on!


-Christina Vanvuren

A freelance sex & reproductive health writer living vicariously through herself in Atlanta, GA. When she’s not championing for a world free from period and slut-shaming you can find her drinking copious amounts of coffee and traveling.


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