Toxic Shock Syndrome & Tampons

Toxic shock syndrome, or TSS, is a bacterial infection that can affect men, women and children. You may have heard of the connection between tampons and toxic shock syndrome, but what's the true danger? Why does every box of tampons come with a paper insert explaining the risk of TSS?

History

• In the late 1970s and early 1980s, tampon manufacturers introduced special, ultra-absorbent tampons that were designed to be worn for multiple days. Manufacturers believed women would want the freedom of not changing their tampon so frequently. Soon after they were introduced, however, the number of cases of staphylococcus (staph) toxic shock syndrome went up and, because TSS can be fatal, so did the number of related deaths. (TSS can also result from infection by group A streptococcus---commonly known as strep---bacteria.)

  Once medical professionals and manufacturers noticed the connection between TSS and multiple-day tampons, manufacturers ceased producing this type of tampon and they were taken off the market. Since the 1980s, tampon manufacturers have clearly labeled tampon absorbency rates and they recommend changing tampons at least every eight hours. As a result, the number of tampon-related TSS cases has declined substantially.

The Facts

• When ultra-absorbent, multi-day tampons first went on the market, medical professionals found that staph bacteria grew and thrived in those tampons. Also, the materials used in the tampons could scratch the surface of the vagina, allowing bacteria easy access to the body.

  Currently, about half of TSS cases occur in menstruating women, while the other half occur in men, children and post-menopausal women. It is much less likely for a woman to get TSS from tampons now than it was in the early 1980s, but it can still happen. Pay close attention to absorbency ratings and how often you change your tampon.

Symptoms

• It's important to know the signs of TSS in case an infection does occur. The onset of the symptoms can be rapid, and the condition can be fatal if it's not treated immediately.

  The first symptom you'll notice is a high fever, usually higher than 102 degrees. You may also feel lightheaded, dizzy, nauseated and may vomit. You may feel as if the flu has come on very quickly. People with TSS usually develop a rash that looks like sunburn on their feet and other parts of the body. This rash will start to peel, especially on the bottom of the feet, just as a bad sunburn does.

  It's very important to get emergency medical treatment if you or someone close to you appears to have TSS, as the staph infection spreads rapidly, attacking major organs and causing them to stop functioning.

Treatment

• If you're using a tampon when you begin to feel symptoms of TSS, remove it immediately, and get medical treatment as soon as possible. Depending on how far the bacteria has migrated throughout your body, you may need to be hospitalized.

  TSS is treated with antibiotics and often the hospital staff will administer intravenous fluids to rehydrate your body and stabilize your blood pressure. Sometimes kidney failure occurs and dialysis must be given. Because organ failure can come on quickly with TSS, unless treatment is started immediately it can take two to three weeks for the body to recover, and you will likely remain in the hospital.

Prevention

• In order to prevent TSS, doctors and tampon manufacturers have two general recommendations. First, use the lowest absorbency possible. Some women bleed heavily, and need to use ultra-absorbent tampons, particularly at the beginning of their cycle. Other women may only need tampons that provide regular or light absorbency.

  The second recommendation is to change tampons frequently. Never leave a tampon in for more than eight hours. If you sleep with one inserted, make sure you use the lowest absorbency possible and remove it in less than eight hours. By following these two recommendations, you can significantly reduce your chances of getting tampon-related toxic shock syndrome.