TSS and Menstrual Products

Toxic Shock Syndrome (TSS) is a rare but serious bacterial infection that has long been associated with tampon use. It became big news in the 1980s when super-absorbent tampons, and people’s tendency to leave them in for too long, caused a rise in cases. Since those products were withdrawn, menstrual cases of TSS have declined to about 1 in 100,000.

What causes TSS?

About 20% of the population carries the offending bacteria on their skin or in their nose. On its own, it’s not something that causes any major problems. But, if it’s in an area where the bacteria can grow and release toxins (such as the vagina) – and those toxins are absorbed into the bloodstream (e.g. from a tampon during menstruation) – then TSS is a risk.

Only carriers of a staph bacteria called Staphylococcus aureus or, less commonly, Streptococcus pyogenes, a strep bacteria can contract Toxic Shock Syndrome.

TSS is not restricted to menstruation. Infection could happen, to men or women, from things like complications with surgery, post-partum wounds, and even bone infections. In fact, 50% of cases are non-menstrual and 25% are found in men.

The symptoms of TSS are: high fever, vomiting, diarrhea, rashes on the hands and feet, dizziness, red eyes and muscle aches. If you find yourself developing any one or a combination of these, seek medical attention immediately.

How can I reduce my risk if using tampons?

A few simple things can reduce your risk but remember to keep your worries in proportion. This is a very rare condition and you can only get it if you’re a carrier.

That said, if you’re happy using tampons, use the lowest absorbency for your flow. Change your tampon every 4-8 hours (even if your flow is light) and keep your hands clean when inserting or removing it.

If you have a skin infection on or near your vagina, avoid using tampons until it’s cleared up.

Can I get TSS with a menstrual cup?

It’s possible, if you’re a carrier, but extremely rare. It’s more likely that you’d acquire the bacteria from your hands when they’re inside your vagina. To reduce risk, always wash your hands before and after inserting or removing your cup and trim your nails so you can’t cause any abrasions inside your vagina. Read more about how to use your cup. 

It’s also important that you empty and clean your period cup at least every 12 hours (overnight is fine). If you’re not sure how or when to do this, read ‘How Often I Should Empty my Menstrual Cup?’.