Q: I know I can get Toxic Shock Syndrome from wearing a tampon, but what exactly is it? What are the symptoms?

A: Toxic Shock Syndrome (TSS) is a rare, but potentially life threatening, condition caused by a bacterial toxin. It affects between 1 and 17 menstruating women per 100,000. Approximately half the cases of reported TSS are associated with tampon use during menstruation, usually in young women aged 15-24. TSS also occurs in children, men, and non-menstruating women, frequently in connection with wounds or surgery. For example, in 1994, a young woman contracted toxic shock syndrome after breast implant surgery. As a result, both of her legs were amputated below the knees.

There is a relationship between TSS development and the use of high-absorbency tampons, but the exact connection is still unknown. Besides TSS, vaginal dryness and ulcerations may occur when using tampons more absorbent than needed. Using any kind of tampon--cotton or rayon of any absorbency--puts a woman at greater risk for TSS than using menstrual pads.

Because the risk of TSS increases with higher tampon absorbency, choose the lowest absorbency to meet your needs. There is usually less need for high absorbency at the end your period. According to Tampax®, you can only use a tampon overnight if you sleep less than 8 hours. They advise women to use a pad if they sleep longer than 8 hours.

Tampon manufacturers are required by the Food and Drug Administration to use standardized terms to describe tampon absorbency:

Absorbency listed on package	Absorbency range
Junior Absorbency	6 grams and under
Regular Absorbency	6 to 9 grams
Super Absorbency	9 to 12 grams
Super Plus Absorbency	12 to 15 grams

Here are some early TSS symptoms to look out for:

• Aching muscles
• Bloodshot eyes
• Sore throat

TSS symptoms are flu-like in nature, and they appear quickly and are often severe. Not all cases are exactly alike; you may not have all of the symptoms.

Remove your tampon and seek medical help immediately if you experience the following symptoms during menstruation:

• Sudden high fever – 102^oF (38.9^oC) or higher
• Vomiting
• Diarrhea
• Muscle aches
• Dizziness, fainting, or near fainting when standing up
• A rash that looks like a sunburn

Early diagnosis and immediate treatment are critical to avoid the most serious effects of TSS. Deaths, though rare, often occur during the first week of illness.

Tips when using tampons:

1. Wash hands with soap and water before inserting or removing a tampon.
2. Follow package directions for insertion.
3. Choose the lowest absorbency for your flow. If your tampon is hard to pull out or shreds when removed, your tampon is too absorbent, and you should use one with a lower absorbency.
4. Change your tampon at least every 4-8 hours, especially during heavy flow days.
5. Consider alternating pads with tampons.
6. Know the warning signs of toxic shock syndrome.
7. Don’t use tampons between periods.

It may also be helpful to read the package insert in the tampon box to stay up-to-date on TSS, and you can ask your doctor about TSS when you get a medical checkup.

Links:

For more information about toxic shock syndrome from the FDA:
www.fda.gov/bbs/topics/consumer/con00116.html

For basic information about pad and tampon use:
www.goaskalice.columbia.edu/0671.html

 

I'm 62 years old and have been taking hormone therapy for about 15 years. If I stop, what will happen? I think something is wrong with my 12-year old silicone breast implants. They might be leaking. Should I consider explantation? I recently got an email that warned about asbestos and dioxin contamination in tampons and the risk of Toxic Shock Syndrome. Should I be concerned? I have breast implants. Do I need to take antibiotics before going to the dentist? I read in an email that antiperspirants cause breast cancer. Is this true? Are they really unsafe? I currently work for an employer that doesn't provide health insurance. My children often need medical care, but I can't afford health insurance for them. Is there anything available? I know I can get Toxic Shock Syndrome from wearing a tampon, but what exactly is it? What are the symptoms? I have a family history of breast cancer. Would having breast implants increase my risk of breast cancer?