Over the course of a woman’s life, she’ll have hundreds of periods. This comes with using various products. Insertable products, like ultra-absorbent tampons, can contribute to a dangerous condition called toxic shock syndrome.
“Understanding how to use products correctly is important for comfort and safety. Practicing proper hygiene will prevent dangerous infections,” said Dominique Boadwine, MD, Avera Medical Group OB-GYN.
Traditional menstrual period products are sanitary pads and tampons. There has been a recent introduction of period underwear and reusable menstrual cups. These were made with attention to environmental impact as well as infection risk. Read more about your options.
What Causes TSS
TSS is caused by the overgrowth of staph bacteria. Staph bacteria naturally live on your skin, around the mouth, nose, vagina, etc. Typically, they’re harmless. However, infection can arise when given the opportunity to travel under the skin — like through a cut.
In a warm, moist environment, the bacteria divide and replicate quickly. The release of toxins from these bacteria can cause toxic shock syndrome.
“Leaving your tampon in too long gives the bacteria time to grow,” said Boadwine. “It is imperative to practice safe hygiene. The best way to prevent infection is by changing tampons about every three to four hours. Don’t leave a tampon in longer than eight hours. Menstrual cups and period underwear have been shown to have lower rates of toxic shock syndrome.”
Personal Risk Factors of TSS
It’s important to remember that the risk is rare — about 1 in 100,000. Yet you might be at a higher risk for TSS if you have a history of:
- Using super-absorbent tampons
- A surgical wound that’s healing slowly
- Skin infections
Symptoms of TSS
The onset of TSS symptoms can occur rapidly. They include, but aren’t limited to:
- A high fever, often exceeding 102°F
- A red, flat rash manifesting around the body
- Chills
- Fatigue
- Headache
- Nausea/vomiting
- Diarrhea
- Muscles aches
- Mental confusion
If you’re feeling unusually unwell on your menstrual period and you have a tampon in place, remove the tampon and contact your health care provider. If your health care provider is unavailable and you’re having fever, rash and body aches, please don’t delay presenting to the emergency room.
How TSS Is Treated
If you suspect you or your loved one has TSS, go to the emergency room immediately. The emergency team will stabilize you. You can expect the medical team to obtain samples of your blood or urine and perform a pelvic exam.
If you’re diagnosed with TSS, the team will place an IV and start fluids and antibiotics. Based on the severity or other dangerous symptoms, you may be given heart medications to control your heart rate, blood products, oxygen assistance, and even dialysis if there are kidney concerns.
Ongoing treatment is determined upon discharge and in communication with your primary care provider.
“Patients who have experienced TSS should not resume tampon use. Reinfection can occur but is rare,” said Boadwine.
Ways to Avoid Toxic Shock Syndrome
There’s no way to completely avoid pelvic infections, but implementing these tips can lower risk:
- Change your period products frequently throughout the day. A good rule is about every four hours. Most period products have instructions in the product packaging. It’s helpful to read safety instructions.
- Because TSS is caused by toxins opposed to product contents, organic products do not seem to provide an advantage. Choose organic products if that’s what you desire.
- Do not reuse disposable period products. Properly clean reusable products before using again.
- Do not excessively touch period products while prepping them for use; this can alleviate some germ transfer.
- Become familiar with your menstrual cycle and your usual symptoms.
- Do not hesitate to contact your provider with concerning symptoms.
Talk to a Women’s Health Expert
Schedule an appointment with your primary care provider or an OB-GYN to discuss concerns related to your period or hormones.
