Toxic Shock Syndrome (TSS) and Period Products

Toxic Shock Syndrome and Tampons

It's been a while since Toxic Shock Syndrome (TSS) has held space in the news, but a recent interview on The Diary of A CEO with Lauren Wasser has brought back attention to this rare but serious illness.

Wasser is a model and activist who lost her legs to TSS after using a superabsorbent tampon. She is now using her platform to raise awareness about TSS and to encourage women to use safer period products. You can view the full episode at the end of this article

What is Toxic Shock Syndrome?

Toxic shock syndrome (TSS) is a rare but serious illness caused by a bacterial infection. It can affect anyone, but it is most common in menstruating women who use tampons. Other factors, such as an infected wound or surgery can also cause TSS.

What are the causes of TSS?

TSS is caused by a type of bacteria called Staphylococcus aureus. This bacteria is normally found on the skin and in the body, but it can sometimes produce a toxin that causes TSS. The toxin, called TSST-1, can enter the bloodstream and cause a widespread inflammation reaction.

What are the risks of TSS?

The risk of TSS is highest in menstruating women who use tampons. This is because tampons can create a warm, moist environment ideal for bacteria growth. Other risk factors for TSS include:

  • Using super absorbent tampons
  • Leaving a tampon in for too long
  • Having a wound or infection
  • Being pregnant
  • Having a weakened immune system

Can all period products cause TSS?

TSS can be caused by any product that creates a warm, moist environment. This includes period products such as tampons, menstrual cups, pads, and sponges. However, the risk of TSS is lower with pads and menstrual cups than with tampons. This is because pads and menstrual cups do not absorb as much blood, which helps to keep the vagina dry.

What are the symptoms of TSS?

The symptoms of TSS can develop quickly, often within a few hours. The most common symptoms include:

  • High fever (102°F or higher)
  • Low blood pressure
  • Rash that looks like sunburn
  • Muscle aches
  • Vomiting
  • Diarrhoea
  • Confusion
  • Seizures

How to prevent Toxic Sock Syndrome (TSS)

There are a few things you can do to help prevent TSS:

  • Limit or avoid using tampons and opt for different solutions
  • If you choose to use a tampon, use the lowest absorbency tampon that is comfortable for you and will provide you with the protection you need
  • Use pads at night rather than tampons
  • Change your tampon every 2 to 4 hours, even if it is not full
  • Do not leave a tampon in for longer than 4 hours
  • Avoid using super-absorbent tampons
  • If you have a wound or infection, be sure to clean it thoroughly and keep it covered

What are the early signs of TSS?

The early signs of TSS can be similar to other illnesses, such as the flu. However, if you experience any of the following symptoms, it is important to see a doctor right away:

  • Fever
  • Rash
  • Muscle aches
  • Vomiting
  • Diarrhoea
  • Confusion

What to do if you suspect you have Toxic Shock Syndrome?

If you think you have TSS, it is important to seek medical attention immediately. TSS is a medical emergency and can be fatal if not treated promptly.

The doctor will likely perform a physical exam and ask about your symptoms. They may also order blood tests to confirm the diagnosis.

Treatment for TSS usually includes antibiotics and supportive care, such as fluids and electrolytes. In some cases, surgery may be necessary to remove infected tissue

Toxic Shock Syndrome (TSS) FAQs

What is the difference between TSS and the flu?

The flu is a respiratory illness that is caused by a virus. TSS is a bacterial infection that can affect multiple organ systems. The symptoms of the flu and TSS can be similar, but TSS is a more serious illness.

How long does it take for TSS to develop?

The symptoms of TSS can develop quickly, often within a few hours. However, in some cases, the symptoms may not appear for up to 2 weeks.

Is TSS contagious?

No, TSS is not contagious. The bacteria that cause TSS are normally found on the skin and in the body. However, the toxin that causes TSS is not contagious.

Can TSS be prevented?

Yes, TSS can be prevented by taking simple precautions, such as using the lowest absorbency tampon that is comfortable for you, changing your tampon every 2 to 4 hours, and avoiding using super-absorbent tampons.

What are the long-term effects of TSS?

The long-term effects of TSS vary from person to person. Some people may experience no long-term effects, while others may have permanent damage to their organs. The most common long-term effects of TSS include:

  • kidney damage
  • liver damage
  • heart problems
  • long-term fatigue
  • memory problems
  • difficulty concentrating
  • joint pain

What are the signs that TSS is getting worse?

If you have TSS, you should seek medical attention immediately. However, there are some signs that TSS is getting worse, such as:

  • fever getting higher
  • blood pressure getting lower
  • having trouble breathing
  • seizures

Real Stories of Toxic Shock Syndrome

Story one:

Shocking TRUE Story: “I Lost Both Of My Legs Because Of A Tampon” (Health Warning) - Lauren Wasser

Story two:

"I recently survived Toxic Shock Syndrome. Here is my experience-- and you don't get it only from tampons!"

Story posted by u/Mjrna

April 29th I was admitted to the ER and my hospital stay was five days. When I had reached the ER I was puking, convulsing and becoming delirious from my fever (104 degrees), and going into septic shock. Just hours before this I was running, swimming, and having a perfectly great and normal time at a birthday party. It all happened extremely fast. I'm skipping a lot of fine details (the number of tests, ultrasounds, etc) and including what's important.

About an hour and a half before the ER, I had felt cold and I assumed this was because it was night and I was still wearing a crop top. So I hopped in the shower with the plans that I'd warm up then watch a new episode of Samurai Jack. But... the longer I stayed in the shower, the colder I felt. I had the heat on as high as it could go and was shaking. When I got out of the shower I assumed I was getting the flu or something and I bundled up in bed. It only got worse and I started feeling nauseous on top of it. I told my mom I needed to go to the hospital and my dad took me there.

This was my first time ever being admitted to a hospital and my first time seeing a doctor for something physical other than when I had my copper IUD put in or seeing a dentist. I was really terrified of everything but the nurses were all very kind. It took my entire stay for the doctors to figure out what was wrong with me beyond "something caused sepsis and septic shock, but we don't know what."

Finally, one of my urine cultures gave a clue. They found staph in my urine. They asked me if I had pain when urinating. I didn't. They think this was from a UTI gone untreated/improperly treated. On my last day in the hospital, the infectious disease specialist told me he believed the staph (s. aureus) from my bladder migrated to my IUD and infected it, thus causing the Toxic Shock Syndrome. He told me that even though I was on antibiotics I needed to get it removed before my run of antibiotics was over, or else I would need to sign a consent form stating that I refused removal and that my family cannot sue the hospital if I die from re infection. He explained that the staph could have created an antibiotic resistant biofilm around the IUD. I quickly realized how serious things were! The doctors said when I had arrived I had an 80% chance of dying and only a 20% chance to live. I'm really lucky.

Since I was now discharged, I made an appointment at my local Planned Parenthood to get the IUD out (this was also where I had got it inserted). However, they initially refused, saying that their own doctor said removing it would increase my re-infection rates. I told them what the hospital told me. I waited THREE HOURS while they talked on and off with their doctor before they agreed to remove it. Now I am trying the hormonal arm implant because I cannot receive another IUD for 3 months because my uterus needs to heal.

During my hospital stay, I also had the telltale sign of TSS which is a sunburn-like rash. It is literally like a stinging sunburn. Apparently, most people get it all over their body, but mine was between my thighs, groin/genital area (yes, "down there"), soles of my feet, and palms of my hands. Eventually, the rash stops hurting and peels off painlessly (except in the genital area. That area was painful and uncomfortable). The bottoms of my feet peeled off in huge sheets of dead skin. My hands are still peeling and my groin stopped peeling over a week ago (thank god!)

I've read online some people have more complications beginning a few months after TSS. I am lucky to be alive and intact so I don't know if I will face these problems (nails falling off, hair loss to name a few) but I hope not. TSS has given me so much anxiety and fatigue as it is. I am 4'11" and was about 110lb (thin and fit, I work out a lot), and during my stay I lost 10lb and a lot of mass and muscle alike. I am finally working out again but it's rough.

Check out the post on Reddit to read the comments:

by u/birdmommy from discussion I recently survived Toxic Shock Syndrome. Here is my experience-- and you don't get it only from tampons! Any other survivors want to share their experiences after TSS?
in TheGirlSurvivalGuide

Article References and Further Reading

  • The relationship of tampon characteristics to menstrual toxic shock syndrome, 1987,  Berkley, S. F., A. W. Hightower, C. V. Broome, and A. L. Reingold [PubMed] [Google Scholar]
  • Risk factors for toxic shock syndrome. Am. J. Epidemiol,  1981, 114:873-878., Kehrberg, M. W., R. H. Latham, B. T. Halsam, A. Hightower, M. Tanner, J. A. Jacobson, A. G. Barbour, V. Noble, and C. B. Smith., [PubMed] [Google Scholar]
  • Reemergence of staphylococcal toxic shock syndrome in Minneapolis-St. Paul, Minnesota, during the 2000-2003 surveillance period. J. Clin. Microbiol., 2004, Schlievert, P. M., T. J. Tripp, and M. L. Peterson. [PMC free article] [PubMed] [Google Scholar]