Toxic Shock Syndrome (TSS)

Toxic Shock Syndrome

All people with periods using tampons and menstrual cups risk TSS.

What is TSS?

Tampon and menstrual cup use has been associated with Toxic Shock Syndrome (TSS) a rare but serious condition that may cause death. Caused by a toxin produced by the bacterium Staphylococcus aureus, TSS is commonly found in the skin, nose and vagina. The risk of TSS is greater in adolescents and those under 30. Although it’s rare, it is important to recognise symptoms and treat it immediately.

The symptoms of TSS can appear suddenly during or just after menstruation and resemble the flu. Contact your doctor immediately and remove the tampon or cup, if you have any of these TSS symptoms:

  • Feeling very ill, headache, muscular pains.
  • A sudden high fever and chills (over 39°C/102°F).
  • Vomiting or diarrhoea, or both.
  • Dizziness or fainting when standing up, weakness or confusion.
  • A rash that looks like a nasty sunburn.

Guidelines for the Use of Tampons to Reduce the Risk of TSS

  • Wash your hands thoroughly before handling tampons.
  • Only use one tampon at a time.
  • Don’t force a tampon to fit inside your vagina.
  • Use the lowest absorbency to suit your flow.
  • Use the tampon immediately after unwrapping it, don’t handle it more than necessary, or place it on any surface.
  • Remove the used tampon before inserting the next one and always remove the last tampon used at the end of your period.
  • Change your tampon regularly (every four hours is a good guide and never more than eight hours).
  • Only use a tampon when you are menstruating. Using a tampon when you don’t have your period can cause dryness and irritation and will absorb the protective mucous that your vagina produces to keep it clean.
  • Avoid the risk of tampon-associated TSS by not using tampons, or reduce the risk by alternating tampon use with sanitary pads during your period or overnight.

Guidelines for the Hygienic Use of Menstrual Cups

  • Only use a menstrual cup when you are menstruating
  • You must sterilise the cup before using it for the first time each month – boiling the cup in water for 3-4 minutes
  • Wash your hands thoroughly before handling the cup
  • During your cycle, empty and wash the cup with clean water, preferably warm, so that it is ready for using again. Remember to thoroughly wash the suction holes
  • Remove and empty your cup at least every 6-12 hours
Seek medical attention if you have any questions about TSS or menstrual cup use.
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