Toxic Shock Syndrome & Your Period: How to Prevent

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Toxic Shock Syndrome & Your Period

When I first started my period in my teens, I was introduced to a whole new world of monthly symptoms – back pain, cramps, and terrible mood swings (you know – the ones that give you the super power to kill someone with just one look), and then I was warned about the dangers of toxic shock syndrome. What was that???

First of all, I was absolutely terrified of the disease for years without actually knowing anything about it, and my over-active imagination drove me to be sure that every new strain of flu that I caught was not in fact the dreaded TSS!

I know I was not the only one who clung to panic as protection rather than arming myself with knowledge – don’t be embarrassed - but now as an adult I want to make sure that others are equipped with education they need.

While we can all sooth ourselves with the knowledge that the disease is extremely rare, it is still a pretty serious one and, we all benefit by learning something about how to lessen the chances of contracting it and also to be familiar with the symptoms in order to visit the doctor when necessary.

Who can get toxic shock syndrome?

Although toxic shock is normally associated with the use of tampons, it can affect just about everyone, children, men, and postmenopausal women.

Around half of the TSS cases affect menstruating women, and the illness has been specifically connected to superabsorbent tampons as well as to other menstrual products like menstrual cups.

How long has TSS been a known disease?

Toxic shock syndrome first hit public consciousness in 1980 when there was an outbreak of the syndrome, with over 800 cases and 35 deaths reported.

While the Center for Disease Control linked it to menstruating women, especially those using tampons, it wasn’t immediately clear exactly why the illness was happening; after all, tampons weren’t exactly groundbreaking technology. A panic quickly spread, and a frenzied media jumped on the story as the number of cases seemed to climb higher every day. The words “toxic” and “shock” were terrifying enough on their own but then gluing them together in association with tampons…..could Stephen King have come up with something scarier??

Women started changing to pads in droves — like, who wouldn’t?

The connection was finally made to the high absorbency tampons, especially Rely tampons, which were made of polyester foam and infused with chemicals as part of a race within the industry to come up with a bigger and better product more absorbent.

These and other high absorbency tampons were quickly pulled off the market, and new regulations required tampon makers to have warnings about TSS be printed on all tampon products.

The number of toxic shock cases quickly dropped, but in recent years has shown an uptick in numbers; there were 5 cases in a three month period in Michigan in 2016. Health authorities wonder if it’s because of a lack of public awareness, something that is really worrying.

How do you know if you might have TSS?

Women who get TSS are on their period or are in the days shortly afterwards.

Symptoms of TSS include:

  • A sudden high fever
  • Headache
  • Muscle aches
  • Redness of eyes, mouth, and throat
  • Sunburn-like rash
  • Low blood pressure
  • Abnormalities in multiple organ systems
  • A dramatic peeling of areas such as the hands and feet

Thirty percent of the women who get TSS are under 19, and women who have gotten TSS once, are more likely to get it again.

Thankfully, modern medicine is able to treat most cases successfully, but even then, it involves a stay in the hospital and intravenous fluids/antibiotics, and sometimes surgery is also needed.

Not. Fun.

Indeed, the worst cases can involve death and the amputation of a limb, which sadly occurred when model Lauren Wasser lost her leg to TSS in December 2017.

Often, those who suffer the most are those who do not seek medical attention rapidly enough because the disease initially displays symptoms similar to those of a viral infection or the flu. If, during your period, you think you may have these symptoms, it’s important to get them checked out immediately, like three days ago last Wednesday.

What causes TSS?

In menstruating women, there is basically one route to TSS: uninvited guests staphylococcus aureus. Staph aureus is a bacteria that normally lives on our skin and doesn’t cause trouble. However, it’s thought that when a tampon is inserted, it drags some staph aureus from the skin into the vagina, riding on the tampon, as it were.

Tampons which have been left in for too long provide a warm, welcoming environment for these bacteria to flourish before they overstay their welcome and invite themselves to the afterparty in your body, where they really begin to cause problems by producing toxins.

These toxins are superantigens that prompt the immune system to massively overreact to an infection, causing the body to go into shock as inflammation spreads and a fever rises. Basically, your uninvited guests have broken into your best Tequila, gotten drunk and then sicked all over your furniture, and when the neighbors called for the police, the swat team arrived instead. Scientists suggest that women who are affected by TSS may have an immune system that doesn’t fight the bacteria off in the same way as the majority of the population, they lack, essentially, a protective anti-toxin antibody. Which is why women who’ve had TSS once, are at increased risk and should never place products, tampons or otherwise, in the vagina.

Completely freaked out?

Don’t be.

Remember that this is extremely rare and there are things you can do to reduce your chances of contracting it.

How to avoid TSS

Three simple rules to avoiding toxic shock syndrome:

  1. Limit the number of hours you leave a tampon in to between four and eight (and not use them at all overnight!)
  2. Use a low-absorbent tampon
  3. Wash your hands regularly

Ignore any urban myths floating around that natural cotton tampons will safeguard you.

They will not.

And, unfortunately, there is nothing you can do to completely safeguard yourself from tampon-related TSS; indeed, the model who lost her leg reported that she had changed her tampon three or four times the day she contracted the illness.

Really, to have complete peace of mind, it would be much better to use a product with no risk whatsoever — such as a menstrual disc, which is the only internally-worn menstrual product which is not linked to TSS. It gives the same benefits of tampons – no having to go back to pads (gads!!!) – along with worry-free days during your period.