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You may have heard of toxic shock syndrome. If so, you probably know that it’s associated with wearing tampons.

It’s a serious condition, and while it’s extremely unlikely you’ll get it, if you use tampons or plan to try them it’s really important to have the facts so you know what to avoid and what to look out for.

While it’s a really rare condition, toxic shock syndrome or TSS is a very serious disease. It’s caused by a toxin produced in bacteria normally found on our bodies. If this bacteria gets in the body it can have extremely serious consequences. That’s why hygiene is key when you use tampons. Always wash your hands before unwrapping and inserting a tampon, and then again afterwards.

TSS is often associated with tampon use, but it can affect anyone of any age. [1] Young people are believed to be particularly at risk as they may not yet have developed enough antibodies to fight the toxin. While women all over the world use tampons without experiencing health issues, it is estimated that half of all TSS cases are related to menstruation, although research has not yet led to any clear idea of what causes the link between tampons and TSS. Tampons don’t actually carry the bacteria that cause TSS but tampon use has been associated with an increased risk of it.

While TSS can occur with tampon use of any absorbency, the risk increases if you use tampons of a higher absorbency. [2] That’s why you should always choose the lowest absorbency to suit your flow. This will not only reduce the risk of TSS, it will also making removing a tampon much less uncomfortable. So instead of thinking ‘it’s better to be safe than sorry’ and going for the most absorbent tampon, it’s actually better to go for the lowest absorbency that suits your flow.

Keep your tampon wrapped until the moment you are ready to insert it. After washing your hands, unwrap a fresh, clean tampon just before use, and don’t handle it or put it down on any surface before insertion. If you’ve had a tampon in your bag for a while and the wrapper has become torn throw that tampon away. If the wrapper is ripped, the tampon could get contaminated with bacteria and cause infection.

But there are other precautions to take to reduce your risk of TSS. Only use a tampon when you are sure that you have your period – not when you suspect it’s about to start – and never for everyday discharge. Don’t insert a tampon if it’s painful to do so, and never insert more than one tampon at a time. Always change your tampon regularly, preferably every four hours. The longest you should ever leave a tampon in is eight hours.

Ideally at night time, use a Libresse sanitary pad when you go to bed rather than a tampon, or if you use a tampon put a fresh one in before going to sleep, making sure you remove it eight hours later at the very latest. If possible, alternate tampons with a sanitary pad during your period. And always make sure you remove your tampon at the end of your period.

It’s important to keep some perspective on this; TSS is extremely rare. But nonetheless, knowing what signs to look for is extremely important. Because while in a few isolated cases TSS can be fatal, if it is diagnosed and treated early there is a good chance of recovery. [3]

Symptoms of TSS can include a sudden high fever, diarrhoea, vomiting, flu-like symptoms, dizziness, the whites of the eyes, lips and tongue turning bright red and/or a sunburn-like rash. [4] TSS gets worse very quickly. If you experience these symptoms you should remove your tampon immediately and seek medical attention as soon as possible, explaining to your doctor that you are menstruating. Most people make a full recovery with treatment.

Key facts about TSS

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1. Half of all cases affect women

50% are from infected burns, boils and insect bites.

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2. The risk of TSS increases with higher absorbency tampons

Always choose the lowest absorbency for your flow.

Illustration of two hands with a rash on a pink background - Libresse
3. Common symptoms

Fever, vomiting, diarrhoea, sunburn-like rash.

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