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What is Toxic Shock Syndrome, and What Are The Alternative Period Products?

If you use tampons, it’s vital that you know about Toxic Shock Syndrome and how it occurs.

Although it’s thankfully a rare condition experienced by around 40 people a year, Toxic Shock Syndrome is dangerous and can be fatal.

As it’s often linked to tampon use, those of us who menstruate need to be aware of the symptoms of the condition so we can act fast should we spot them.

So let’s take a look at Toxic Shock Syndrome, the symptoms, and what alternative period products we can choose.

What we’ll be looking into:

  • What is Toxic Shock Syndrome, and how does it occur?
  • How to recognise the symptoms
  • The treatment for Toxic Shock Syndrome
  • Alternative period products to replace tampons

What is Toxic Shock Syndrome?

The condition of Toxic Shock Syndrome is caused by an infection triggered by certain bacteria in the body.

The NHS explains: “TSS is caused by either Staphylococcus or Streptococcus bacteria.

“These bacteria normally live harmlessly on the skin, nose or mouth, but if they get deeper into the body, they can release toxins that damage tissue and stop organs working.”

Once the infection takes hold, toxins spread through the bloodstream and the body will go into septic shock, which is extremely dangerous and can be fatal.

Did you know?

The NHS explains that sepsis is “a life-threatening reaction to an infection. It happens when your immune system overreacts to an infection and starts to damage your body’s own tissues and organs.”

Research suggests that “Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.”

Therefore, it’s important to highlight that TSS is a serious case of sepsis.

How is Toxic Shock Syndrome linked to tampon use?

The link between tampon use and Toxic Shock Syndrome is down to several factors.

These are primarily around hand and genital hygiene during the insertion of the tampon or by leaving the product in your body for too long.

It’s important to note that people who don’t menstruate can also develop TSS and that tampon use is not the only cause of the condition. There are other risk factors that could lead to TSS.

Instead, the tampon itself is a ‘co-factor’ in the development of Toxic Shock Syndrome in people using period products.

What the experts say:

Author Sharra Vostral explains: “Toxic shock syndrome specific to tampons requires the presence of Staphylococcus aureus in vaginal flora and lack of requisite antibodies to neutralise toxic shock syndrome toxin-1 produced by the bacteria.

“Many scientists believe that other co-factors include: oxygen (brought into the vaginal canal by the tampon) that creates an aerobic rather than anaerobic environment, a less acidic environment during menses, and dynamic vaginal ecosystems that influence microbial constituency and activity including that of Staphylococcus aureus.” 

In summary, Sharra Vostral explains that TSS requires the following conditions to thrive:

  • Presence of Staphylococcus aureus in vaginal flora
  • Lack of antibodies to neutralise the toxic shock syndrome toxin-1 which is produced by the bacteria
  • Oxygen brought into the vaginal canal by the tampon allows the bacteria to multiply
  • A less acidic environment during menstruation

What are the symptoms of Toxic Shock Syndrome?

If you develop Toxic Shock Syndrome, there are several symptoms that you’ll potentially experience.

These may include:

  • A high temperature
  • Shivering and aching muscles
  • A skin rash that makes the surface of the skin feel rough like sandpaper
  • Swollen or peeling skin
  • Vomiting and diarrhoea
  • Severe pain in the arms and/or legs
  • Sickness and dizziness
  • Bright red palms of your hands, feet soles, or tongue
  • Redness of your eyes

What the experts say:

The charity Sepsis Alliance highlights the importance of seeking treatment as soon as you can so medical professionals can work out if the condition you are experiencing is Toxic Shock Syndrome.

They explain: “Because the symptoms for TSS occur so quickly, it’s vital that they be recognised, and TSS diagnosed and treated as quickly as possible.

“Blood tests will be done to find out what type of bacteria caused the TSS. Other tests, such as swabs from parts of your body that could be infected, urine tests, CT scans, and lumbar punctures may also be done.”

How do doctors treat Toxic Shock Syndrome?

Once your medical team diagnoses TSS, they will move quickly to treat the condition.

If you are menstruating, doctors will first check that the tampon is removed, as it could be the cause of the condition.

From there, all efforts will be made to treat the infection and restore the body’s functions.

What the experts say:

The NHS website is clear that if you have Toxic Shock Syndrome, you need immediate attention.

They explain: “You’ll need urgent hospital treatment for toxic shock syndrome (TSS).

Treatment can include:

  • Antibiotics to treat the infection
  • Fluids to rehydrate you, usually through a drip in your arm
  • Medicine to help control your blood pressure
  • Oxygen
  • Surgery to remove the infection from cuts or wounds.”

Once treatment is successfully administered, you should hopefully feel better in a few days. However, you may need to remain in the hospital for several weeks.

What can I do to minimise the risk of contracting Toxic Shock Syndrome from tampons?

If you use tampons, there are several things you can do to reduce the risk of TSS.

First things first, make sure that your hands are clean when you insert the tampon, and regularly change your tampon.

Don’t leave the tampon in for longer than eight hours, the maximum time advised by professionals, which is why they also advise against sleeping with one in.

What the experts say:

In their helpful blog on Toxic Shock Syndrome, healthcare company Yoxley has some other excellent advice on choosing the best tampon to use.

They suggest, “Opt for the lowest absorbency tampon, as this will minimise the amount of time the tampon is inside, reducing the likelihood of bacterial growth.

“In addition to this, if a tampon is too absorbent for your flow, it can lead to vaginal dryness and small tears in the vaginal wall, which can make it easier for bacteria to enter the bloodstream.

“This is because tears can provide a perfect environment for bacteria to grow and produce toxins which can, in turn, increase the risk of developing TSS.”

Choosing alternative period products

While tampons do not cause TSS alone, we’ve seen how they are often a co-factor in cases experienced by menstruating people.

For many people, tampons are the preferred period product because they absorb blood well and reduce leakage, offer flexibility for active lifestyles and freedom of movement, and can’t be seen through clothing.

However, if you are looking for alternative products, there are other options available:

  • Period underwear

Reusable period underwear has become popular because it is so wearable, absorbent and eco-friendly and are a great alternative to wearing tampons at night.

The underwear, which comes in various styles, including swimwear, is worn like regular underwear but has a layer to catch blood as it leaves the body.

As they fit snugly, they don’t move around like pads and reduce the risk of staining through clothes.

Once used, they can go into the washing machine with your other clothes and be dried, ready for reuse.

If you are wondering which brand to go for, check out this article by Women’s Health magazine, which has tried and tested the best.

  • Reusable sanitary pads

Another option is reusable sanitary pads.

These products are made of cloth and attach to your underwear to stay in place.

It’s good to know that they are both gentle on your skin and suitable to use while swimming as well.

You can choose from different sizes and absorbencies, and like period underwear, you can throw used pads in the wash each time.

The cost of reusable sanitary pads is often a big bonus, as they are often cheaper than period underwear and, indeed, a more cost-effective choice than one-use pads.

 If you want to see a good comparison of products on the market, check out The Independent’s Guide.

Be safe, keep informed, and choose wisely

We hope you’ve found our guide to Toxic Shock Syndrome helpful.

Remember that if you develop the symptoms, seek medical treatment immediately.

Tampons are often credited with giving menstruating people more freedom and flexibility to live their lives as usual during periods.

You can continue to use them if you practice hygiene and safety at all times, but if you want to try something different, there are some great options out there.

As ever, it’s about finding what’s best for you and making informed decisions.

At Kari Health, we’re here to support you and help increase awareness around period health, one conversation at a time.

This article has been reviewed by our Kari Health Experts and Editorial Board to ensure accuracy and reliability of the information presented. However, please note that the content provided is for informational purposes only and should not replace advice from your medical professional.

Did you find this article helpful this article? 

If so, you can read related Kari Health articles here:

How To Maintain A Healthy Vagina

What is a Period – and Why Menstruation is Amazing

How To Feel More Body Positive During Your Period

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