Here’s How Likely It Really Is to Get Toxic Shock Syndrome

Raise your hand if toxic shock syndrome — and the fear of leaving a tampon in for too long — has lived rent-free in your mind since your teenage years. (Thanks, 2000s teen magazines.) Same. So we connected with OB-GYN Dr. Allegra Cummings to find out how toxic shock syndrome can develop from tampons and other period products, how common it really is, and how to prevent it in the first place. 

Expert Interviewed:

Dr. Allegra Cummings - Dr. Allegra Cummings is an OB-GYN at Weill Cornell Medicine.

Remind me. What is toxic shock syndrome?

Toxic shock syndrome (TSS) is a rare but serious illness that’s caused by the overgrowth of certain types of bacteria. You can get TSS when those bacteria — more commonly Staphylococcus aureus, Streptococcus pyogenes, or Clostridium sordellii — “grows and multiplies and [gets] into the bloodstream,” said Dr. Cummings. 

How common is toxic shock syndrome? 

TSS was more common in the 1980s, when it was first linked to the super-absorbent tampons of the time. “The good news is that it is really not that common anymore,” said Dr. Cummings. Think: Up to three out of 100,000 people who have periods get it. Because tampons are made differently than they were decades ago, it’s much rarer. 

What are the symptoms of TSS?

Early symptoms of toxic shock syndrome can seem like the flu and get worse very quickly. So be on the lookout for:

• Fever

• Chills

• Headache

• Low blood pressure

• Rash (particularly on palms or soles of the feet that look like a sunburn)

• Peeling skin on palms or soles of feet

• Vomiting

• Diarrhea

• Red eyes, mouth, and throat

• Muscle aches

If you think you might be experiencing symptoms of TSS — especially textbook symptoms like a rash or skin peeling — see a doctor right away, said Dr. Cummings. Toxic shock syndrome treatment can include IV fluids and antibiotics. 

So do tampons cause toxic shock syndrome?

Not exactly. TSS can also start when certain bacteria get into cuts or sores anywhere on the body, or in the vagina. And if a tampon is left in for too long, it can create an environment for too much of that bacteria to grow. And the toxins that the bacteria release are what can make you sick, Dr. Cummings explained. 

Super-absorbent tampons are more likely to create that environment than low-absorbency tampons "because they can be left in for longer, and they have the ability to trap up a larger volume [of bacteria],” Dr. Cummings said.  

Some studies have found that other products meant to be inserted into the vagina can also encourage TSS-causing bacteria to grow. See: menstrual cups, diaphragms, cervical caps, and contraceptive sponges. So remember to remove the products you use within the recommended time period (more on that below).

Can organic tampons lead to toxic shock syndrome, too?

Short answer: Yes. If worn for too long, any tampon can create an environment for TSS to develop. 

Anything I can do to reduce the risk of contracting TSS?

Change your period and contraceptive products within the recommended time frames. For period products, that means within eight hours for tampons and 12 hours for menstrual cups. Pro tip: Using the lowest-absorbency tampon that your flow can handle may help you remember to change it in time. 

And when it comes to contraceptives, cervical caps should be removed within 48 hours after having sex, diaphragms within 24 hours, and sponges within 30 hours. 

theSkimm

For years, there’s been a lot of fear around TSS and tampons — but not enough information on why it happens and how common it actually is. The good news: It’s really rare, and good period and contraceptive product hygiene can reduce your risk even more.