The realities of toxic shock syndrome

Photo illustration by Joel McCarthy
Photo illustration by Joel McCarthy

What causes it, how to avoid it, and how to recognize if you have it

By Brittney MacDonald, Life & Style Editor

Every woman has heard of toxic shock syndrome (TSS), or, at least, she should have. Unfortunately, because sexual education in high school and elementary school isn’t standardized, this dangerous and potentially fatal result of poor period handling goes largely ignored.

When I was going through those awful and embarrassing puberty classes in grades 5–7, I never heard TSS mentioned once. Instead, I had to hear it from my older sisters when I decided to make the switch from sanitary napkins to tampons. To me, this seems like a major gap in education—essentially, you are risking young girls suffering extreme illness in an effort to avoid a public discussion about menstrual cycles. Does anyone else think that’s a little ridiculous?

Toxic shock syndrome is a build-up of bacterial toxins in the body. In menstruating women, the most common cause is leaving a tampon in too long. Because the uterine lining was essentially meant to “feed” a developing fetus, it is packed full of nutrients and other things that organisms, such as harmful bacteria, could use to rapidly reproduce. This is why the body needs to expel it every month, should pregnancy not occur.

Toxic shock syndrome can be fatal.

In fact, during the Renaissance, menstrual blood was considered poison that caused “hysteria” (an early name for “period rage”) in women. Expelling the blood was therefore necessary. This myth was perpetuated by the fact that women who inserted cloth or sponges into the vagina in order to stem the flow, would sometimes die.

Most tampons carry a warning that they shouldn’t be inserted for more than eight hours. This was done in an effort to avoid TSS, though for a lot of brands the risk of TSS is never mentioned in the instruction manual. This is changing, thankfully, as the public becomes more outspoken about women’s sexual and reproductive health. Some brands have started including a section explaining the disease and its symptoms in their instruction manuals included in every box of tampons.

Symptoms of TSS include high fever, low blood pressure, confusion, a general sense of discomfort or uneasiness, and sometimes a sunburn like rash, which can appear anywhere on the body. These symptoms can quickly progress, leading to coma and multiple organ failure—hence why the disease can be fatal.

So, how do you avoid all of this? Avoiding tampons with high absorbency, such as the heavy flow ones; ensuring if you do use them you change your tampon every three to five hours; and switching to sanitary napkins at night, when you won’t be awake to change your tampon within the allotted time. Your last option is eliminating tampons in general—which is probably the best option, in my opinion. Doing this doesn’t necessarily mean you’re stuck with the “diaper” of a sanitary napkin. DivaCups are available and they are similar to tampons in that they are inserted, but, because the blood doesn’t remain trapped in the uterus, they greatly reduce the risk of TSS. Also, DivaCups can remain in place for upwards of 12 hours, meaning you can sleep in them, and they’re more cost effective because they last for about a year. If you like math, that’s about $330 a year in savings, and I’m low-balling.