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Toxic Shock Syndrome: Why the Warnings?

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Women who use tampons may notice the insert about toxic shock syndrome. In the early 1980s toxic shock syndrome was all over the news media. Nearly 30 years later, we rarely hear about it. What is toxic shock syndrome and why do we need to be warned about it?

Toxic shock syndrome (TSS) is a very rare but potentially fatal illness caused by a complication of bacterial infection; primarily the Staphylococcus aureus bacteria. It occurs mostly in menstruating women who are using high absorbency tampons.

Although the exact connection is not crystal clear, many researchers suspect certain types of high-absorbency tampons provide a moist, warm home where bacteria can thrive. While TSS was originally linked to tampons, now it is also connected with contraceptive sponges and diaphragms.

Toxic shock syndrome hits hard. Shock, organ failure, and death have all been associated with TSS. Three percent of women who get TSS die from it. Toxic shock syndrome from staphylococcus starts suddenly, usually during or just after a period. Common symptoms include a high fever (sometimes accompanied by chills), vomiting, diarrhea, and a drop in blood pressure. Also muscle aches, headaches, sore throat, blood-shot eyes, confusion, a widespread rash that looks like sunburn, and skin peeling. Get immediate medical attention if you develop any of these symptoms, particularly during menstruation and tampon use.

For many who started menstruating in the early 1980s, the term toxic shock syndrome is nothing new. There was a tidal wave of media attention when an epidemic broke out. It was linked to the prolonged use of highly absorbent tampons. According to the Boston Women's Health Book Collective, 942 women were diagnosed with tampon-related TSS from 1980 to 1981. Forty of them died. At that time, several companies sold super-absorbent synthetic tampons. These tampons didn’t create TSS, but provided a breeding ground for the toxins to grow.

As an outcome, the FDA implemented regulations listing tampons as medical devices. It forced manufacturers to standardize tampon absorbencies and include package inserts warning tampon users of TSS risk. Since then the number of cases of tampon-induced toxic shock syndrome has dropped significantly, but it’s still wise to exercise caution when using tampons.

Avoid using highly absorbent tampons. Alternate between using tampons and sanitary napkins during your period. Never leave a tampon in overnight. Change tampons frequently, at least every four to six hours. It’s also recommended to keep tampons away from heat and moisture where bacteria can grow.

Stacy Lloyd is a writer and video producer in Phoenix, Arizona. A former television news journalist, she covered stories around the world. Currently, she produces corporate and non-profit videos and broadcast programming.

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EmpowHER Guest
Anonymous

Dr. Philip Tierno Jr., chief of clinical microbiology and immunology at New York University Medical Center and a leading authority on tampon health risks writes in his recent book, The Secret Life of Germs:

“the number of current cases of TSS is underreported, perhaps significantly so. In 1989, only 45 cases of menstrual TSS were reported to the CDC. But to be reported to the CDC, an incidence of TSS must meet what is called a strict case definition. This requires that the patient have symptoms in all of five major categories: fever of 102 degrees Fahrenheit or greater, rash, skin peeling one to two weeks after illness begins (assuming, of course, that death has not already occurred), low blood pressure or dizziness, and involvement of three or more organ systems. If symptoms are absent in one or two categories but present in others—for example, if a woman has a fever of 101.9 degrees Fahrenheit rather than 102, or if she does not have a rash—the situation may fulfill a clinical diagnosis of TSS. For every case I see that meets the CDC’s strict case criteria, I see five or more that fit the clinical bill.”

Dr. Tierno goes on to note that over the past 30 years he has never seen a single case of TSS resulting from the use of a pure cotton tampon. He also states his belief that because viscose rayon offers up to 4 times more specific surface area than cotton, every case of TSS is caused in part by the use of this material.

One way that women can be certain about what's in their tampons, is by moving to organic brands. Organic cotton tampons contain 100% pure cotton grown without pesticides and not bleached with chlorine. They contain no rayon, fragrances, or dyes. www.letstalkperiod.com is a great site to learn more about organic options.

August 23, 2010 - 8:28am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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