How to Reduce Your Risk of Toxic Shock Syndrome

Toxic Shock Syndrome (TSS) is a rare, potentially life-threatening condition the develops in women when staphylococci bacteria in the vagina enter the bloodstream. Although scientists have recognized a connection between tampons and instances of TSS, the exact connection remains unclear.

First, the good news: You don't have to quit using tampons in order to avoid toxic shock syndrome. Most cases of tampon-related TSS are a result of using tampon products the offer the highest absorbency and/or leaving them in for too long. When it comes to TSS, most medical professionals agree that it’s not the tampons that are the problem, necessarily, but improper tampon use.

That said, manufacturers of tampons sold in the United States no longer use the materials or designs that were initially associated with early cases of TSS. Perhaps more importantly, the Food and Drug Administration (FDA) now also requires manufacturers to use standard measurements and labeling for absorbency and to print guidelines on the boxes to educate women about proper use.

Still, when it comes to the risk of a serious condition, it doesn't hurt to play it safe.

To avoid toxic shock syndrome, follow these eight safety tips:

1. Always use the lowest possible absorbency tampon for your flow. This might mean using different absorbency levels at different points in your period. All tampon products in the U.S. use the standard Light, Regular, Super, and Super Plus labeling, according to FDA guidelines for tampon absorbency.
2. Change tampons at least every four to eight hours, and avoid wearing one to bed unless you plan on waking during the night to change it. When your flow is light, use sanitary napkins or mini pads.
3. Be sure to wash your hands thoroughly before and after inserting tampons. Staphylococci bacteria are often found on the hands.
4. If vaginal dryness is an issue, use a lubricant when inserting a tampon to avoid irritating the vaginal lining.
5. Do not use tampons for vaginal discharge, or any other reason, between menstrual cycles.
6. Do not use tampons if you have a skin infection near your genitals.
7. Keep in mind that tampon misuse isn't the only way you can get toxic shock syndrome. Although the condition is most commonly linked to tampon use in menstruating women, it can affect people of all ages, including men and children. Infection usually occurs when bacteria enters your body through an opening in your skin. For instance, bacteria can enter through a cut, sore, or other open wounds.
8. If you experience any signs of TSS—a sudden, high fever; vomiting or diarrhea; a sunburn-like rash on the palms of your hands and soles of your feet; redness of your eyes, mouth, and throat; or a drop in blood pressure—call your physician immediately.

If you develop TSS, you'll likely be hospitalized and treated with antibiotics and fluids to treat dehydration. Depending on your symptoms, your doctor may ask for blood and urine samples to test for the presence of a staph or strep infection. Since TSS can affect multiple organs, your doctor may also order other tests like a CT scan, lumbar puncture, or chest X-ray.