My first encounter with Toxic Shock Syndrome (TSS) was as a 2nd year resident. I was on call that night and was called by the ER about an admission. It was a 17 year-old girl who was being admitted to the intensive care unit with the diagnosis of TSS.She fit the classic picture of menstrual TSS. Her history was as follows: She was a previously healthy girl who was on her period and was a tampon user. The day prior to her admission she started to feel ill, and then her condition rapidly deteriorated. She had a high fever, her blood pressure dropped, and she developed a generalized sunburn-like rash.Up until that moment I had only heard or read about TSS in my textbooks in medical school. I first heard about TSS when it gained some media attention back in the 80s, linking TSS to tampon use. That 17 year-old girl’s diagnosis is one patient experience that has stuck with me all these years.Toxic shock syndrome is a rare, life-threatening complication of a bacterial infection. It has been historically associated with the use of superabsorbent tampons. Half of all the TSS cases are linked to tampon use. But TSS can happen to anyone; man, woman or child. A skin infection caused by the bacteria linked to TSS is another common cause of TSS.We don’t know exactly how tampons can cause TSS. Some theories include:
- Tampon fibers can scratch or irritate the vagina, therefore breaking down the protective barrier against bacteria or their toxins, allowing them to enter the bloodstream.
- Tampons left in place for an extended period of time can create an environment that encourage bacterial growth.
Menstrual toxic shock syndrome can be prevented by changing tampons frequently; at least every four to eight hours. Consider using the lowest absorbency tampon you can, and avoid using tampons at all when your flow is very light, using pads instead.A wonderful and safe alternative to tampon use is Softcup. Softcup does not alter the vaginal environment in terms of pH, nor does it contain fibers that can irritate the vagina or cause dryness due to absorbency. Studies conducted on Softcup and over a decade of anecdotal evidence show no link to TSS.Here is a list of symptoms that are associated with TSS. If you experience these symptoms and are presently or have been recently on your period and using a tampon, see your doctor.Possible signs and symptoms of toxic shock syndrome include:
- A sudden high fever
- Low blood pressure (hypotension)
- Vomiting or diarrhea
- A rash resembling a sunburn, particularly on your palms and soles
- Muscle aches
- Redness of your eyes, mouth and throat
Dr. Christine Ko is a Board Certified Family Practice physician with more than 15 years of medical experience. Her interests and focus are in women's health, integrative medicine, and sports medicine, and her approach to clinical care centers on knowledge of the disease process as well as the individual. Dr. Ko is a champion of integrated and holistic medicine, and in addition to her traditional medical training, she is trained in both medical acupuncture and mesotherapy.