TSS (Toxic Shock Syndrome)

The symptoms of TSS include:

• fever
• vomiting
• diarrhoea
• a skin rash that looks like sunburn
• peeling patches of skin on the feet and hands
• muscular aches
• headaches
• a sore throat
• red eyes
• confusion
• a drop in blood pressure
• joint pains
• sensitivity to light
• kidney failure
• collapse.

It is the toxin made by the bacteria that causes TSS, rather than the actual presence of the bacteria. Staphylococcus aureus is a common type of bacterium that lives on the skin and inside the nose. In most cases it is harmless, but it can cause a wide range of infections if it enters the bloodstream.

For TSS to occur, these particular types of bacteria must first over-grow and make large amounts of the TSS toxin, which then enters the bloodstream.

Tampons can increase the risk of TSS in two ways, including:

• Tampons (especially super-absorbent varieties) that are left in the vagina for a long time may encourage the bacteria to grow.
• Tampons can stick to the vaginal walls, especially when blood flow is light, causing tiny abrasions when they are removed.

If you think you could have toxic shock syndrome, stop using tampons immediately and go to the emergency department of your nearest hospital.

Treatment for TSS includes:

• a stay in hospital
• medication (antibiotics) to kill the infection
• fluids given through a drip (intravenously) to increase blood pressure and treat dehydration
• medical treatment for any complications, such as kidney failure.

Given the number of women worldwide who regularly use tampons, TSS is a very rare condition. Suggestions to reduce the risk include:

• Change tampons regularly (at least every four hours).
• Avoid using super-absorbent tampons.
• Only unwrap the tampon if you are going to use it immediately.
• Do not handle the tampon more than you need to.
• Wash your hands thoroughly before and after inserting the tampon.
• Be gentle when inserting and removing tampons.
• Avoid applicator tampons, as the applicator may scrape the vaginal walls.
• Use pads (sanitary napkins) instead of tampons overnight.
• Maintain personal hygiene during your period.
• Do not wear tampons when you do not have your period.
• Consider using pads or panty liners during the last day or so of your period when your flow is light.
• Use a lubricating jelly when inserting tampons in the last day or so of your period when your flow is light.

There are no clinical trials supporting the use of menstrual cups to reduce the risk of TSS.

In an emergency, always call an ambulance by dialling triple zero (000)

• Contact your local doctor (GP)
• Visit the emergency department of your nearest hospital
• Visit Sexual Health Victoria
• Visit Better Health Channel