Everything You Need To Know About TSS (Toxic Shock Syndrome)

You may have seen the TSS (aka Toxic Shock Syndrome) warnings on your tampons and wondered what all the fuss was about. This is a rare but potentially harmful condition, and we’re keen to make sure everyone knows about the risks and potential symptoms so you can feel safe wearing tampons.

What is TSS?

TSS stands for Toxic Shock Syndrome, and is caused by toxins produced by staphylococcus aureus, a bacteria commonly found on the skin, inside the nose, and inside the vagina. These bacteria typically exist harmlessly on the body, but in rare cases can invade the bloodstream and release poisonous toxins that can damage tissue, including skin and organs. 

Most worryingly, they can disturb many vital organ functions, which is why TSS is considered to be so serious. While it is considered a medical emergency, it’s really nothing to worry about as long as you know the signs and symptoms, and change your tampon regularly. TSS is often associated with tampon use in young women but it can actually affect anyone, including men and children, so whether you’re a tampon-user or not it’s important to know more about this harmful condition. 

What are the symptoms of TSS?

According to the NHS website, symptoms of TSS can start very suddenly and escalate quickly, so knowing the signs to watch out for is crucial. Not all symptoms occur at once, and they include but are not limited to:

• A temperature of 39°C (102°F) or above 
• Fainting or dizziness
• Erythema, a sunburn-like rash or redness of the eyes
• Swollen palms and feet
• Muscle aches
• Headache
• Vomiting or diarrhoea
• Sore throat 
• Severe flu-like feelings 
• Badly smelling vaginal discharge when using tampons 

In a BBC News article, one TSS sufferer described when she first noticed symptoms: "The first symptom I had was the headache one evening while I was at university”. She later developed muscle pains and began vomiting. It is important to take note of changes in your body that may be an early indicator of TSS.

What causes TSS?

While using tampons is the main cause associated with TSS, there are a number of ways it can occur:

• Broken skin, such as cuts, burns, boils or insect bites, or a wound after surgery
• Leaving tampons in for longer than the recommended time, or using super-absorbent tampons when they are not required
• Using barrier contraceptives, such as a diaphragm or cap
• Using nasal packing to treat an excessive nosebleed
• Having a staphylococcal infection or streptococcal infection, sometimes referred to as a ‘staph infection’ or ‘strep throat’ 

It’s also important to know that TSS is not transferable from person to person, and you do not develop immunity to it if you have had it in the past - you can get it more than once. 

When is it time to seek medical advice?

While Toxic Shock Syndrome is rare and shouldn’t be fretted about on a daily basis, it is still considered a medical emergency if symptoms occur. There’s no way to tell if the symptoms you are experiencing are from a different, less serious condition, but it’s safer to rule out TSS by contacting your GP, or NHS 24 on 111, the 24-hour urgent healthcare helpline. 

If instructed, or if your symptoms are particularly bad, it is advised that you go to your nearest A&E department ASAP, or call 999 for an ambulance. If you are wearing a tampon, remove it immediately and tell the medical professional treating you that you have been using one. 

According to WebMD, upwards of a third of all cases of TSS involve women under 19, and up to 30% of women who have had TSS will get it again. If you have had TSS in the past, you should always look out for symptoms and seek immediate medical care if in doubt. 

What is the treatment for TSS?

If you are admitted to hospital with TSS, you may need to be treated in an intensive care unit. Treatment will depend on the severity of the case, but can involve:

• Taking antibiotics to treat the infection
• Oxygen to help with any laboured breathing
• Fluids to prevent dehydration and organ damage
• Medicine to help control blood pressure
• In extreme cases, dialysis if the kidneys stop functioning, and potentially surgery to remove dead tissue

Many people who suffer from TSS will begin to feel healthy again in just a few days, but it can take several weeks before you're considered well enough to leave hospital.

How can TSS be avoided?

Preventing the risk of TSS can save you a lot of suffering, so here are some things to know about reducing your risk: 

• Treat any open wounds quickly and seek the advice of your GP if you notice signs of an infection (swelling, redness, increasing pain, etc.)
• Wash your hands before inserting tampons
• Always use tampons with the lowest absorbency suitable for your period
• Change tampons regularly (usually packs advise at least every 4 - 8 hours) and always remove the last one at the end of your period
• Use sanitary towels on days with a lighter flow
• If you use barrier contraception, follow the manufacturer’s instructions on how long to leave it in for, and if you’ve had TSS before, it’s best to avoid using this type of contraception 
• Use tampons free from harsh materials like rayon, which can increase risk 

Remember, TSS is a serious condition, but as long as you know the signs and use tampons as recommended then it isn’t something to worry about. If you would like to know more about TSS, you can visit toxicshock.com. 

Have more questions? Float them in our private Facebook group or drop us a note on Insta @itsyoppie. Don't forget that our personalised period subscription box can get organic tampons (and more) delivered easily and regularly through your letterbox. Easy, simple, and kinder to your body.