Click on any of the five categories below to find answers to common questions.
FAQ About Toxic Shock Syndrome (TSS)
What is Toxic Shock Syndrome (TSS) and who is susceptible?TSS is a rare disease believed to be caused by some forms of the bacterium called Staphylococcus aureus. This bacterium can be found normally in the vagina of some women. Without this bacterium, tampons alone have not been found to cause TSS. However, there are studies that have indicated tampons, in the presence of this bacterium, are associated with an increased risk of menstrual TSS.
By using tampons you increase your risk of getting menstrual TSS. It has been estimated that each year 1 to 17 of every 100,000 menstruating women and girls will get TSS. TSS occurs most often in menstruating females using tampons, in particular women under thirty years of age, and especially teenage girls. TSS also occurs, however, among men, children, and non-menstruating women.
What are the warning signs of TSS?Warning signs of TSS include: sudden high fever (usually 102ºF or more) accompanied by vomiting and/or diarrhea, fainting or near-fainting when standing up and dizziness or a sunburn-like rash. These symptoms usually appear very quickly and are often severe. Not all TSS cases are alike, and all symptoms are not always present. Other signs might be aching of muscles and joints, redness of the eyes, sore throat and weakness.
What should I do if I think I might have TSS? If you have a sudden high fever and one or more of the other TSS symptoms during your period, remove your tampon at once, discontinue using tampons, and contact your doctor right away or seek emergency medical care. You might need emergency medical care. Tell the doctor that you are menstruating and you were wearing a tampon.
How does tampon absorbency affect the risk of TSS? There are studies that suggest that higher absorbency tampons are associated with an increased risk of menstrual TSS. Therefore, you should use a tampon with the lowest absorbency that meets your menstrual flow needs to reduce your risk of getting menstrual TSS. Tampons are available in four absorbency ranges: regular absorbency for light flow (6-9 g); super absorbency for moderate flow (9-12 g); super plus absorbency for heavy flow (12-15 g); and ultra for very heavy flow (15-18 g). Under this absorbency rating system adopted by all tampon manufacturers, tampons within a given range have the same absorbency label.
Wasn't it higher absorbency tampons that caused the TSS scare back in the late 1970's and early '80's? As stated in the FDA website dated July 23, 1999 on the topic regarding tampons and TSS: "Although scientists have recognized an association between TSS and tampon use, the exact connection remains unclear. Research conducted by the CDC suggested that use of some high absorbency tampons increased the risk of TSS in menstruating women. A few specific tampon designs and high absorbency tampon materials were also found to have some association with increased risk of TSS. These products and materials are no longer used in tampons sold in the U.S." Because of this we recommend using the tampon with the lowest absorbency that meets your menstrual flow needs.