For many girls, one of the first things we learned when we got our period was to avoid the menstrual boogeyman — toxic shock syndrome. My mom told me if I kept a tampon in a minute past the eight-hour-mark, I would be at risk. Health teachers shared horror stories of women who got tampons lost inside of their bodies and then got TSS. I grew up in constant fear of Toxic Shock, without ever knowing much about it. 

Let’s take a look at what this frequently discussed but misunderstood health risk is – and what you can do to prevent it. 

Toxic shock syndrome, or TSS, is a rare complication that occurs in bacterial infections. It happens when bacteria spread toxins into the blood and then to the organs. It doesn’t just occur in women who are menstruating —TSS can happen to anyone. Around half of TSS cases are in women of menstruating age. TSS may occur from skin wounds, surgery, tampons, menstrual cups, contraceptive sponges, or recent flu or chickenpox. 

The following are the most common symptoms of TSS to look out for:

• sudden high fever (over 102)
• low blood pressure 
• vomiting 
• diarrhea 
• rash
• confusion 
• seizures 
• headaches
• muscle aches

These symptoms can vary depending on the bacteria that caused it. If you are displaying any combination of these symptoms, you should go to a doctor. This is especially true if you can identify one of the potential causes, such as a tampon left in longer than recommended. After ruling out other potential causes of symptoms, a doctor may test your blood and/or run blood cultures to diagnose TSS. The complication can then be treated with antibiotics, fluids, dialysis, ventilation, wound cleaning, and/or a blood infusion, depending on the patient and their symptoms. 

As stated previously, TSS is a rare complication. There are, however, certain risk factors to be aware of. If you have heart disease, diabetes, a weak immune system, and/or chronic lung disease, you are at higher risk. Additionally, your risk is increased if you have recently given birth (vaginally or by c-section), had a miscarriage, or had an abortion.

While tampons have been redesigned in the US to address common features that had previously been linked to TSS, there are still several things you can do to further protect yourself from TSS. 

• Use a lower absorbency tampon when you can.
• If you’ve had TSS previously (even if it was not caused by a vaginal infection), ask your doctor before using tampons – TSS has a high reinfection rate.
• Always wash hands before inserting a tampon.
• Be mindful of how long tampons, menstrual cups, and contraceptive sponges are recommended to be used.

The risk of TSS can be frightening — and rightfully so — but as long as you follow these guidelines, it doesn’t need to be the looming fear we see it as!