Toxic shock syndrome (TSS) is a serious illness caused by bacteria. Toxic shock syndrome can cause severe damage and illness if the symptoms are not recognized and treatments started as soon as possible.
Risk factors for toxic shock syndrome
It’s most commonly caused by Staphylococcus (staph) or Streptococcus (strep) bacteria that can produce and release toxins into the bloodstream, which then spread to body organs.
“Toxic shock is rare, but those at risk are those who wear tampons,” said Cynthia Eckes, obstetrics and gynecology nurse practitioner with Marshfield Clinic Health System. “Most importantly, the higher risk is with tampons with higher absorbency, using tampons for many days of your cycle or keeping a single tampon in place for a longer period of time.”
Menstrual cups also carry a risk and should be cleaned properly, as well.
“It’s advised to empty every four to six hours,” Eckes said. “The risk with menstrual cups is leaving them in too long, similar to tampons.”
There are risks for toxic shock syndrome not associated with menstruation, too. Although rare, TSS may be a result of surgical or postpartum wound infections, cuts or burns, some lesions and respiratory infections.
Men, women and children are all at risk for TSS.
Toxic shock syndrome symptoms
TSS starts suddenly, often with symptoms including a high fever, dizziness, diarrhea, vomiting, headache, a rash or muscle aches.
Normally, the bacteria that cause TSS live on your skin or on your mucus membranes, like your throat or mouth, and don’t cause harm. Under certain conditions, some bacteria may grow rapidly and produce toxins.
For example, when you use a tampon, staph bacteria may become trapped in your vagina and enter your uterus through your cervix. The bacteria may grow on tampons, especially if they are not changed often. Tampons also may cause tiny cuts in your vagina, allowing bacteria to enter your bloodstream.
TSS symptoms can progress quickly and symptoms may be sudden. It may lead to pelvic inflammatory disease, sepsis, multi-organ damage or failure and death.
“If you feel you are experiencing symptoms of TSS, I encourage you to seek care immediately,” said Eckes.
Tampon-associated toxic shock syndrome can be prevented
When using tampons:
- Change the tampon every four to six hours.
- Do not leave the tampon in overnight.
- Use the lowest absorbency tampon you can.
- Consider using a pad at night or on low-flow days.
People who have had TSS can get it again. If you have had TSS, do not use tampons.
Toxic shock syndrome treatments
Standard treatment for toxic shock syndrome includes antibiotics through an IV. Antibiotics can help control bacteria growth. They would not eliminate the toxins already in your body.
Treatments also may include:
- Oxygen to help with breathing.
- Fluids to prevent dehydration and organ damage.
- Medicine to help control blood pressure.
- Dialysis to help kidneys function.
- Surgery to remove dead tissue.
“Prompt treatment with antibiotics is imperative,” Eckes said.
This can help prevent potentially deadly complications.