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Health & Wellbeing / Claire Blackmore

The Body Experts: The Facts On Toxic Shock Syndrome

Toxic shock syndrome is super-rare, but it can be deadly if the symptoms aren’t recognised quickly. If you use tampons there’s no need to go into panic mode, but it is sensible to know the signs and understand the circumstances that can put you at risk.

Today, consultant gynaecologist, Mr N Pisal, from London Gynaecology, talks us through toxic shock syndrome…

What is toxic shock syndrome?

Toxic Shock Syndrome, or TSS as it’s known for short, occurs when usually harmless bacteria called Staphylococcus aureus and Streptococcus bacteria get into the bloodstream. These bacteria normally live harmlessly on the skin, nose or mouth, but once they penetrate deeper into the body they can produce dangerous toxins that damage tissue and stop organs working.

Mr Pisal says that TSS is typically caused by tampons that are left in for longer than the recommended time, forgotten tampons, or using a higher-than-needed tampon absorbency for your flow, which can lead to a bacteria build up. “Other than tampons, toxic shock syndrome can be caused by retained foreign bodies such as pessaries or swabs,” he adds.

What are the symptoms?

The symptoms of toxic shock syndrome can start suddenly and progress quickly, and at first may seem similar to the flu explains Mr Pisal. “Confusion and drowniness, a high temperature, chills and muscle ache, a widespread sunburn-like rash, nausea, vomiting and diarrhoea and feeling dizzy are all signs associated with TSS,” he says.

How can TSS be avoided?

To reduce the risk of toxic shock syndrome, a tampon should be changed every four-eight hours, but never longer than eight hours, with the lowest absorbency used for your menstrual flow.

“Check the leaflet that comes with your tampons for information and guidance on how to use them safely, and although it rarely happens, always remember to take a tampon out before inserting another one,” adds Mr Pisal.

What should I do if I think I have TSS?

If you’re using a tampon, remove it immediately and see your doctor straight away. “An examination will be necessary along with vaginal swabs to look for infection or a missed tampon. A course of antibiotics may also be prescribed if necessary,” says Mr Pisal.

Are some sanitary products safer than others?

To lessen the risk of TSS, you might choose to use sanitary towels when you’re sleeping, or switch to panty liners at the end of your period when your flow is much lighter. It is still possible to develop TSS when using menstrual cups so regular sterilisation of the cup, rather than just rinsing and washing in water, is advised to avoid bacterial build up.


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