Toxic Shock Syndrome

All women and girls using tampons and 
menstrual cups risk TSS.

What is TSS?

Tampon and menstrual cup use has been associated with Toxic Shock Syndrome (TSS) a rare but serious condition that may cause death.

The Toxic Shock Syndrome is caused by a toxin produced by the bacterium Staphylococcus aureus, which is commonly found in the skin, nose and vagina. TSS can occur in women, men and children. The risk of TSS is greater in adolescents and women under 30 than in older women. Although it is rare, it is important to know how to act if necessary. Recognition of symptoms and early treatment is important. It is estimated that the incidence of TSS is 1 to 17 per 100,000 women and girls of childbearing age.

tss-circleSEEK Medical attention if you have any questions about TSS, tampon or cup use.
CONTACT YOUR DOCTOR IMMEDIATELY and remove the tampon or cup, if you have any of the below symptoms.


Symptoms of TSS

The symptoms of TSS can appear suddenly during or just after menstruation and they resemble the flu. If symptoms appear remove the tampon or menstrual cup at once and seek medical attention immediately. Symptoms include:

  • Feeling very ill, headache, muscular pains.
  • A sudden high fever and chills (over 39 °C/102 °F).
  • Vomiting or diarrhea, or both.
  • Dizziness, fainting or near fainting when standing up, weakness or confusion.
  • A rash that looks like you have a nasty sunburn.

Guidelines for the Use of Tampons to Reduce the Risk of TSS

  • Make sure you have washed your hands thoroughly before handling tampons.
  • Only use one tampon at a time.
  • Don’t force a tampon to fit inside your vagina.
  • Use the lowest absorbency to suit your flow.
  • Use the tampon immediately after unwrapping it and don’t handle tampons more than necessary, or place it on any surface.
  • Remove the used tampon before inserting the next one and always remove the last tampon used at the end of your period.
  • Change your tampon regularly (every four hours is a good guide).
  • Only use a tampon when you are menstruating. Using a tampon when you don’t have your period can cause dryness and irritation and will absorb the protective mucous that your vagina produces to keep it clean.
  • Avoid the risk of tampon-associated TSS by not using tampons, or reduce the risk by alternating tampon use with sanitary pads during your period or overnight.
  • Seek medical attention if you have any questions about TSS or tampons use.

Guidelines for the Hygienic Use of Menstrual Cups

  • Only use a menstrual cup when you are menstruating
  • Before using the cup for the first time each month you must sterilize it
  • Make sure you have washed your hands thoroughly before handling the menstrual cups.
  • During your cycle, empty and wash the cup with clean water, preferably warm, so that it is ready for using again. Remember to thoroughly wash the suction holes
  • Remove and empty your cup at least every 6-12 hours
  • Seek medical attention if you have any questions about TSS or menstrual cup use.