The use of tampons and toxic shock

In the early 1980s in North America, more than 700 women suffered from toxic shock syndrome (TSS). This outbreak has been linked to toxins from the bacteria Staphylococcus aureus, when using tampons with very high absorbency. Researchers could not determine a specific link between tampon use and toxic shock syndrome. The researchers hypothesized that the lining of the vagina of women who kept tampons for a long time became drier, and therefore more fragile. Staphylococci aureus had more time to multiply and make enough toxins to cause toxic shock.

They concluded that several factors could be involved and certain precautions should be observed by users of tampons:

• Use tampons with low absorbency. Hyper-absorbent tampons have also been banned everywhere. A woman should not use a tampon with more absorbency than what meets her needs. Otherwise, the tampon can dry out the vaginal mucosa, irritate it, cause small lesions that facilitate the passage of staphylococci or their toxins in the body.
• Replace the pads every 4 to 8 hours.
• Avoid wearing tampons at night.
• Never use tampons before the onset of menstruation, use a sanitary napkin.
• Wash hands before handling a tampon.
• Use the sanitary napkins alternately with the tampon.

The material currently used for the manufacture of tampons (cotton or rayon) would not be linked to bacterial infections.

The use of so-called barrier methods of contraception, such as the sponge, cervical cap or diaphragm, could also be risk factors for the onset of toxic shock, as they can irritate the vaginal mucosa.