Apparently high absorbency tampons put you at greater risk
Last week, we spoke to Katie Knight who nearly died from Toxic Shock Syndrome. It’s a rare but life-threatening condition caused by bacteria getting into the body and releasing harmful toxins. It’s often associated with tampon use in young women, but it can affect anyone of any age – including men and children.
Even though it can happen to anyone, it’s something most people don’t know enough about. I spoke to Pete Kilvert, founder of charity Tampon Alert which aims to teach people about the condition. He told me everything you need to know about TSS, including it’s misconceptions and how to avoid it.
TSS isn’t necessarily caused by leaving a tampon in for ages
It is not caused by leaving a tampon in too long. It can start after only two hours of inserting a tampon. Most GPs and Gynaecologists will tell you that they have had to remove tampons that have been in place for weeks. They may be disintegrating, black and smelly, but they haven’t caused TSS.
Any woman may develop TSS when using tampons as directed by the manufacturer’s instructions if she is carrying the particular strain of bacteria that produces toxins and if she has not developed immunity to these toxins.
The exact combination of circumstances in which toxin production occurs in the vagina of individual women is not known. It is therefore not possible to state any completely safe time limits on the use of a tampon, although it could be assumed that the longer a tampon is left in place or the more tampons are used continuously, the greater the chance of toxin production starting. This is why we recommend keeping tampon use to a minimum and breaking the use regularly by using a sanitary towel/pad.
All known victims of TSS followed the manufacturers instructions on usage implicitly, but they still became seriously ill or even died.
We think that there are several reasons why people think that a “forgotten tampon” causes Toxic Shock Syndrome:
It’s caused by a fabric used in most main brand tampons
TSS i caused by rayon, a textile fibre or fabric made from regenerated cellulose (viscose). It’s in most main brand and chain store brands. All-cotton tampons are safe.
Super absorbent tampons put you at higher risk
The higher the absorbency, the greater the risk of TSS.
When using tampons, it’s important to choose the lowest absorbency necessary for your menstrual flow. Because the amount of flow varies from day to day, it is likely that you will need to use different absorbencies on different days of your period. Selecting the right absorbency comes with experience, but as a guide, if a tampon absorbs as much as it can and has to be changed before 4 hours, then you may want to try a higher absorbency. On the other hand, if you remove a tampon and after 4-6 hours white fibre is still showing, you should choose a lower absorbency.
Make sure to alternate between tampons and pads
Research indicates that tampons should not be used continuously during a period as continuous use is a high risk factor. The most obvious time to break this continuous use is at night. AKTA recommends the use of a sanitary towel at night. However, if you choose to use a tampon at night, choose the lowest absorbency needed, insert a fresh one just before going to bed and remove it as soon as you wake up in the morning. Slim line tampons are quite absorbent for their size, so it is highly recommended that young girls do not use tampons at night.
Anybody can get TSS
TSS can affect anyone – men, women or children. However, only women and girls use tampons.
Once you’ve had it, you’re more likely to get it again
A person who has had TSS can develop it again. If a women or girl has had TSS in the past, it is advisable not to use tampons again.
Menstrual TSS recurs in around 30 per cent of cases. Dr Mary Andrews of the Dartmouth-Hitchcock Medical Centre in New Hampshire advises that symptoms were most likely to return in women who were not treated during their first attack, and continued to use tampons. Two thirds of Dr Andrews’ study group experienced a recurrence within 5 months, although only 16% of women who were treated had recurring symptoms of TSS.
The symptoms
Symptoms can be similar to flu or food poisoning, but they can become serious very quickly. Note that only one or two symptoms may occur, and they do not always persist. They always begin after a period starts.
aching muscles and high temperature (fever)
What should I do if I get these symptoms?
If you have any of these symptoms and are using a tampon you should, remove and save your tampon and seek immediate medical attention (preferably at an emergency HOSPITAL). Tell the doctor that you have been using tampons and suspect TSS (Take a TSS information leaflet with you).
Don’t worry about wasting the doctor’s time, you could be saving your life.
With early diagnosis, TSS can generally be effectively treated with antibiotics and other medication to counteract the symptoms.
Professor Joan Chesney, Head of Paediatrics at the University of Tennessee said in September 1997 that concerns that Staphylococcus aureus could become resistant to antibiotics have so far proved unfounded. Tests on TSS-associated strains of S-aureus at the Dartmouth-Hitchcock Medical Centre in New Hampshire failed to find any methicillin-resistant Staphylococcus aureus (MRSA), the strain which has caused so many problems for hospitals in Europe and America. All 62 samples from menstrual and non-menstrual cases referred to the D-H Medical Centre between 1984 and 1995, were susceptible to two key antibiotics – oxacillin and clindamycin – although only a handful would have responded to treatment with penicillin.
Standard therapy for TSS continues to be on high-dose antibiotics, usually with a beta lactam agent, with or without clindamycin or a related drug. You also need to stop toxin production which can be best done with a protein synthesis inhibitor such as clindamycin, gentamycin, erythromycin or clarithromycin. Intravenous fluids are another essential aspect of management, but doubts remain over the value of intravenous immunoglobulin (IVIG) injections as they carry the risk of side-effects.
View more information on Pete’s website here.