Periods and sanitary protections

Toxic Shock Syndrome

Toxic Shock Syndrome

Toxic Shock Syndrome (TSS) is a rare but very serious infectious disease that is not necessarily always linked to periods. This article covers menstrual TSS only.

As it develops extremely quickly and can be fatal, it is important to recognise the early signs, see a doctor as quickly as possible and, above all, follow instructions to avoid it!

Which factors promote toxic shock?

In the case of menstrual TSS, several conditions must be met together for it to develop:

  • Be a carrier of the Staphylococcus aureus bacteria that produces the toxin TSST-1 (only 4% of women are affected*),
  • Not be immunised against this toxin,
  • Not having followed certain hygiene rules for using menstrual cups and tampons.

*Memorandum of 15/09/2017 to GENESIS-PARIS from Prof. Lina, Biologist at Lyon Civil Hospital

Staphylococcus aureus: the bacteria responsible for toxic shock

Staphylococcus aureus is bacteria commonly found on the skin, in the nose and, on rare occasions, in the vagina. Some of these staphylococcus aureus bacteria are capable of producing a specific toxin. – Staphylococcus aureus is responsible for an infection, particularly TSS, when it comes into contact with the blood.

Menstrual blood is the ideal culture medium as it provides all the nutrients required for it to multiply. Its growth is especially significant when blood stagnates in the vagina, something promoted by tampons and menstrual cups.

Are tampons and menstrual cups responsible for toxic shock?

Tampons and cups are not necessarily responsible, but misusing them, for example wearing them for too long (over 6 hours), is one of the main risk factors for menstrual TSS. This is why it is highly recommended that they not be left inside the vagina for longer than 6 hours.

Toxic shock and staphylococcus aureus: largely unspecific symptoms

The symptoms of toxic shock syndrome are not manifested in the gynaecological area. In fact, they are largely unspecific and very similar to a serious flu or gastroenteritis: feeling unwell, extreme fatigue, high fever, muscle pain, digestive disorders (vomiting, diarrhea, etc.), occasionally associated with skin rashes (similar to sunburn). They come on suddenly and can develop rapidly, within 48 hours, into toxic shock if treatment does not begin.

If these symptoms appear when wearing a tampon or cup, remove it and see a doctor immediately.

Toxic shock: urgent treatment

If left untreated, toxins can spread to other organs and cause potentially life-threatening complications. Treatment for menstrual TSS requires immediately hospitalisation of the patient and requires antibiotics to be administered.

How to prevent the risk of toxic shock

There is no need to panic and stop using tampons or menstrual cups altogether.

You can still use this sanitary protection, but it is essential that you follow certain rules for their proper use:

  • Change your tampon a maximum of every 4 to 6 hours,
  • Empty your cup a maximum of every 6 hours, clean it well (Saforelle’s cup has its own sterilisation box),
  • Do not wear a tampon or menstrual cup while sleeping, instead opt for sanitary towels during the night,
  • Wash your hands carefully before and after inserting your tampon or menstrual cup.
  • Read the leaflet carefully


Medical and obstetric Gynaecologist