Toxic Shock Syndrome and Tampons

What is toxic shock syndrome (TSS)?

TSS is a rare bacteria caused illness occurring mostly in menstruating women who use high absorbency tampons. Non-menstrual TSS risk is increased for women who use vaginal barrier contraceptive methods (such as the diaphragm), although the incidence is much lower.

What causes TSS?

The main cause of TSS is a strain of staph, the bacterium Staphylococcus Aureus. Hyperabsorbent tampons may facilitate the infection because their prolonged intra-vaginal use enhances the bacterial growth. Wearing a diaphragm or sponge for more than 24 hours is not recommended because of possible risk of TSS.

What are the symptoms?

Symptoms of TSS occur suddenly: a high fever (102°F, 38.8°C or higher), vomiting, diarrhea, a sunburn-like rash, red eyes, dizziness, lightheadedness, muscle aches and drops in blood pressure, which may cause fainting. The infection can cause shock, kidney and liver failure. These symptoms require prompt medical evaluation.

How is it treated?

If TSS is suspected, hospitalization is recommended. Intravenous fluids and antibiotics will be administered.

Can it be prevented?

You can reduce the risk of TSS by alternating your tampon or internally worn products with pads. Use a tampon with the minimum absorbency needed to control your flow. Review the information on absorbency of your tampon brand. Change the tampon or internally worn product as directed. If you have ever been diagnosed with TSS, you should not use tampons.

What should I do if I suspect TSS?

At the first sign of a fever or rash, remove tampon immediately - as this may help prevent your symptoms from worsening. Seek medical care immediately.


Hatcher, R., Guest, F., Stewart, G. Trussell, J., Bowen, S. & Cates, W. (2007). Contraceptive Technology, 19th Revised Edition. New York: Irvington.
Tampax package insert, 2008 Tampax Corp / Web site at: