Supporting women’s health and fertility

Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors


Toxic Shock Syndrome (TSS) is an illness caused by rare bacteria which occurs mostly in menstruating women who are using high absorbency tampons.

What causes it?

The main cause of TSS is a common bacteria, Staphylococcus aureus. It is thought the bacteria produces toxins (poisons) which cause the symptoms of TSS. Tampons may facilitate the infection because their use may cause lacerations and ulcerations of the vaginal wall. These lacerations allow bacteria to enter into the vaginal wall. Super absorbent tampons are especially dangerous, because as in some cases they expand so much they actually stick to the vaginal wall. When the tampon is removed, a layer of the vaginal lining may be scraped or peeled off.

What are its symptoms?

Symptoms of TSS occur suddenly, usually during or just after a menstrual period. The more common symptoms include a high fever (over 102 degrees F.), vomiting, diarrhea, a sunburn-like rash, and drop in blood pressure. Muscular aches and pains, headaches, sore throat, blood shot eyes, confusion, and peeling of the skin on the palms and soles may also appear. These symptoms are important and require prompt medical attention.

Is it serious?

Yes, TSS is a potentially life-threatening infection. Shock, kidney and liver failure, and death have all been associated with TSS. Three percent of women who get TSS die from it.

How is it treated?

If TSS is suspected, hospitalization is recommended, as there is no way of predicting which individuals with early TSS will develop severe medical problems. The physician will order anti-staphylococcal antibiotics, as well as intravenous fluids to counteract low blood pressure and fluid loss from vomiting or diarrhea. Individuals who get proper treatment usually get well within 2-3 weeks.

Can it be prevented?

The risk of TSS can be greatly reduced by following the recommended tampon guidelines:

  • Avoid super absorbent tampons.
  • Alternate the use of tampons with sanitary napkins or mini-pads during your period.
  • Never leave a tampon inserted overnight.
  • Change tampons frequently, at least every 4-6 hours.
  • When inserting a tampon, be extremely careful not to scratch the vaginal lining. Plastic applicators may cause an increased risk because of the sharp edges produced when opening the applicator. If your vagina seems dry, use a water-soluble lubricating jelly to ease insertion.
  • Do not use a tampon between periods because it may dry out the vagina.
  • Use 100% cotton tampons instead of those made with synthetic materials.
  • If you have had TSS, do not use tampons at all. Consider natural altermatives like Sea Sponge Tampons or the Keeper


  • Always choose the tampon with the least absorbency to meet your needs.
  • Follow the recommended tampon guidelines.
  • 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.

I acknowledge the resource of the FDA Consumer for some of the information on this page.

Recognise Fertility Guide