Toxic shock syndrome can be a terrifying topic, especially when it’s been ingrained in our minds since we first learned about menstruation. The condition is undeniably dangerous and alarming if it occurs, but contrary to common perception, it’s actually rarer than you might imagine. When it comes to menstrual hygiene products like tampons, which typically consist of materials such as cotton or rayon, the key lies in their safe usage. By ensuring regular changes (every 6-8 hours), you can effectively prevent bacterial overgrowth and reduce the risk of toxic shock syndrome. Properly used, these products carry minimal risk of infection or other adverse effects, providing reassurance and peace of mind during that time of the month.

What is toxic shock syndrome?

TSS is rare. However, it is a serious condition. I’ll reiterate – your risk of getting toxic shock syndrome from tampon use is extremely low, with an estimated incidence of about 1 to 2 cases per 100,000 menstruating individuals in the United States each year. Bacterial toxins are the cause. High-absorbency tampons or improper tampon use can be culprits, too. By using the lowest absorbency needed for your flow, changing tampons, and practicing good hygiene, again – you will be just fine. 

What are the symptoms of toxic shock syndrome?

High fever, vomiting, diarrhea, dizziness, and a rash can be symptoms. But please keep in mind again – TSS is rare – and these symptoms are also symptoms of many other illnesses.

Some of the most common myths with TSS

  1. Myth 1: TSS is common and everyone who wears a tampon for 8 hrs and 1 min will get it.
    • Fact: Half of all TSS cases are not related to menses or tampons. Period-related TSS risk is about 1 in 100,000. Risk factors include wearing tampons for a long period of time or higher absorbency tampon use, but most people will not get TSS despite these factors.
  2. Myth 2: Chemicals in tampons can cause TSS.
    • Fact: A strain of Staph aureus causes TSS. About 1-4% of people with vaginas have this bacteria present in normal flora. These are probably people at risk for TSS.
  3. Myth 3: Organic tampons have lower risk of TSS.
    • Fact: There is no evidence to support this. The staph aureus that causes TSS requires oxygen in its medium to proliferate. All tampons can provide this environment as can menstrual cups. Higher absorbency tampons provide higher oxygen content and, therefore, pose a slightly higher risk. Additionally, modern tampons undergo rigorous testing and quality control measures. But, this brings me to dioxins.

What are dioxins?

Dioxins are environmental pollutants that can be present in trace amounts in various products, including tampons. Dioxins are not intentionally added to tampons. However, they may be produced as byproducts during the bleaching process of wood pulp fibers during manufacturing. The levels of dioxins found in tampons are typically very low. Regulatory bodies such as the FDA considers these levels safe. However, there is ongoing concern about the potential health risks associated with long-term exposure to dioxins. But, to mitigate these concerns, many tampon manufacturers have shifted to using alternative bleaching methods or opting for unbleached organic cotton tampons to reduce this.

I would like to point out that in this recent study, researchers discovered toxic metals such as lead and arsenic in various popular brands of tampons. This of course is not related to TSS. However, the presence of these metals has raised concerns among consumers regarding the safety of tampon use. Further research is needed to fully understand the implications of these findings. If this concerns you, learn about the different types of menstrual products available to you here. Toxins are everywhere so just be mindful of product choices, lifestyle habits, and environmental factors as you go about your daily life. The bottom line is you are safe to wear tampons if that is your choice.

Bottom line

  • Use whatever period products are accessible to you and you are most comfortable with.
  • Choose the lowest absorbency tampons you need.
  • Wear a tampon for 6-8hr at maximum.


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