21 September 2011

Toxic tampon shock

A recent report of a teenage girl collapsing with toxic shock attributed to tampon use has resurrected the tampon debate.


A teenaged girl in the UK almost died in an extremely rare case of blood poisoning caused by a tampon.  Paige Roffey, aged 15, collapsed at her home in Rayleigh, Essex with toxic shock syndrome after using a tampon for four hours.  Roffey was put into an induced coma for two days and after more than a week in hospital was fortunate to recover.

Toxic shock syndrome (TSS) isan infection that will make you feel severely ill very quickly.  It is caused by the common bacteria Staphylococcus aureus which normally live harmlessly on the skin and in the nose, armpit, groin or vagina of one in every three people. In rare cases certain strains of these bacteria can produce toxins (poisons) that cause TSS.

Some facts about TSS

  • Toxic shock syndrome is a rare but very serious illness that can develop rapidly in anyone.
  • Men, women and children can get toxic shock syndrome, for example following burns, boils, insect bites or infections after surgery. About half of the reported cases are linked to women who use tampons; the other half are not.
  • With early diagnosis toxic shock syndrome can be successfully treated. Sadly, however, out of the small number of people who fall ill each year, 2-3 people die from TSS. It is important to remember that if TSS is diagnosed and treated early there is a good chance of recovery
  • Most doctors will never see a case of toxic shock syndrome. TSS is so rare that most doctors will not come across TSS during their medical careers

TSS related to tampon use is rare

While tampons allow women to 'hide' menstruation while undertaking various activities such as swimming and other sports, the disadvantage of tampon use is the potential change in the vaginal microflora.

If abnormal bacteria are harboured in the vagina (either sexually transmitted or due to self-contamination with rectal germs), menstrual blood which is accumulated inside the vagina above and within a tampon, can act as a culture medium, allowing micro-organisms to multiply, thus promoting infection.

This also explains why tampon use is associated with a slightly increased risk for toxic shock syndrome (TSS), caused by a bacterial infection.

It must be emphasized that toxic shock occurs very infrequently. The risk of TSS can be even further reduced by maintaining good hygiene, changing tampons regularly (every four hours or more often if the menstrual flow is heavy) and by alternating wearing tampons with pads.

Send your questions about TSS or menstruation to GynaeDoc



Toxic Shock Syndrome Information Service

(Joanne Hart, Health24, September 2011)


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