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Toxic shock syndrome (TSS) is a cluster of symptoms that involves many systems of the body.
What is toxic shock syndrome?
Toxic shock syndrome (TSS) is a cluster of symptoms that involves many systems of the body. Certain bacterial infections release toxins into the bloodstream, which then spreads the toxins to body organs. This can cause severe damage and illness.
What causes toxic shock syndrome?
The following bacteria commonly cause TSS:
TSS from Staphylococcus infections was identified in the late 1970s and early 1980s when highly absorbent tampons were widely used by menstruating women. Due to changes in how tampons are made, the incidence of tampon-induced TSS has declined.
TSS from streptococcus infections is most commonly seen in children and the elderly. Other people at risk include those with diabetes, weak immune system, chronic lung disease, or heart disease.
Staphylococcus aureus (or S. aureus) may normally exist on a person's body and does not cause infection. Because it's part of the body's normal bacteria, most people develop antibodies to prevent infection. S. aureus can be spread by direct contact with infected persons. People who develop TSS usually have not developed antibodies against S. aureus. Therefore, it's not usually considered a contagious infection. S. aureus infections may also develop from another infection, such as pneumonia, sinusitis, osteomyelitis (infection in the bone), or skin wounds, such as a burn or surgical site. If any of these areas are infected, the bacteria can penetrate into the bloodstream.
Streptococcus pyogenes (or S. pyogenes) TSS may occur as a secondary infection. Most commonly, this is seen in people who have recently had chickenpox, bacterial cellulitis (infection of the skin and underlying tissue), or who have weak immune systems.
Clostridium sordellii infections
Clostridium sordellii (or C. sordellii) normally exists in the vagina and does not cause infection. The bacteria may enter the uterus during normal menstruation, childbirth, or gynecological procedures such as abortion. Intravenous drug use can also cause C. sordellii infections.
Toxic Shock Syndrome is not caused by tampons.
Toxic Shock Syndrome is caused by bacteria, not tampons, specifically Staphylococcus aureus. In the 1980s, TSS became more well-known because it was associated with highly absorbent tampons (those highly absorbent tampons were quickly taken off the market). However, tampons aren’t required for TSS. You can get it while using pads or menstrual cups, or no period protection at all. Anyone can get TSS. Even men and children can get TSS, and only about half of TSS infections are related to menstruation.
How long can I wear a tampon safely and not get TSS?
There’s no exact answer for this one, but there are recommendations. The United States FDA (Food and Drug Administration) which regulates tampons, states you should never wear a tampon more than eight hours for hygiene purposes. Most gynecologists also recommend you change your tampon every 4-8 hours for vaginal health reasons. We know that the risk of TSS increases with absorbency, and there is no precise time limit supported by research. It’s always healthiest and safest to use the smallest tampon that will manage your flow and change them regularly.
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