Toxic Shock Syndrome

Tampon use increases the risk for the bacterial infections Toxic Shock Syndrome (TSS) or Toxic Shock-Like Syndrome (TSLS).

Both of these syndromes are extremely rare – about 1 to 17 out of every 100,000 menstruating females will get TSS each year and even fewer get TSLS. But it can kill you if you don’t get treatment.

TSS symptoms are sudden and intense. They include:

• A sunburn-like rash or peeling skin.
• Sudden high fever.
• Nausea or vomiting.
• Stomach cramps.
• Diarrhea.
• Headache or muscle aches.
• Dizziness, fainting or near fainting when standing up.
• Lightheadedness and confusion.
• Pale, clammy skin.

If you have these symptoms during menstruation, quickly remove your tampon and get medical help immediately.

Reduce Your Risk

If you choose to use tampons, the U.S. Food and Drug Administration recommends the following to reduce your risk of TSS:

• Use the tampon with the lowest absorbency you need; that is, don’t use a bigger or more absorbent tampon for a small blood flow.
• Change your tampon at least every four to eight hours.
• Alternate tampon use with pads.
• Use pads instead of tampons overnight when sleeping.
• Store tampons in a clean, dry place.
• Wash hands with soap and water before and after inserting or removing a tampon.
• Try a less absorbent variety if a tampon is irritating or difficult to remove.
• Stay informed of TSS by reading the package information included in the tampon box and asking about TSS when you have a medical checkup.
• Stay aware of TSS symptoms. Early diagnosis and speedy treatment are crucial in avoiding the most serious effects of TSS.

Last reviewed: October 2019