choc toxique
Daily life
3 min

Menstrual toxic shock: respect the conditions for wearing feminine hygiene products

About twenty cases of menstrual toxic shock syndrome (TSS) are recorded each year in France. Menstrual TSS is linked to the conditions of use of internal sanitary protection products. What are the potential consequences of this syndrome? Who may be affected? And above all, how can TSS be avoided? The answers to your questions are found below.

What is menstrual toxic shock? 

Menstrual toxic shock syndrome (TSS) is an acute infectious disease. It is caused by the release of a bacterial toxin, TSST-1, produced by a particular strain of staphylococcus (Staphylococcus aureus) into the bloodstream.  

It is promoted by poor conditions of use of internal sanitary protection products.

Which sanitary protection products are affected?

TSS is only linked to the use of internal protection, i.e. protection that is inserted inside the vagina, such as tampons and menstrual cups.

External protection (sanitary towels, panty liners, menstrual panties, etc.) cannot cause TSS. 

What are the potential consequences?  

The first symptoms of TSS appear within 3 to 5 days:

  • high fever (> 39°C),
  • flu-like symptoms (muscle aches, sore throat) or gastroenteritis (vomiting, diarrhoea, etc.),
  • a skin rash resembling sunburn.

These symptoms are non-specific, therefore making it difficult to identify TSS. 

In the absence of medical care, after just a few days the failure of various organs (kidneys, brain, liver, etc.) may occur and can lead, in rare but already observed cases, to serious complications that may require amputation or even be fatal.

Who may be affected?

The TSST-1-producing S. aureus strain is responsible for toxic shock. People are affected if they already have this strain in their body and do not have enough antibodies to fight it. However, most menstruating people do not know whether they are carriers of this strain or not.

Therefore, all menstruating people who wear internal protection (tampons, menstrual cups, etc.) may potentially be affected. 

How many women per year are affected?

Menstrual TSS is a rare disease: about twenty cases are reported each year in France. However, as the disease is not subject to mandatory reporting, this figure is probably underestimated.

What causes toxic shock? 

Our expert assessment shows that menstrual TSS is linked to the conditions of use of internal sanitary protection products. The risk of developing the disease increases with prolonged use of an internal sanitary protection product and/or the use of an internal sanitary protection product with higher-than-necessary absorbency.

Preventing this risk is possible. What are the best practices?

  • Follow the recommendations for use specific to each protection product, in particular those concerning the duration of use (tampons, menstrual cups, etc.): 
    • 6 hours maximum, 
    • one protection at a time and only during menstruation,
    • At night, use external protection such as sanitary towels.
  • Wash your hands before and after changing sanitary protection;
  • Choose protection with an absorption capacity adapted to your menstrual flow and change it regularly;
  • Avoid using internal protection if you have already been diagnosed with TSS.

What should I do if I suspect toxic shock?

If menstrual TSS is suspected, users are advised to:

  • promptly remove the internal protection;
  • consult a doctor immediately and explain that they are menstruating and have used internal sanitary protection.