Pads outselling tampons: What is Toxic Shock Syndrome and should you be worried about it?

In January 2018, American model Lauren Wasser lost her second leg following toxic shock syndrome.

Wasser originally fell ill in 2012 while on her period and using tampons. She was found by paramedics face down on her bedroom floor and rushed to hospital, where she was diagnosed with the rare but potentially fatal condition Toxic Shock Syndrome (TSS).

Wasser underwent a below-the-knee amputation of her right leg and lost the toes of her left foot due to complications with the infection. Ongoing problems with her left foot led to her second amputation earlier this year.

Wasser’s moving story has played out on Instagram, beautifully captured by her photographer girlfriend. And her personal crusade to warn women #itsnotrareitsreal has once again shone a spotlight on TSS. Almost forgotten, the condition hadn’t made headlines since the 80’s, when Rely (a super-absorbent tampon using the synthetic material CMC) was pulled off the shelves in the US due to a spike in TSS cases.

Here at home in 2017, Priceline Pharmacy sold 74 per cent more sanitary pads than tampons, with the sanitary pad category growing by 14 per cent. The figures are vexing, particular as they come in the golden age of fitness and athleisure … pads aren’t exactly the go-to under lululemon tights.

Is it the Lauren Wasser Effect? According to Priceline Pharmacist Regina Cowie, TSS anxiety is one factor in the trend.

“There has been an increase in awareness over the last decade about the implications of wearing a tampon for an extended period of time and associated risk of TSS. However, with proper use this risk is low. The great advances in the technology of pads over the years may also be a contributing factor,” says Cowie.

What actually is Toxic Shock Syndrome?

TSS is a very rare but potentially life-threatening condition typically caused by toxins from the bacteria Staphylococcus aureus, says gynaecologist Dr Jenny Cook.

TSS doesn’t just affect women, anyone can carry the staphylococcus bacteria on their skin, in their nose – or vagina. The danger comes when the bacteria multiplies and releases toxins, hence why tampons (super-absorbent tampons provide a potential environment for bacteria growth) are associated with risk.


Should you be worried?

In her 20 years as a gynaecologist, Dr Cook has never seen a case of tampon related TSS and does not know of a doctor who has.

“Toxic Shock Syndrome is something that is incredible rare, especially when following the guidelines on tampon use.”

And while she has removed forgotten tampons from patients – including one left in for several weeks – Dr Cook stresses this is definitely not a common occurrence.

“Yes, I’ve seen it a couple of times … but when it comes to tampons, I think Australian women know what they’re doing,” Dr Cook says.

Do you? Let’s refresh. According to the information pamphlet contained in your tampon packet (the one you’ve probably never read) those guidelines generally state you should:

  • Use the lowest absorbency tampon for your flow
  • Use only one tampon at a time
  • Wash your hands before unwrapping and after inserting a tampon
  • Do not overly handle a tampon or rest it on any surface
  • Do not insert a tampon if it hurts to do so
  • Change tampons regularly and never leave longer than 8 hours
  • Seek a doctors clearance to use tampons if you have recently given birth, had a miscarriage, caesarean, abortion or any operation on your reproductive system
  • Do not use tampons overnight

If there’s a takeaway from the reappearance of TSS in the headlines it’s be alert, not alarmed.

Vigilant, but not anxious. Read the info and re-educate yourself on tampon guidelines, set your phone alarm to change them if you’re the forgetful type and rethink wearing them overnight (as Dr Cook suspects women do).

If you’re still anxious, consider switching to organic cotton tampons – which have a lower absorbency but are not a risk for TSS.

“What happened to Lauren Wasser is very sad, it’s tragic, but it’s not a cause for anxiety over tampon use. And I wouldn’t be alone in saying that,” says Dr Cook.

Caelia Corse is a health and beauty writer based in Sydney. 

While you’re here, have you ever wondered what sex workers do when they get their periods? Samantha X told Mia Freedman on the No Filter podcast below.

Shout out to all Dads.

Here at Mamamia we are always looking for ways to make Mamamia even better. Dads, we need you to help us do that by filling out this quick 15 min survey for us. Click the button below for your say.