The Myths of Toxic Shock Syndrome (and How to Really Prevent It)

Woman's hand holding a clean cotton tampon in a pink background

Clean cotton tampon | Emapoket/iStock/Getty Images

Toxic shock syndrome (TSS) — you’ve heard about it, you’ve feared it, but you may not be as educated as you think. While you’ve certainly panicked when you felt you left your tampon in a bit too long, that’s not the only way to get TSS — and not always the instance you should worry about.

We compiled the most common myths of TSS as well as information on how to prevent it — and stop worrying — once and for all.

Myth no. 1: Tampons are the sole cause of TSS

The common myth that the tampon itself is the cause of TSS is wrong: it’s actually because of the bacteria Staphylococcus aureus, otherwise known as Toxic Shock Syndrome Toxin-1 (TSST-1). So while prolonged tampon use can aid the spread of the bacteria, they aren’t the only thing you can get TSS from.

“These bacteria can produce and excrete toxins which are the cause of TSS,” Dr. Linda Nicoll told Hello Giggles. “Small numbers of the bacteria produce smaller amounts of toxin than larger numbers of bacteria do. So the problem of TSS often occurs when staph are allowed to grow.” In fact, Nicoll said that the bacteria that causes TSS resides symptom-free in 30 to 50% of healthy adults and children.

In fact, according to the U.S. National Library of Medicine, fewer than half the cases of TSS are even linked to tampons.

Myth no. 2: Only women can get TSS

The common misconception that only women can get TSS needs debunking: both men and women who aren’t menstruating are in danger too. “Toxic shock syndrome is caused by a bacteria, so anyone can be affected by it — men, women, and children,” Sara Gottfried, M.D., a Harvard-educated gynecologist said. “Burn units with men and women see TSS — and your risk is related to your immunity.”

According to the Mayo Clinic, only half of TSS cases affect adult women, while the other half affect children, men, and post-menopausal women.

Myth no. 3: You’re guaranteed to get TSS if you leave your tampon in too long

While leaving your tampon in too long is a risk factor for TSS, it’s not a guarantee. Even in cases where women leave tampons in for a longer-than-usual period of time, it’s rare they’ll contract TSS.

We aren’t saying to exceed the general eight-hour limit — you should really change your tampon every four to eight hours or when you feel like you need a fresh one — but just because you do, doesn’t mean you’ll get TSS.

“Even in cases where TSS is associated with menses, it is not clear that tampons are causative factors in the development of this syndrome,” Dr. Tosin Goje, Cleveland Clinic OB/GYN, told Hello Giggles. “I have never seen a patient with a retained tampon present with symptoms of TSS and, upon removal of the tampon, none of the patients subsequently developed TSS,” she said.

Two clean white tampons

Don’t worry, they’re still safe. | iStock.com

Myth no. 4: Your vagina will show symptoms of TSS

TSS symptoms aren’t pleasant in the slightest, but none of them are vaginal. “Symptoms can include fever, low blood pressure, rash, chill, malaise, headache, sore throat, muscle pain, fatigue, vomiting, diarrhea, abdominal pain, and dizziness or loss of consciousness,” Nicoll said.

Symptoms of TSS are more flu-like than anything. If you notice any of the above symptoms — specifically high fever, vomiting, or seizures — seek immediate medical attention. This is especially crucial if you’ve been using tampons/vaginal insertion devices or have an infection or surgical incision since TSS wreaks havoc on those with compromised immune symptoms.