As a woman of menstrual age, toxic shock syndrome (TSS) is a condition you may be aware of due to its link to tampon usage. But what exactly is toxic shock syndrome? What causes toxic shock syndrome? And, will ditching the tampons eliminate your risk of toxic shock syndrome?

Albeit a rare condition, TSS can be life-threatening, so we’re here to clear the air. Because if one thing’s for sure, when we refer to toxic shock syndrome, we’re not talking about the feeling warranted from hearing Britney’s 2003 hit.

What is toxic shock syndrome?

Toxic shock syndrome is a rare but fatal infection commonly linked to tampon usage. The thing is; anyone can be diagnosed with TSS, whether they’ve used a tampon or not. That’s because TSS is caused by two bacteria, Staphylococcus aureus and Streptococcus pyogenes. For the purpose of our sanity, we’re going to refer to them by their nicknames, Staph and Strep, partners in TSS crime.

So, how do Staph and Strep cause toxic shock syndrome?

Exposure to Staph and Strep isn’t enough to develop TSS on its own. These bacteria already inhabit different parts of the body, including the throat, nasal, vagina and rectum. The problem occurs when these bacteria multiply rapidly, at which point they produce a toxin called Toxic Shock Syndrome Toxin (negative bonus points for creativity, toxin-naming nerds). When this toxin enters the bloodstream, the immune system is compromised, causing a disruption to normal organ function and damage to tissue.

So, what’s the link between tampons and toxic shock syndrome?

One theory is that when a tampon is left inside the vagina for too long, a bacteria breeding ground is formed. It’s important to know that this can occur when any item is left inside the vagina for an extended time, including menstrual cups and diaphragms.

What are the symptoms of toxic shock syndrome to look out for?

When toxic shock syndrome toxins enter the bloodstream, several bodily systems can be affected simultaneously. Toxic shock symptoms manifest quickly and can include sudden fever, vomiting, diarrhoea, skin rash or irritation, muscular aches, headaches, confusion, low blood pressure, joint pains and sensitivity to light.

How common is toxic shock syndrome?

The precise number of Australians affected by TSS cannot be determined due to TSS not being a notifiable disease in Australia. If Australia is on par with the United States, however, toxic shock syndrome is estimated to affect approx. 0.8 to 3.4 per 100,000 people.

How to prevent toxic shock syndrome?

Australia’s Therapeutic Goods Administration (TGA) does a pretty good job of ensuring tampons are regulated and manufactured in ways that minimise recognised health risks, including toxic shock syndrome. To be extra safe, ensure hands are sanitised prior to removing or inserting a tampon, the plastic protective cover is removed immediately prior to tampon use, tampons are removed within recommended timeframe, and lowest absorbency tampons are used whenever possible.


This blog is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your medical practitioner.