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Everything you should know about Toxic Shock Syndrome

Everything you should know about Toxic Shock Syndrome
Tampons.
PHOTO: The Straits Times

Some of us might have heard about the dangers of tampons and how to use it with care. We recently read the gut wrenching tale of a mum losing her teenage daughter to Toxic Shock Syndrome.

It is harrowing. Young Maddy succumbed to the deadly condition within hours, with no warning, and no respite.

Her death was linked back to her use of tampons, and if I was a parent I'd be freaking out by now too.

But before you ditch yours or your daughter's tampons, let us take a closer look, so you can rest a whole lot easier.

Firstly, it is a very rare condition. Secondly, let us not blame the tampon entirely.

Toxic Shock Syndrome - TSS - is actually an infection of the bacteria Staphylococcus aureus, commonly known as 'Staph'. Only about 40 per cent of cases are linked to tampons - termed 'menstrual TSS'.

"I can guarantee you've all had several staph infections in your life"

Staph normally lives happily on our body, only popping up periodically when conditions are right to cause an infection.

Living on your skin, up your nose, and in sweaty places like your armpits, it is usually associated with skin infections such as boils or cellulitis.

But it can get into anything, so it may cause a bout of gastro, ear or chest infection, or even a urinary tract infection, to name a few.

But what is different about TSS, regardless of whether it is menstrual or non-menstrual, is that the staph gets into your bloodstream where it produces a truckload of toxins, triggering a heightened immune response, which can become overwhelming. It is the same sort of process as the other common issue known as "sepsis".

The excess of toxins and immune system chemicals progressively shut the body down. Muscles, nerves, and organs are pretty much melted from the inside. It's relentless and unforgiving - every part of the body is under attack - eventually leading to multi-organ failure.

ALSO READ: Girl, 14, dies after using tampon for first time

And that's why death can be so rapid

Fast fact: By our 20s, over 80 per cent of us have developed a solid immunity to the main toxins from staph. This means if a staph infection takes hold most are able to combat the rise in toxin levels and alleviate the overwhelming immune response.

As with any infection it all starts with people feeling unwell. A few aches, pains, headaches, and some tiredness. But what sets TSS apart is a rapid decline. Heart rate skyrockets, blood pressure plummets leading to dizziness, people rapidly become confused, drowsy, plus slip in and out of consciousness.

And all of this can occur in a matter of hours, which is why it so often goes unrecognised.

Dangers of tampons: Why do tampons get such a bad rap?

Our awareness of TSS, especially menstrual TSS, first came to light in the 80s when there was a spike of cases linked to tampon use. With the withdrawal of highly absorbent tampons and polyacrylate rayon-containing products from the market, rates have plummeted since then.

But the use of tampons still underlies the greatest majority of menstrual related TSS. The tampon if left in for too long can allow the levels of Staph to build. Plus any irritation to the delicate lining of the vagina can cause tiny cuts and grazes, allowing the staph to easily enter the bloodstream.

Forgotten tampons, or bits that break off will obviously hang around inside the vagina until discovered. In the setting of a developing infection, this may increase the risk of TSS, but overall it remains small.

So the best approach to reduce your risk is to be gentle down there, and change your tampons regularly. You may even consider using pads overnight.

Fast fact: Whilst an effective alternative to tampons, we aren't sure whether mooncups are safer when it comes to TSS. In fact some research point towards a small increase in risk.

ALSO READ: How to use a menstrual cup and why you should switch to a more eco-friendly period product

Symptoms of Toxic Shock Syndrome

  • Diarrhoea
  • Sudden high temperature (40 deg C or above)
  • Confusion/dizziness
  • Tiredness
  • Vomiting
  • Aching muscles
  • Headaches
  • Low blood pressure
  • Red eyes, mouth and throat
  • Red rash like sunburn on hands and feet that peels
  • Seizures

Ok, time for another deep breath. Remember we mentioned that TSS is rare?

TSS is rare, affecting about two people in every 100,000. And remember, associations with tampons are less than half of those.

Time for a bit more reassurance. Whilst TSS can be catastrophic, there is no denying that, Maddy's tragic situation is thankfully rare.

Increased awareness, plus advancements in detection techniques and treatments have seen the fatality rate for TSS drop to less than 5 per cent - and as low as 1 per cent for menstrual cases.

There is no denying that Toxic Shock Syndrome can be a devastating illness, even though it is rare.

And we certainly do not need to be panicking every time we feel a bit unwell. So do not ditch the tampon entirely, but minimising the amount of time you leave it in for will decrease your already tiny risk.

ALSO READ: Advanced ovarian cancer may someday be detected with tampons

How to lower your chances of getting Toxic Shock Syndrome

  • Washing your hands before and after inserting a tampon
  • Using low absorbency tampons if possible
  • Alternating tampons with sanitary towels every so often during your period
  • Changing the tampons as often as advised on the pack
  • Making sure you remove the last tampon at the end of your period
  • Inserting a fresh tampon when going to bed and removing it upon waking

This article was first published in theAsianparent.

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