The first time a young woman uses a tampon can be a pretty scary experience, and a lot of them will refer to the little instruction leaflet inside the box to figure out how to use it exactly. Emblazoned across these sheets will be the note “WARNING: RISK OF TOXIC SHOCK SYNDROME. Which scared the shit out of 13 year old me. I don’t want a syndrome, I just wanna be able to go swimming with my period!? What do I do!?
So let’s dive in, what is toxic shock syndrome, and why does using tampons mean I could get it?
Toxic shock syndrome (TSS for short) describes a variety of symptoms that can occur when you get an infection with a particular bacteria called Staphylococcus aureus or in rare cases, a group A Streptococcus. Now let me tell you this; 30% of the entire world population have S. aureus in their nasal passages. And about 100% of the world have S. aureus living on their skin. In general, it is not a harmful bacteria. BUT. S. aureus is what we call an opportunistic pathogen; given the right opportunity, it will multiply and do stuff to cause infection and make you sick. In the case of TSS, the opportunity comes in the form of a vagina, as many opportunities do.
Lemme paint you a picture. A young woman has just played the first half of the school semi-final in football. It’s half-time, and she rushes to the loo to change her tampon before the second half of the match begins. She’s been stopped on the way to the bathroom by a teammate to discuss tactics, hence she has to hustle to get back to the game on time. She goes into the loo, and without thinking, changes her tampon without washing her hands first. In the meantime, a nasty little S. aureus bug called Lionel has been hanging out on her hands. When she touches the tampon and inserts it into her vagina, Lionel seizes the opportunity and jumps from her hand to the tampon. Now he’s all up close and person with her cervix, and he’s like “OMG! It’s so warm in here! There’s lots of moisture! And delicious food (in the form of menstrual blood)! I think I’ll set up camp here and make some babies.” And so Lionel does, and an infection begins.
Now here’s where we get a bit complicated. You remember how you have that immune system thing? Okay, so what Lionel the S. aureus bug does, is he releases a bacterial toxin called the toxic shock syndrome toxin (TSST). This toxin activates those T cells in your immune system, which then go, “Hey, we’re under attack! Let’s kick some ass!” Except the toxin non-specifically activates those T cells. And this is bad because the TSST doesn’t just activate a few T cells to take down the bugs, it activates a whole buttload of them. It basically runs around the body knocking on every door going “HEY WAKE UP” and it wakes up the whole town instead of just the sheriff. Around 20% of the T cells in the body actually (that’s ~50,000 times more than needed). This makes TSST a superantigen.
So we have 20% of the T cells in the body working, which means we should clear the infection quickly and be on our way right?
Well here’s the thing, T cells do kill bugs, but they do it in a way which could actually kill you. By activating this much of the immune system the body essentially shuts down all non-essential functions (or so it thinks). Symptoms of TSS include high fever, low blood pressure, inflammation and redness of the skin, rashes, tiredness, vomiting, diarrhea, muscle weakness, kidney failure, liver inflammation, confusion, dizziness, neurological symptoms; basically everything goes to shit. The thing that kills most people with TSS is the drop in blood pressure which means the heart and lungs stop working. In the initial stages of TSS it sort of seems like a flu, but it gets worse and worse and has no respiratory symptoms.
And you may think “Oh, that’s just scaremongering, people don’t get TSS, I leave my tampon in for hours overnight and I’ve never had it!” But I, me, this author typing right now, I have known one person who has actually had TSS. She had to go into hospital, spent a week vomiting, a bunch of her hair fell out, sheets of her skin on her hands and feet were coming off, and she couldn’t walk up a flight of stairs. So yeah, TSS is no joke.
If you suspect you have TSS, go to the emergency room. This is not a drill, this is not something that can be fixed with some oral antibiotics, this is not gonna get better on it’s own. Go directly to jail, do not pass GO, do not collect $200.
TSS is not contagious, and using tampons isn’t the only way to get it, it’s just the most common. Some women can leave their tampons in for 12 hours without getting TSS, some for only a couple of hours and they might get it. It’s rare but dangerous. So do me a favour; change your tampon regularly just in case? Don’t take the risk.
You know what, just keeping on this women’s health train, I’ma talk about contraception next. We all gotta know about it, dudes included.
Thanks for reading about periods and vaginas and stuff! GET LEARNED!