Menstrual Cup and Toxic Shock Syndrome (TSS)

I remember that when I started menstruating there was no talk of Toxic Shock Syndrome or TSS. It was only after a few years that I found out about it and decided to ask a gynaecologist about it because it was written in small print on the tampon packaging. Is it because the risk is so small that it appears in such small print? Let’s see! 

In this video you will find more information!

What is TSS?

Toxic Shock Syndrome (TSS) is a serious illness that can be caused by two types of bacteria: Streptococcus pyogenes and Staphylococcus aureus. The latter bacterium is found on the skin, nose, vagina and other mucous membranes of our body, but in most cases it is not a problem. However, it can generate a toxin that can be harmful to people who do not have antibodies against it and thus cause TSS.

Although most adults are immune to these toxins, this is not always the case and there is no method to detect it. Therefore, it is a mystery who may suffer from TSS until it happens to them.

Symptoms of toxic shock syndrome

As you cannot know whether you are immune or not, it is important to know the main symptoms of this disease, especially if you use tampons frequently.

Here are the most common symptoms:

General malaise


High fever

Low blood pressure

Nausea, vomiting or diarrhoea

Skin rash

What are the causes and what causes TSS?

TSS is a condition that affects both men and women and is not only associated with tampon use. TSS can also be caused by skin infections, burns and surgery.

Although it is a rare disease, there are a number of risks that can lead to the toxic bacteria that cause it. These are the most common:

Recent childbirth

Staphylococcal infection

Tampon use during menstruation

Recent surgery

Infection of a wound

Use of a nasal packing to treat bleeding

Concurrent use of IUDs and tampons

Tampon use and toxic shock syndrome

Is it known how tampons produce these bacteria?

Most studies indicate that the ability of tampons to absorb fluid into the vagina and their placement allow for a higher concentration of oxygen in the area, which may encourage the production of bacteria.

Using highly absorbent tampons when they are not needed, leaving the tampon inside the vagina for more than 4-6 hours, using it overnight… all of these further increase the chances of TSS.

Menstrual cup use and toxic shock syndrome (TSS)

TSS is a fairly rare bacterial infection that is associated with tampon use (but not exclusively). In particular, leaving tampons in the vagina for long periods). Although only two cases of TSS have been reported in connection with menstrual cup use, we recommend that you limit the time you keep the cup inside you to 12 hours (even if your flow is very light). 

The menstrual cup remains one of the most sustainable menstrual hygiene products, not only environmentally, but also healthier and safer for our bodies. And of course, much safer than using tampons.

How to prevent toxic shock syndrome? 

– In the case of the menstrual cup, as it is a product that we insert inside our vagina and comes into direct contact with our skin and mucous membranes, it is important to take several things into account:  

– Make sure you choose a menstrual cup made of 100% medical grade silicone, totally hypoallergenic, such as PERIODiNO. Yes, there are also plastic cups, a material that is not harmless to your health…  

– Always wash your hands before inserting or changing your menstrual cup. Also wash your nails if you have long or porcelain nails.

– Always keep your cup clean each time you use it, sterilise it correctly before first use and then once every cycle, preferably just before menstruation.  

– Do not leave it for more than 12 hours without emptying it (even if it is not full). 

If you use tampons:

– Never use a tampon for more than 8 hours and change it regularly.

– Always wash your hands every time you change your tampon.

– Always use the correct absorbency for your menstrual flow, not a higher absorbency as this increases the risk.

– Do not use a tampon before menstruation.

– Use sanitary towels instead of tampons, at least at night.

In summary, the use of tampons causes TSS deaths every year and the link between the two has been proven by many clinical cases. As for the menstrual cup, rather than the use of a menstrual cup, the bacteria that cause TSS are more likely to pass from the hands into the vagina.  So, although it is extremely rare, to reduce the risk you should be very hygienic when using your menstrual cup and follow the instructions for use.😉 

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