Preventing toxic shock syndrome

Toxic shock syndrome is an uncommon but serious illness caused by toxins made by certain bacteria. It can occur during menstruation, but it is also associated with wounds, burns, surgery, nasal products and some vaginal devices. Good hygiene lowers exposure, yet no routine can remove all risk.

Tampons and menstrual cups should be used exactly as their packaging says. A product that stays in place too long can increase concern, so use the lowest absorbency that manages your flow and consider pads when appropriate.

Wash your hands before and after inserting or removing a tampon or menstrual cup. Change menstrual products at the interval on the instructions, never use a tampon overnight beyond that limit, and clean and store reusable products as directed. Do not use a tampon when you are not menstruating.

Keep cuts and grazes clean and covered, and follow wound-care instructions after a procedure. Remove a menstrual product and seek advice if it causes irritation, pain, unusual discharge or fever. Do not ignore a suspected vaginal, skin or pelvic infection; prompt assessment may be needed.

Seek emergency medical care for sudden fever with vomiting or diarrhoea, dizziness or fainting, confusion, severe muscle aches, a widespread rash, severe weakness or breathing difficulty, particularly during menstruation or after a wound or procedure. Remove a tampon or cup if one is in place, but do not delay emergency help while trying to locate it.

Ask: Which menstrual products suit me? How should I clean a reusable cup? What wound changes are concerning? Could my symptoms indicate an infection, and do I need treatment?