Toxic shock syndrome and sanitary pads

Toxic shock syndrome, or TSS, is a sudden illness caused by toxins made by certain bacteria. It can occur during menstruation, after a wound or operation, or with another infection. A pad sits outside the body, so it is not the same exposure as a product placed inside the vagina. Poor hygiene is not the only issue, and changing a pad does not remove every possible cause of TSS.

Early symptoms may include a high temperature, chills, headache, muscle aches, vomiting, diarrhoea, dizziness or confusion. A widespread red rash, peeling skin later on, or faintness can also occur. These symptoms can worsen quickly and may affect several organs.

If you feel suddenly very unwell while using a pad, remove the pad and do not put another menstrual product inside the vagina. Note when the symptoms began and tell the clinician about menstruation, recent wounds, surgery, medicines and any products used.

Use pads as directed on the packaging, change them regularly, wash your hands before and after changing them, and keep the skin clean and dry. These habits support comfort and hygiene, but they cannot treat suspected TSS. Treatment requires prompt medical assessment and may include hospital care and antibiotics.

Seek emergency medical help immediately for a sudden fever with vomiting, diarrhoea, severe weakness, dizziness, confusion, fainting, breathing difficulty or a spreading red rash. Do not wait to see whether symptoms settle and do not drive yourself if you feel faint or confused.

Ask which symptoms should prompt a return to hospital, whether a wound or another infection could be involved, and how to care for your skin during future periods. You can also ask whether any current medicines or health conditions change your risk.