You’ve probably seen warnings for toxic shock syndrome (TSS) in fine print on a tampon box, and you may remember the example of model Lauren Wasser whose tragic and much-publicized health problems were blamed on tampon use. In 2012, the 24-year-old famously contracted the illness and ended up having both a heart attack and a leg amputation. Doctors blamed the tampons she was using, and they may have indeed played a part. However, using (or leaving in) tampons is actually only one of the rarer ways you develop this complication, and there are some pretty unsettling facts about the condition that you need to know.
TSS is caused by a buildup of toxins thanks to the strep and staph bacteria that lie inherently and mostly dormant in a human body. Though most of the human population can deal with this small amount of bacteria normally, there’s a small segment of the population who can’t. This is why it isn’t solely a problem for women; in fact, only about 50% of TSS cases are in women.
Many people have struggled with staph infections, but staph and strep are both bacteria that can naturally live in or on the body. Though TSS is serious and can be fatal if not diagnosed quickly, it’s incredibly rare, much like many other serious diseases.
1. The Most Famous Person To Die From It Was A Man
Jim Henson, creator of the beloved Muppets, passed at age 54 of toxic shock syndrome. Clearly, Henson wasn’t using tampons, but he did have the Streptococcus pyogenes germ (the same germ that causes strep throat). Henson appeared for the last time with Kermit on May 4, 1990. On May 15 of that year, he told his wife he felt awful and eventually went to the hospital. On May 16, he succumbed to pneumonia, a direct result of what TSS had done to his immune system.
Though the doctors gave him antibiotics, the toxins had already damaged many of his organs.
2. TSS Wiped A Woman’s Memory
In 2011, a woman from Wales reportedly ended up in an induced coma, and reportedly TSS was to blame. She also lost her memory. Four years afterward, her memory had still improved only slightly. Considering that she originally couldn’t walk, talk, or feed herself in the immediate aftermath, it’s practically a miracle that she recovered at all.
The woman originally thought she had the flu, but when she soon became unable to even walk or communicate, she went to the emergency room where the staff ran CT scans. The woman had an ovarian cyst, and emergency surgery quickly removed not only the cyst and her ovary but also her fallopian tube. Doctors at the time suspected the problem developed because she had been using the highest absorbency tampons throughout her entire menstrual cycle.
3. A Model Had Her Legs Amputated
Lauren Wasser, a 24-year-old model living in Los Angeles, fell ill quickly – despite using tampons responsibly and changing them frequently. In 2012, she ended up at the hospital with a fever of 107 degrees after having a heart attack. Like others who have suffered from this sudden illness, she was put in a medically induced coma. When she woke, she had developed gangrene as blood was no longer flowing to her legs. When they tested the tampon she had in when she arrived at the hospital, analysis revealed TSS. She has since described the experience as the most excruciating pain you could ever imagine.
The infection turned into gangrene and Lauren ended up losing her right leg below the knee. In 2018, due to lingering complications, she had the left leg amputated as well.
4. A Brand Of Tampons In The 1970s Caused An Outbreak
Part of the initial clamor around tampons dates back to the 1970s. When Rely – a brand of super-absorbent tampons – was released by Proctor & Gamble, cases of TSS skyrocketed. The high absorbency, mixed with the synthetic fibers that were becoming more common, allowed bacteria to grow aplenty. They were taken off the market in 1980.
If you need further proof that Rely was not legit, you should know that the marketing of Rely said that one tampon could absorb the blood from your entire period – yes, your entire period, which typically lasts for multiple days.
5. Tampons Have To Be Approved By The FDA
In 1982, Proctor & Gamble was found negligent in a court case – and 400 more trials followed. Today, tampons are considered an “intermediate risk” device and must be approved by the FDA, hence the small-print warning on all the boxes.
What was Proctor & Gamble’s defense in that 1982 trial? That the woman had the flu.
6. Things Go Downhill Very Quickly If You Get TSS
If you think you have the symptoms of TSS, you need to move quickly, and it’s better safe than sorry. It’s much like having a bad flu, with a high temperature over 102 degrees, vomiting, rash, lightheadedness, dizziness, or confusion. Other symptoms include low blood pressure, decreased urination, bruising, and difficulty breathing.
If you’re having symptoms all over your body, that’s a sign that you need to get to a hospital ASAP.
7. The Tampon Itself Doesn’t Cause The Syndrome
Tampons themselves don’t have TSS hidden somewhere inside of them. Toxic shock syndrome is a result of strep or staph bacteria, both of which aren’t a problem for most of the population. However, for those who are at risk, strep and staph bacteria can result in a buildup of toxins. Those toxins are what cause the complications.
8. A Lot Of People Already Have The Bacteria In Their Bodies
If so many people have staph and strep bacteria (probably a third), why do an unlucky few get TSS? Turns out, it’s all in your HLA genes. Some HLA genes can make you more likely to develop this illness; others can prevent you from getting it. Strep bacteria affects the immune systems of those more likely to get it, and the cytokines that destroy bad bacteria end up destroying pretty much everything else.
9. Genetic Testing To See If You’re Susceptible Doesn’t Exist
Remember Proctor & Gamble, the company that created Rely tampons? In 2003, P&G funded a study at the University of Tennessee in Memphis to see if a genetic test could tell if a woman was susceptible to TSS. They decided that it could have something to do with a protein in some women’s blood, which can be tested via chromosome 6.
Philip Tierno, who was the person to figure out that tampons and TSS were related, doesn’t think this is the case at all. He says that the lack of antibodies in someone isn’t because of a protein in their blood, it’s because the toxins prevent the antibody creation at all. Some speculated that P&G just funded this study to help their legal woes.
10. It’s Not Clear If 100% Cotton Tampons Are Better For You
Some experts say that cotton tampons would indeed be safer, since mixed-material tampons have the chemicals necessary to produce toxins if a woman already has staph bacteria. Following their logic, 100% cotton tampons wouldn’t carry this same risk.
The research doesn’t necessarily validate this claim, though. A study from 1995 actually found that organic cotton and mixed-material tampons carried the same risk. A 1994 study did find that organic cotton tampons were safer – however, the results from either study have never been replicated. Safest bet? Just don’t leave any tampons in all day.
11. Most Doctors Will Never See A Case Of TSS
Before you throw out all your tampons, remember that this condition is incredibly rare (affecting roughly 1,000 of 50 million tampon-using women). That is .00002%, so chances are, you’re not among that tiny sliver of the population who will get it. In fact, in 2014, there were 59 cases of TSS.
Those are pretty low odds — low enough that most doctors will never even see a case (making it all the more important to inform the doctor that you’ve been using tampons if you get sick quickly).
12. Leaving A Tampon In For Nine Days Is Not A Good Idea
A college student in England reportedly left her tampon in for nine days – and yep, you guessed it. The young woman said that she just forgot about the tampon thanks to stress from her final exams. By the time she realized that she still had a tampon in, she described it as “pure black.”
She began slurring her words, became faint, and went to the hospital; she was already showing signs of TSS. After spending three days in ICU, she was able to mostly recover with time.
13. We Don’t Really Know The Long-Term Effects
Due to the rarity (and severity) of TSS, we don’t know what effects it has long-term, if any. If it’s found early enough, most are able to fully recover. However, if you’ve had TSS once, you’re at risk to get it again – your body still harbors the bacteria that caused it in the first place, and you don’t magically become immune. For example, the condition can sometimes pop up again after you’ve delivered a baby.
The long-term effects that we know of are mostly one-offs; a few women have had memory loss, but that doesn’t mean that all who get TSS will lose their memories.
14. Private Areas Love Bacteria, Unfortunately
Anyone’s reproductive area is a breeding ground for bacteria, but that’s not necessarily a bad thing. For women, the vaginal pH needs to stay in balance for you to be healthy. When it’s out of balance, it means that bad bacteria can thrive. Healthy vaginal flora means that you’ve got a lot of helpful lactobacillus bacteria.
Though TSS is definitely one of the most serious things that can go wrong in the ovarian area, an imbalanced vaginal flora can also cause bacterial vaginosis and other concerns.
15. If Not Fatal, TSS Could Increase Memory Loss And PTSD
Assuming your case is not fatal, treatment and recovery time can be slow and challenging. Doctors report increased memory loss as a fallout effect as well as PTSD. TSS is by its very name a shock to the nervous system, and it only makes sense that it would have mental repercussions during a long recovery time.
16. Recovering From TSS Can Be Slow
Toxic shock syndrome is debilitating to the central nervous system of the human body but also aggressive, and early medical attention can save lives and increase the likelihood of recovery, however slow it might be. In a body that has experienced TSS, changes to the arteries near the heart are likely, kidney damage is common, and a weakened immune system along with fatigue and psychological damages are probable side effects.
There are more temporary side effects too, like hair loss, that have been reported in recovering patients.