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toxic shock syndrome

We've all sat there and read the warnings on the box of tampons – but have you ever really thought about Toxic Shock Syndrome?

Probably not, to be fair.

Toxic shock syndrome (TSS) is rare, but potentially life-threatening illness, so it’s SO important to know the signs and symptoms. 

Toxic shock syndrome is typically associated with the use of tampons. The good news is that since manufacturers pulled certain types of tampons off the market, the incidence of TSS has declined.

Toxic shock syndrome can affect ANYONE (something we actually didn't know), including men, children and postmenopausal women.

Risk factors for toxic shock syndrome include skin wounds and surgery.

What are the symptoms?

Possible signs and symptoms of toxic shock syndrome include:

  • A sudden high fever
  • Low blood pressure 
  • Vomiting or diarrhoea
  • A rash resembling a sunburn, particularly on your palms and soles
  • Confusion
  • Muscle aches
  • Redness of your eyes, mouth and throat
  • Seizures
  • Headaches

And the causes? 

Most commonly, Staphylococcus aureus (staph) bacteria cause toxic shock syndrome. The syndrome can also be caused by group A streptococcus (strep) bacteria.


About half the cases of toxic shock syndrome associated with Staphylococci bacteria occur in women of menstruating age; the rest occur in older women, men and children. Streptococcal toxic shock syndrome occurs in people of all ages.

Toxic shock syndrome can progress rapidly. Complications may include:

  • Shock
  • Renal failure
  • Death

Prevention (the most important part of this article)

Most manufacturers of tampons no longer use the materials or designs that were associated with toxic shock syndrome. Also, manufacturers are required to use standard measurement and labelling for absorbency and to print guidelines on the boxes.

If you use tampons, read the labels and use the lowest absorbency tampon you can.

Change your tampons frequently, at least every four to eight hours. Alternate using tampons and sanitary napkins, and use minipads when your flow is light.

Toxic shock syndrome can recur. People who've had it once can get it again.

If you've had toxic shock syndrome or a prior serious staph or strep infection, don't use tampons.


All those warnings on tampon boxes about Toxic Shock Syndrome? Yeah, you should definitely be paying attention to them.

One UK student has revealed she ended up with severe blood poisoning, close to death, after forgetting about her tampon for nine full days.

Emily Pankhurst, 20, described to The Daily Mail how she assumed the pain and bloating she was feeling were just down to stress, as she was studying hard for upcoming university exams at the time.

"I blamed deadlines, returning to uni after the New Year and exams. Actually I was seriously ill," she explained, adding that she had simply inserted a new tampon, having forgotten to take the old one out.

"When I finally realised, I pulled it out it was pure black," she says of the moment she realised what she had done.

"I was feeling really ill by that stage. I was hot and dizzy and felt really strange.

"I wouldn't have known what it was apart from the string. It was horrible. I immediately chucked it in the loo, I felt sick."

However even after removing the forgotten tampon, Emily's symptoms continued to worsen, and she was eventually rushed to hospital with intense stomach pains and slurred speech.

"I was sat in the dark. I can't remember much, but mum said I kept repeating, "I feel ill – my stomach".

"'My speech slurred and my skin became mottled. I started to feel faint and I was rushed to hospital by ambulance.

"During the journey they said I was displaying all the symptoms of sepsis [blood poisoning] and so the blue lights were put on. I became an emergency case."

Thankfully Emily received medical treatment before the sepsis took hold of her body completely, but it was a long road to recovery.

"I was fed through a tube," she recalls, adding that she couldn't even use the toilet as normal.

"My bladder was full – I had two litres of urine in me – but I couldn't go to the toilet naturally and was given a catheter.

"I've never been in pain like it so was given morphine and doctors said if I had left it any longer I would be dead."

Even now, two months on, Emily is still feeling the consequences of her illness and finds she is constantly exhausted, needing up to 13 hours sleep a night to function.

Emily has shared her story to warn other women to be mindful of their health, especially in times of stress.

"I hope my story can help others to take care of their health and not take their lives for granted, because you never know what might be around the corner."