Written by: Nirajana Sinha
Toxic Shock Syndrome (TSS) is an extremely rare and serious medical condition that is caused by the bacterium Staphylococcus aureus. It occurs when this bacterium gets introduced to the bloodstream and produces toxins. The toxins then produced can cause organ damage, including kidney and heart failure, and even death. Many scientists believe that other factors that can act as a catalyst are oxygen (brought into the vaginal canal by the tampon) that creates an aerobic rather than an anaerobic environment, a less acidic environment during menstruation to name a few. Although it has been linked to super absorbent tampon use in menstruators, it can affect anyone irrespective of their age.
Some of the symptoms of toxic shock syndrome include sudden fever, low blood pressure, vomiting or diarrhoea, muscle pain, redness of eyes, mouth and throat, seizures and headaches. Tampons used by menstruators are one of the causes of menstrual TSS (mTSS). They are commonly made of cotton, rayon or a blend of the two. The absorbent fibres used in most tampons sold commercially today are made with a bleaching process, which is free from elemental chlorine. This prevents products from having dangerous levels of dioxin.
Tampons should always be used once. Tampons marketed as reusable may carry the risk of infections such as yeast, fungal and bacterial infection. In the 1980s, the Center for Disease Control and Prevention (CDC) in the United States implicated Rely tampons produced by Procter & Gamble as the single tampon contributing to the mTSS.
After being threatened by the US Food and Drugs Administration (FDA), the company decided to withdraw all the unpurchased products from the market shelves. Between 1970 and 1980, there were 941 confirmed cases of toxic shock syndrome, 928 in women and 905 at the onset of menstruation in which 73 women died.
Ways To Prevent Menstrual Toxic Shock Syndrome
Here are some ways to prevent mTSS:
- Change tampons every 3-8 hours. Do not use a tampon longer than that.
- Use a low absorbency tampon or sanitary napkin during menstruation (if a tampon can be used for more than eight hours a day, it is possibly high absorbent).
- Shift to reusable silicone menstrual cups (they are also environment and pocket friendly).
- Wash hands thoroughly before and after changing.
- Do not reuse an already used tampon.
- Since menstrual toxic shock syndrome can occur again, it is advisable to not use tampons if one has once survived mTSS.
One important point that needs to be taken into consideration is the ingredients used by the producers and manufacturers of these menstrual hygiene products. Often times, producers shift the ingredient composition in their tampons. A non-disclosure of these menstrual product ingredients creates a gap in the standards set for these products.
However, because of more advanced and rigid safety procedures that menstrual hygiene products now have to go through, cases of menstrual Toxic Shock Syndrome or mTSS have decreased drastically. But the cases are not nil. The threat of mTSS continues to loom large over menstruators if they do not adhere to certain safety and hygiene guidelines.
In India, incidents of mTSS are unknown and occurrences are reported only in isolated case reports. This is because very few menstruators in India use tampons or are even aware of them. For a very long time, tampons were considered something that “break one’s hymen” and lead to a loss of virginity. This “loss” of virginity is in turn linked to the honour of a woman, her family, and in some cases, her entire village or clan. India’s obsession with controlling women’s sexuality and virginity restricts menstruators from accessing menstrual hygiene products.
We face issues finding tampons at local medical stores; even mainstream media chooses to not talk about tampons or popularise or normalise them, feeding more to the situation. Families like mine raise eyebrows at the very thought of inserting something inside the vagina, even if it is for managing menstruation, because any form of vaginal insertion before marriage makes a menstruator impure.
This lack of awareness around menstruation is probably one of the biggest contributors to why India has few isolated incidents of mTSS which, though is a positive thing, puts the health of menstruators in jeopardy and indicates an urgent need to address and fight menstruation-related social stigma.
For in a country where only 36% of women use sanitary pads, only 48% of adolescent girls know what menstruation is prior to their menarche, and where thousands of women die every year due to lack of menstrual hygiene management, proper tools and menstrual knowledge, the urgency is yet to be felt.