Toxic Shock Syndrome Explained: As Model Loses Leg, We Explore What Really Causes TSS

Toxic Shock Syndrome Doesn't Just Affect Women Who Wear Tampons
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Lauren Wasser was just 24 years old when she was rushed to hospital with a fever of 107 degrees. Just ten minutes from death, her internal organs were shutting down and she'd suffered a heart attack.

As doctors frantically tried to stabilise her, nobody seemed to know what exactly was wrong. It was only after an infectious disease specialist asked if she had a tampon in that something clicked.

The tests that followed revealed the worst - Wasser had toxic shock syndrome (TSS).

Now, the LA-based model is suing the tampon brand Kotex which, she claims, was to blame for her contracting the rare condition and losing a leg.

Many women will have heard about TSS at some point in their lives - after all, anyone who's read the instructions on a tampon packet with be familiar with the term - however a lot of people don't actually know that much about it (doctors included).

Toxic shock syndrome is a bacterial infection caused by Staphylococcus aureus and Streptococcus pyogenes bacteria.

Usually, these bacteria live harmlessly on the skin, nose or mouth but can invade the body's bloodstream and release poisonous toxins, which also damage tissue, including skin and organs, and can disturb many vital organ functions.

This fact becomes even more disconcerting when you think about how much time a woman will actually spend with a tampon inserted in her vagina - to put this into perspective for you, the average woman will be on her period for an average of six to seven years during her life.

According to the NHS, a significant proportion of TSS cases occur in women who are on their period and using a tampon. There are roughly 40 cases of the condition reported each year in the UK, half of which are associated with tampon use.

But Tracy Stewart, director of the Absorbent Hygiene Products Manufacturers Association (AHPMA) - an independent body that carries out research on items such as tampons, nappies and incontinence pads - says that "there's no proven link between tampon use and toxic shock syndrome" and that it can actually affect anyone.

"What we do know is that women should be aware of this in relation to any internally-worn device," she adds. "We know that there are cases related to internal contraception, we know there are cases associated with child birth and so it's wrong to say that one type of product can cause this."

She also highlights that statistics surrounding the condition aren't particularly reliable.

"It can affect anybody: men, women, children," says Stewart. "Unfortunately you often hear of very young children getting toxic shock syndrome, for example, when they've had a very minor scold or burn. Or even from a chicken pox spot that's become infected."

She adds: "People tend to think they've got something like the Novovirus or gastroenteritis. You get flu-like symptoms and experience muscle aches, cramps, dizziness, chronic nausea and diarrhoea.

"Sometimes you'll get a rash that pops up and goes, a high fever, and the thing that denotes it as being toxic shock syndrome is a drop in blood pressure.

"That's a very important symptom to watch out for as it can tell a doctor that there's shock going on. So it's really important that blood pressure is taken - particularly in children."

Story continues below...

Top 10 Stupid Period Myths
MYTH: Don't exercise when you are on your period (01 of24)
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TRUTH: Run, bike, dance — do whatever you want. These are just some of the so-called "strenuous" activities you can still do while you're on your period. Unless you're in a lot of pain, feel free to exercise or partake in any other type of activity. In fact, some studies even suggest exercising can help with painful periods.
MYTH: Don't go swimming (02 of24)
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TRUTH: There was a time when young girls were told strange things like if they went swimming in the ocean, their period scents would attract sharks, or their tampon would swell with water, causing them to drown. These are pure myths. Tampons, for example, make it easier for women to enjoy swimming or beach days during periods.
MYTH: People can tell when you're on your period (03 of24)
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TRUTH: Unless you're carrying a big red sign that says "it's my time of the month," nobody will know you're on your period. If you're embarrassed about pad lines (even though you can hardly tell), try wearing a tampon. Sometimes, you may also have a period odour. Again, nobody else can smell it. If you are worried, change your tampon or pad more often.
MYTH: Teens shouldn't use tampons(04 of24)
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TRUTH: Tampons are perfectly safe for both teens and adults. If you still haven't used a tampon and you're worried about discomfort, make sure you read the instructions carefully. And no, using tampons doesn't mean you lose your virginity.
MYTH: During your period, you lose a lot of blood(05 of24)
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TRUTH: For the first few hours/days of your period, it may seem like you’re losing a lot blood. On average, women lose about 60 ml (4 tablespoons) of blood, and considering a teen who weighs 110 lbs has about 3,500 ml of blood in her body, you can see the loss isn't that big.
MYTH: A tampon can float away inside your body (06 of24)
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TRUTH: No. Just no. There is no way a tampon can "float" away inside your body. Once you insert a tampon, it will stay there until you have to take it out.
MYTH: Don't wear tampons overnight (07 of24)
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TRUTH: You CAN wear a tampon overnight. Most tampons can be worn for eight hours a day or night, keeping in mind you should change your tampon every four to eight hours.
MYTH: During your period, only sleep on your side (08 of24)
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TRUTH: Again, false. Sleep on your back, front, side, whatever makes you feel comfortable. If you're worried about leaks, try pads and tampons that are meant to be worn overnight.
MYTH: PMS is not real (09 of24)
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TRUTH: PMS (premenstrual syndrome) can occur seven to 14 days before the period begins. During this time, women may experience acne, bloating, tender breasts/nipples or mood swings. Some studies have shown mood swings, for example, may not exist, but this again varies from woman to woman.
MYTH: Inserting a tampon hurts (10 of24)
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TRUTH: The key to using tampons is to relax. If you don't get it right the first time, don't worry. Practice makes perfect, even when it comes to tampons.
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(12 of24)
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What it sounds like: A really bad horror film about a group of teens who drive their car out into the woods and get haunted by a ghost.
But what you're actually referencing: There are cramps, and yes, blood to deal with, but getting your period isn't a curse of any sort — it's part of being a woman of a certain age. Periods involve our ovaries releasing eggs, while hormonal changes prepare our uteruses for pregnancy. See ... not so scary.
(13 of24)
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What it sounds like: A really cool and urban aunt who likes to listen to hip hop and buy vinyl records
But what you're actually referencing: Aunt Flo only visits once a month (a 28-day cycle to be exact). She is kind of uncomfortable, annoying and her conversations never stops flowing...
(14 of24)
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What it sounds like: Your really really really old aunt who has a kind soul.
But what you're actually referencing: Similar to her sister Aunt Flo, Aunt Rose seems to be the nicer of the two: Because we all know things like rose petals and rose bushes resemble menstruation.
(15 of24)
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What it sounds like: Like you have a giant wound and you can't stop bleeding. Ever.
But what you're actually referencing: You're being pretty literal here, but yes, a period means you're bleeding from your vagina.
(16 of24)
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What it sounds like: A really trendy urban cafe.
But what you're actually referencing: The dot/dots that appear on your liner, pad and sometimes on your bed sheets and underwear. Also, dot = period.
(17 of24)
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What it sounds like: Not just any friend, but a really annoying friend you don't like.
But what you're actually referencing: Sometimes we try to make the best of what life throws at us by staying positive and remembering our periods can be our friends.
(18 of24)
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What it sounds like: When the plumbing went wrong ... for a week.
But what you're actually referencing: Again, the leak refers the constant flow of blood coming out of your body. We also assume people are referring to leaks they get on their pants or bedsheets. The worst.
(19 of24)
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What it sounds like: Time of the month sounds like a hush-hush thing that happens to your body that only you and members of a secret club understand.
But what you're actually referencing: TOTM refers to time of the month when your period is taking place — just so we're all on the same page.
(20 of24)
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What it sounds like: A newsletter or a magazine that comes out once a month
But what you're actually referencing: To add emphasis that everything is cool with your flow and your period only happens once a month.
(21 of24)
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What it sounds like: Teenage slang
But what you're actually referencing: PMS actually stands for premenstrual syndrome, and isn't a synonym for your period at all.
(22 of24)
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What it sounds like: A dirty old cloth you use to wash your dishes and floor
But what you're actually referencing: The rag is closely related to the pad or tampon we wear during periods... and how uncomfortable it is. It's also an unfortunate visual.
(23 of24)
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What it sounds like:This river in China!
But what you're actually referencing: We're not sure with the obsession of words like "river," "water" or "flow" when it comes to describing your period. Our best guess? The assumption that when a woman is on her period, she is forever bleeding.
(24 of24)
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What it sounds like: It sounds like what it is, the bleeding elevator from the 'The Shining.'
But what you're actually referencing: Periods are scary and women bleed and if you see/talk about this blood, something terrible will happen. Get a grip, people — the only thing frightening about periods is using phrases like "the shining" to describe it.

Due to the lack of research and statistics surrounding toxic shock syndrome, more and more questions are now being raised surrounding the condition itself, alongside tampon usage in general.

In a piece for the Guardian, Congresswoman Carolyn Maloney argued that not enough is known about whether tampons are safe to use over a long period of time.

She wrote: "The average woman who uses tampons will use over 16,800 during the course of her lifetime – and there is almost no data on the health effects of the cumulative use of tampons over a woman’s lifetime."

So are they safe?

Nowadays, tampons are made from a "natural cellulosic absorbent material", which is often rayon or cotton or a mixture of both. And to make them easy-to-insert (while also reducing the loss of fibres) they are covered with a non-woven or perforated film.

A study on tampon safety published on the National Center For Research suggested that tampons might not be that safe to use.

Rayon is a synthetic fibre which is made from wood pulp and during the manufacturing process, a toxic byproduct called dioxin is created. According to researchers, a very small amount of dioxin can be found in rayon fibre.

The WHO states that dioxins are "highly toxic" and can cause reproductive and developmental problems, damage the immune system, interfere with hormones and also cause cancer.

In trials where monkeys were exposed to dioxins, they were found to have an increased risk (80%) of developing endometriosis - which occurs when uterine tissue is found outside of the uterus and can sometimes cause infertility.

Of course, small traces of dioxin are found in tampons and, scientists argue that this isn't really an issue. But if they're used again and again over half of a woman's lifetime, then could it impact her health?

"Because of that, we conduct ongoing safety evaluations of our tampons and we regularly review our safety information with independent experts, physicians, nurses, and scientists to assure our products can be used with confidence."

The jury's out.