At the latest since the US -model Lauren water his legs through the so-called toxic shock syndrome (TSS ) and is now suing a large tampon manufacturer, is TSS on everyone’s lips. To counteract rumours and half-truths, we spoke to experts about the disease and the advantages and disadvantages of tampons, sanitary pads and menstrual cups.
What is Toxic Shock Syndrome?
TSS is caused by staphylococcus and streptococcus. “These are virtually ‘everyday germs’, which most of us have in small quantities on our skin and mucous membranes – without getting sick,” explains gynecologist Prof. Werner Mendling, who conducts scientific research into the colonization of germs during infections.
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“These bacteria release toxins that are harmless on the skin surface. When the skin is injured, the bacteria come into contact with the unprotected tissue and release their toxins there. Normally our immune system can cope with this, the wound reddens or ulcerates and then heals. If the toxins have entered our blood in small quantities during such an inflammation, our immune system forms antibodies against them.
According to Mendling, over 90 percent of all adults have antibodies against these toxins.
A tampon should be changed after a maximum of 6 hours. © Ema Woo / Shutterstock.com
The bacteria are often found in small quantities in the bacterial colonization of the vagina. “Normally, however, this is not a problem,” explains Prof. Mendling. “Because of the lactic acid bacteria, the vagina has a very acidic pH value. Pathogenic germs such as staphylococci, streptococci or our intestinal germs Escherichia coli cannot multiply well in this acidic environment. In short, the germs are normally harmless.
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But the situation changes with menstruation: “Blood has a pH value of 7 and is therefore not acidic. Blood at body temperature is an ideal breeding ground for all germs and leads to rapid multiplication,” explains Dr. med. Christian Albring, resident gynaecologist and president of the Professional Association of Gynaecologists.
“Tiny injuries in the wall of the vagina, caused for example by pressure points of a menstrual cup, micro threads of the tampon or sex, can cause the germs to enter the bloodstream.” But don’t panic: “Most adults have already formed antibodies – the immune system can help here,” Mendling warns. However, if the body’s own antibodies are not yet present, the germs can multiply unchecked in the blood and release toxins.
This massive release of toxins triggers toxic shock syndrome, which in the worst case can lead to multi-organ failure.
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What are the symptoms of TSS ?
At first the symptoms are similar to the dangerous inflammation of a flu. Anyone who suddenly suffers from fever, low blood pressure, skin rash, dizziness, vomiting or diarrhoea during their period should remove the tampon or menstrual cup immediately and consult a doctor.
Toxic Shock Syndrome, however, is not caused by menstruation, so it also occurs in men or women outside their period. Nevertheless, most of those affected are girls and women between 10 and 50 years of age. In Germany, however, only about 50 to 70 people a year are diagnosed with TSS put.
Period slips as tampon alternative The alternative to tampon & co.: Free bleeding – just let it run. © Estrada Anton / Shutterstock.com
How can I help the TSS prevent?
Yes, tampons and menstrual cups are incredibly practical. Nevertheless: “The only way to stop the explosive increase of undesirable germs during menstruation is to let the blood flow out”, says the press officer of the Professional Association of Gynaecologists, Dr. med. Susanna Kramarz. “And this is not just about the germs that TSS but also all other potential pathogens.” She is thus clearly expressing her distrust of tampons and menstrual cups and sanitary towels.
Those who cannot get used to bandages completely should use a tampon or cup at least in the smallest possible size and always change it after 6 hours at the latest. It is also important to be sensitive to your own body: “If you notice that your menstrual blood smells unpleasant, you should not use tampons or menstrual cups for the time being”, says Kramarz. “Normally, blood smells neutral, an unpleasant smell indicates bacterial decomposition.”
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Caution is required with TSS better than panic
Of course, Toxic Shock Syndrome is not to be trifled with. Nevertheless, it is a disease that occurs very rarely and can be counteracted with knowledge and caution. Whenever possible, you should avoid tampons and menstrual cups and use bandages so that the blood can flow out together with the germs. Otherwise, you should take the regular change of tampons seriously and pay attention to the signals your body sends you.