March 25, 2013 • 25 mins
What is toxic shock syndrome, and what's the risk of contracting it? Why was 1980 the worst year for tampons? Listen in to learn all about toxic shock syndrome (including how to prevent it) in this episode.
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Speaker 1 (00:03):
Welcome to Stuff Mom Never Told You from how Stop
Works dot Com. Hello, and welcome to the podcast. I'm
Kristin and I'm Caroline and Caroline. Today, let's tackle a
question that has crossed the mind's probably every menstruating woman.
(00:32):
What is that tampon's tampons and whether or not tampons
caused toxic shock syndrome? And what is toxic shock syndrome? Anyway,
this is a basic question that we really have not
addressed in the eight thousand episodes of Stuff Mom Never
Told You. We have done, even though we've talked about
(00:54):
tampons and plenty of times, we've talked about menstruation plenty
of times, but toxic shock syndrome, as a listener kindly
pointed out, is something that we have not directly addressed.
And I remember when I was a young lass and
I found a box of my sister's tampons, and you
(01:14):
know that that sheet that they have inside, Yes, the
answer to the insert with the diagram of the female
pelvis and how you put a tampon in, and then
in bold letters you see toxic shock syndrome. And in
my mind, I thought these are very dangerous. Why would
women do this to themselves. I was scared. Well, I
(01:36):
remember reading the insert because my you know, I've said
before in the podcast that my mother never had a
sex talk with me and that I was just kind
of left to my own devices slash romance novels to
figure things out. And it was the same thing with tampons,
like she handed me a box and or she bought
me a box, and I think left it strategically on
my bathroom counter. And so I followed the diagram to
(01:56):
a T down to like Chris, and I laid down
on the floor to insert my first tampon. I was like,
so scared. I was like, how do I It's it's
pointing strange. I'm pretty sure I did that as well.
But yeah, I I read the insert and I read
the thing about toxic shock syndrome, and I was like, Holly, Molly,
what is this. I'm gonna die if I put in
too many tampons. But I mean I think because of that,
(02:19):
I changed my tampon like way more than necessary every
thirty minute. Yeah, yeah, I don't. The thing about the
the insert is that you come away knowing that something
terrifying called toxic shock syndrome exists. And that you could
potentially die from it, but it doesn't really tell you
what your chances are and what it is. So before
(02:41):
we get into toxic shock syndrome, let's go over very
briefly when we started using tampons to begin with, because
obviously administruation is not a new thing, and we've been
improvising up until the nineteen thirties when tampons became mass marketed.
(03:04):
But before tampons, Caroline, what kind of stuff were women
using during men's struation? Just any old thing like what
like what Egyptians Kristen in the fifteenth century BC. Well,
they used softened papyrus, so you'd write a note to
your friend and then after after she read it, you
just you just slug up that keep it there um.
(03:27):
In Rome they used wool. Japan they had paper held
in place by a bandage, which the name for that
bandage was the Japanese word for pony id. Just like
to point out, I like that and you would change
it ten to twelve times a day. I mean, how
do you have time for anything else? But anyway, Indonesia
they use vegetable fibers. In Equatorial Africa, rolls of grass,
(03:47):
Hawaii people would use a furry part of a native
fern called the hapoo, and other grasses, mosses and plants
all throughout Asia and Africa. Yeah, and in the US,
as more revealing clothing styles came into vogue, Uh, it
spurred the need for internal period absorbers. When I'm talking
(04:12):
about tampons, because when you were wearing bustles and lots
of quinoline and such, uh, you could get away with
wearing a pat all the time. But then once the
silhouette became more close cut to the female body than you, uh,
the need for the for tampons increased. And fun tadbit
(04:35):
that I did not know about was that after World
War One there was greater interest put in developing tampons
because there was this highly absorbent surgical dressing called sell
you Cotton that needed a new market after the war ended,
and what can you make with absorbent surgical dressing? T
(05:00):
And there's been a lot of technolog technological development around tampons.
Dr Earl Hass was the first to develop an applicator,
a little cardboard applicator, because his wife was having so
many problems with the bulky pads and adult diaper type things. Yeah,
and the idea came to hass after he talked to
a friend of his in California who used a vaginal
(05:22):
sponge for her periods. Um. Yeah, has actually sold the
patent to Gertrude Tendrick, a German immigrant who became tam
PACs is first president. She made the tam PACs on
her sewing machine at home. Yeah, has said a little
bit of a sad story because he had his patent,
he couldn't really do anything with it. And then savvy
(05:44):
Gertrude comes along, buys it up forty two dollars and
builds the tamp PACs empire. And it was really in
the mid to late n Thanks to Tampacs with that applicator,
the tampons started to become more readily available and more
widely used, and everything was all fine, well and good
(06:06):
tampons were just chugging along. Tampacs and other companies are
figuring out how to make more absorbent tampons and so
you don't have to change the tampons all the time.
And then all of a sudden, in the nineteen eighties,
a lot of stuff goes awry. Yeah, all of these
lawsuits started cropping up because toxic shock syndrome emerge. Yeah.
(06:29):
Toxic shock syndrome was first officially identified in nineteen seventy
eight in a study, but it wasn't the kind that
we would think of as related to to tampons. It
appeared in seven kids between eight and seventeen years old.
The study was published in the Lancet Journal, and in
(06:49):
nineteen eighty the Centers for Disease Control and Prevention began
investigating some follow up reports of fifty five toxic shock
syndrome cases and they noticed a pattern among the women
because of that group was female, and of those of
(07:11):
women who came in with t s s, we're on
their period. Yeah. A CDC and u C. Berkeley report
from n talks about this time and says that toxic
shock syndrome emerged as a result of changes in industry
and personal behavior, but responded to rapid public health action,
(07:33):
including active surveillance. So all of a sudden, these people, men, women, children,
menstruating women, non menstruating women, women who used tampons, women
who didn't use tampons. People were all of a sudden
having this disease, this problem, and so people, researchers doctors
responded pretty pretty quickly to the outbreak. Yeah, and the
(07:54):
CDC investigation in some additional case studies implicated rely p
are brand of super absorbent tampons, and in September of
nine eight, rely pr Is pulled off the market voluntarily
because of this t s S problem. And the thing
in the tampons that the CDC suspected was causing the
(08:17):
problems was a polyester foam that was cross linked with
another synthetic fiber, and it's a combination that's no longer
used in tampons and in polyakrelate containing tampons were also
withdrawn from the market because of concerns over toxic shock syndrome.
(08:38):
And we should highlight yet again that those rely pair
tampons were the super absorbent kind uh and women may
have been leaving them in longer and and as a
result of this tampon tampon gate n eight, there was
a flurry of media reports about the dangers of tampons
(09:00):
because doctors still weren't entirely sure and really still aren't
today what the connection between tampons and toxic shock syndrome was.
They knew it had something to do with a super absorbancy,
perhaps women leaving them in their vaginal canals longer, and
also those synthetic fibers. But for instance, the New York
Times called it a baffling disease that was thought to
(09:22):
be linked to the reversal of blood flow, and in
November of nineteen eighty, the Times also reported toxic shock
amongst six hundred and fifty two people with sixty three fatalities.
But we should point out around this time that after
the Rely brand tampons were pulled, TSS cases continued to
be reported, so it wasn't like it was just Rely
(09:44):
or just super absorbent tampons. Up to sixteen percent of
the reported cases after the fact after Rely pulled its tampons,
up to sixteen percent of these cases we're in children, men,
and non menstruating women, and usually were associated the localized
staff infection, so it's not just like you know, leaving
(10:05):
a tampon in too long. There are also links to surgery,
especially like transplant type surgeries, but the legacy, the public
legacy of toxic shock syndrome isn't something about what happens
perhaps on the operating table, but more so continually linked
to tampon's kind of the same way that intra uterine
(10:27):
devices still battle a negative reputation that they got in
the seventies and eighties when one particular brand had a
negative impact on I forget what the specific uh side
effect was for women um. And in two for instance,
(10:48):
the first federal jury award of nineteen thousand dollars was
doled out to a woman who contracted TSSUM after using
plate Tex brand tampons. And there were more than four
d other victims of toxic shock who filed suit against
Procter and Gamble, which were the makers of the rely
pr campons. And I mean around this time, it was
(11:10):
sort of a cycle because all right, so people, men, women,
children start contracting this disease somehow, this this crazy disease
that has all of these scary symptoms, uh, and that
was fatal some of the time. So the media starts
reporting on it. Tampons are an interesting angle. The more
the media reports on it, the more cases are reported.
(11:30):
So it's the cycle of like, oh my goodness, so
you you do have to ask, and researchers did ask, like, uh,
is this a case of their being more or is
this a case of the reporting just kind of crystallizing
and coming together and realizing, Okay, what we may be
thought was something else is actually toxic toxic shock syndrome.
(11:50):
So they looked at the death rate, the fatality rate
of this disease, and it does, it does ramp up.
Eighty eight deaths were known who have occurred in nineteen
eighty two, which was the time of the Institute of
Medicine report being written about this. It was the first
major report about toxic shock syndrome. They found that before
(12:11):
nineteen seventy nine, fifteen people were reported to have died
from TSS, thirteen in nineteen seventy nine, forty four in
nineteen eighty and fifteen in n one. So there's definitely
like a bell curve, but a lot of that has
to do with increased awareness. So the increased awareness is
a double edged sword. More more cases are being reported,
(12:32):
but also more women are aware of how to safely
use tampons so and maybe go to their doctor when
they noticed symptoms. And it does improve the industry in
terms of getting products off the market that turn out
to not be so good hanging out inside of your vagina.
But one thing we have not addressed yet, Caroline is
(12:53):
what is toxic shock syndrome anyway? Yeah, so you know,
as much as there was a giant scare in the eighties, uh,
and a lot of people were talking about it. TSS
is actually a rare bacterial infection that is historically associated
with the use of super absorbent tampons and occasionally with
the use of contraceptive sponges um. Often it results from
(13:17):
toxins produced by wait for it, I'll pronounce it staphylo
caucus aureus staff bacteria, but the condition may also be
caused by toxins produced by group A strepped a caucus
bacteria or strep. So basically, if you have had doctors
say that if you have had a previous staph infection
(13:38):
or really severe strep infection, you just should not use tampons,
like as a general rule, like if you have had
a very severe previous infection of this type. And I mean,
you know, kids, we've all had strap before, but they're
talking about like, if you've had something really severe as
an adult, you should probably avoid tampons because of that bacteria.
And it's characterized by having a fever, the shock and
(14:02):
problems with the functions of several bodily organs, which is
why it is so fatal. It can be fatal enough
to of cases. And do I need to even go
through the symptoms because they're wide ranging and similarly upsetting, well,
one of them, one of them. Okay, yeah, this is like,
this reads like the worst webin D entry ever. You know,
(14:24):
webin D. It's always cancer. But so well, I guess
we don't need to go into everything. But one particular
sign of TSS is a widespread red rash that looks
like a sunburn with skin peeling that occurs one to
two weeks after the rash, particularly on the palms of
the hands and the bottoms of the feet. And this
occurs also you know, there's there's hypotension with a high fever, headaches,
(14:48):
So it does affect a large portion of the body. Yeah,
and that's why you know it can be challenging to
diagnose UM and why you know looking for rash is
important because otherwise, you know, you might have symptoms like headache, fever, diarrhea,
low blood, sugar, muscle eggs, which could be any number
(15:09):
of things. And like you said, if you get to
women D, probably cancer of your entire body. Um. But
one thing to emphasize is that yes, men can develop
it too. We've said it before in about of toxic
shock cases. It affects non menstreating women, which includes men, kids,
and post menopausal women. Now, as far as prevention, uh,
(15:34):
it's some common sense stuff that you should keep in mind.
If you use tampons and you know you're a menstuating
woman in general, Uh, you need to change your tampons frequently,
at least every four to eight hours, and consider using
the lowest absorbency tampons. You can't. I always use just regular,
non scented because you know, we all, we've all we've
(15:55):
talked about scented things in the podcast. To try to
alternate pads and tampons and avoid using tampons at all
when your flow is very light. And the thing is
and I'll rely re emphasize this toxic shock syndrome can recur,
so if you've had it before or a prior serious
strep or staff infection, just try not to use tampons.
And the reason why doctors will urge you to change
(16:17):
your tampons regularly is that left in place, they become
a breeding ground for bacteria. And with those super absorbent
fibers to the tampons might be able to scratch the
surface of the vagina, making it possible for bacteria or
their toxins to enter the bloodstream. So it can set
you up for some some bad stuff going on. But
(16:39):
if you're now saying, well, oh, I'm just gonna stop
using tampons, no, it's not a thing that you have
to stop using tampons. TSS is extremely rare. This shouldn't
be some kind of scare tactic, you know, away from
tampons um. But one other way, though, if you are
worried about toxic shock, menstrual ups might be a good alternative.
(17:02):
Go ask Alice that we've started many times over at
Columbia University and other sources will confirm that menstrual cups
might be one way to lower your risk of that.
But again, though, because of the fact that these cases
can happen outside of the realm of menstrual products, you know,
it's it's not just that that we need to pay
(17:24):
attention to. Even though when we think of toxic shock
a lot of times, the next thing we think of
is tampons and periods. Right, there's also reusable cloth paths,
but those don't really necessarily prevent toxic shock syndrome either.
It's just that the risk is probably slightly lower than
with tampons. Um glad Rags, who are the makers of
(17:45):
one type of reasonable cloth pad, say that their product
is a safer option because blood is not staying in
the vaginal canal where the development of TSS is most
likely to occur, while the risk is still minimal. Tampons
create more ideal opportunity for the growth of these bacteria
and dry out the vaginal canal by observing the vagina's
natural moisture, which can lead to minute tears and increase
(18:06):
the chance of t SS. Nowadays, though we don't hear
as much about toxic shock syndrome, it seems like when
we hear about it, it's things like you and I
were talking about, like, oh my gosh, you've hit peobody,
you started your period, you've started to use tampons, and
you just read about it as some weird, abstract, scary,
nightmarish thing in an insert and in reality it is
(18:28):
a bit of an abstract thing because it has such
a low incidence rate. For instance, in two thousand one,
according to stats from the CDC, the annual incidents rated
TSS was one to two cases per one thousand women
from fifteen to forty four years old, but that staff
doesn't say whether or not it was tampon related during
(18:52):
this time. A less common form, the non menstrual TSS,
did stay fairly constant from ninety nine to and like
we said, that's often associated with hospitalization and surgical procedures.
But what's up with the decline after the eighties? You know,
we talked about how you know, there's increased awareness you know,
women women uh no to maybe take better care when
(19:13):
they're using tampons um The c d C. You see
Berkeley report that we sat it earlier from cites the
decrease in tampon absorbancy, the standardized labeling required by the
US Food and Drug Administration, greater awareness like we said
about the disease, and the proliferation of educational materials for women,
including those scary tampon package inserts. However, of the minstrual
(19:40):
cases of TSS continue to affect women thirteen to nineteen,
and age group that maybe needs more education, maybe because
TSS has been out of the mainstream news for so long.
This younger group of women is more prone to get
it because they just haven't been hearing about it. Yeah,
and then we need to know about how to what
it is and how to prevent it. And not to
(20:02):
say that the only way you can prevent it is
to would never ever ever wear a tampon, But it's
just knowing how to take care of your body, you know.
It's it's simply not good for you to leave a
tampon in for a really long time. Right. You would
change a bandage on your arm frequently, wouldn't you. Yeah,
And that's actually one other tip that the Mayo Clinic
offers for t SS prevention because any place that you
(20:25):
have an open wound like that, you have the opportunity
for bacteria to get in there for some kind of
staff infection to develop into t s S. So it's
more than just tampons, hooray, but it's also tampons. It's
also tampons. So to to cal many fears, we can
(20:46):
say that t S S, while it does have a
scary range of symptoms and candy fatal, is extremely rare,
and that tampon technology has certainly improved and if you
are not comfortable with tampons. There are plenty of other
options out there, such as pads, uh, menstrual cups, reusable pads. Yeah. Maybe.
(21:10):
I mean, if if this is something that really worries you,
the next time you go talk to your doctor, just
ask him or her about it, maybe find out some
stats or some opinions or just some suggestions. Absolutely. So
I hope that answers and you know, all questions about
toxic shock. And remember men, you are not immune as well. Yeah,
(21:30):
so there you go, toxic shock, not just tampons. Uh.
So I would like to hear from other women, especially um,
whether or not they had similar experiences as Caroline and
I did with kind of being freaked out about what
is this t S S thing? Are these tampons gonna
kill me? Yeah? But I mean, hey, I'm I'm twenty nine.
(21:53):
I haven't had any problems with tampons. Knock on wood,
knocking on wood. Well, then, as your letters, mom, stuff
at Discovery dot com is the email address, so you
can also hit us up on Facebook and now here's
some letters. Well, I wanted to share a heartwarming letter
that we got from a vy in response to our
(22:15):
podcast from October about peggeria. A V writes the quote
you read from I think her name was Hayley was
a little girl in England with peggeria. It really rang
true with me. She said that if she had three wishes,
she would in fact not wish away her progeria. Personally,
I have something called Marfan syndrome, which is a genetic mutation,
(22:36):
and it affects the physical appearance and can be life
threatening in certain cases. I too have been asked would
I rather not have this mutation? If I had the choice, yes,
I would be better off physically, I'd be healthier, and
I would have fewer restrictions. But I would not be
the same person. I would not be as sensitive and
caring and kind as I am now, and I wouldn't
empathize with others in hard situations. So I wouldn't trade
(22:58):
my experiences for anything. My disease slash syndrome shaped me
into who I am today. I know it sounds a
little cliche. Lastly, I firmly believe that any hardship that
has put onto you can help you get where you
need to be and forces you to grow where otherwise
you wouldn't have. It's a little inspiration from Maybe Thank you,
(23:19):
and I have an email here from Robert about our
Black women at the Oscars episode. He says, near the
end of the podcast, I heard you guys mentioned Carrie
Washington as the star of the show Scandal. I thought
it might have been worth mentioning that one of the
show's producers is Shawna Rhymes, who is also the creator
of Grey's Anatomy and Private Practice, and Irene Kara, who
(23:39):
was the first black woman to win a Non Acting
Academy Award in for the Best Song Flash Dance. What
a fee then, and he says, keep doing what you're doing. Thanks, Robert,
You keep doing what you're doing with with feeling. I
wish you'd keep builting out that too, nice lebrato. Yeah,
(23:59):
I mean I do sing that song every night before bed. Well,
thanks to everyone who's written in to mom Stuff at
Discovery dot com. Keep your letters coming. You can also
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go over to Facebook if you haven't been there already,
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(24:20):
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(24:42):
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Welcome to Stuff Mom Never Told You from how Stop
Works dot Com. Hello, and welcome to the podcast. I'm
Kristin and I'm Caroline and Caroline. Today, let's tackle a
question that has crossed the mind's probably every menstruating woman.
(00:32):
What is that tampon's tampons and whether or not tampons
caused toxic shock syndrome? And what is toxic shock syndrome? Anyway,
this is a basic question that we really have not
addressed in the eight thousand episodes of Stuff Mom Never
Told You. We have done, even though we've talked about
(00:54):
tampons and plenty of times, we've talked about menstruation plenty
of times, but toxic shock syndrome, as a listener kindly
pointed out, is something that we have not directly addressed.
And I remember when I was a young lass and
I found a box of my sister's tampons, and you
(01:14):
know that that sheet that they have inside, Yes, the
answer to the insert with the diagram of the female
pelvis and how you put a tampon in, and then
in bold letters you see toxic shock syndrome. And in
my mind, I thought these are very dangerous. Why would
women do this to themselves. I was scared. Well, I
(01:36):
remember reading the insert because my you know, I've said
before in the podcast that my mother never had a
sex talk with me and that I was just kind
of left to my own devices slash romance novels to
figure things out. And it was the same thing with tampons,
like she handed me a box and or she bought
me a box, and I think left it strategically on
my bathroom counter. And so I followed the diagram to
(01:56):
a T down to like Chris, and I laid down
on the floor to insert my first tampon. I was like,
so scared. I was like, how do I It's it's
pointing strange. I'm pretty sure I did that as well.
But yeah, I I read the insert and I read
the thing about toxic shock syndrome, and I was like, Holly, Molly,
what is this. I'm gonna die if I put in
too many tampons. But I mean I think because of that,
(02:19):
I changed my tampon like way more than necessary every
thirty minute. Yeah, yeah, I don't. The thing about the
the insert is that you come away knowing that something
terrifying called toxic shock syndrome exists. And that you could
potentially die from it, but it doesn't really tell you
what your chances are and what it is. So before
(02:41):
we get into toxic shock syndrome, let's go over very
briefly when we started using tampons to begin with, because
obviously administruation is not a new thing, and we've been
improvising up until the nineteen thirties when tampons became mass marketed.
(03:04):
But before tampons, Caroline, what kind of stuff were women
using during men's struation? Just any old thing like what
like what Egyptians Kristen in the fifteenth century BC. Well,
they used softened papyrus, so you'd write a note to
your friend and then after after she read it, you
just you just slug up that keep it there um.
(03:27):
In Rome they used wool. Japan they had paper held
in place by a bandage, which the name for that
bandage was the Japanese word for pony id. Just like
to point out, I like that and you would change
it ten to twelve times a day. I mean, how
do you have time for anything else? But anyway, Indonesia
they use vegetable fibers. In Equatorial Africa, rolls of grass,
(03:47):
Hawaii people would use a furry part of a native
fern called the hapoo, and other grasses, mosses and plants
all throughout Asia and Africa. Yeah, and in the US,
as more revealing clothing styles came into vogue, Uh, it
spurred the need for internal period absorbers. When I'm talking
(04:12):
about tampons, because when you were wearing bustles and lots
of quinoline and such, uh, you could get away with
wearing a pat all the time. But then once the
silhouette became more close cut to the female body than you, uh,
the need for the for tampons increased. And fun tadbit
(04:35):
that I did not know about was that after World
War One there was greater interest put in developing tampons
because there was this highly absorbent surgical dressing called sell
you Cotton that needed a new market after the war ended,
and what can you make with absorbent surgical dressing? T
(05:00):
And there's been a lot of technolog technological development around tampons.
Dr Earl Hass was the first to develop an applicator,
a little cardboard applicator, because his wife was having so
many problems with the bulky pads and adult diaper type things. Yeah,
and the idea came to hass after he talked to
a friend of his in California who used a vaginal
(05:22):
sponge for her periods. Um. Yeah, has actually sold the
patent to Gertrude Tendrick, a German immigrant who became tam
PACs is first president. She made the tam PACs on
her sewing machine at home. Yeah, has said a little
bit of a sad story because he had his patent,
he couldn't really do anything with it. And then savvy
(05:44):
Gertrude comes along, buys it up forty two dollars and
builds the tamp PACs empire. And it was really in
the mid to late n Thanks to Tampacs with that applicator,
the tampons started to become more readily available and more
widely used, and everything was all fine, well and good
(06:06):
tampons were just chugging along. Tampacs and other companies are
figuring out how to make more absorbent tampons and so
you don't have to change the tampons all the time.
And then all of a sudden, in the nineteen eighties,
a lot of stuff goes awry. Yeah, all of these
lawsuits started cropping up because toxic shock syndrome emerge. Yeah.
(06:29):
Toxic shock syndrome was first officially identified in nineteen seventy
eight in a study, but it wasn't the kind that
we would think of as related to to tampons. It
appeared in seven kids between eight and seventeen years old.
The study was published in the Lancet Journal, and in
(06:49):
nineteen eighty the Centers for Disease Control and Prevention began
investigating some follow up reports of fifty five toxic shock
syndrome cases and they noticed a pattern among the women
because of that group was female, and of those of
(07:11):
women who came in with t s s, we're on
their period. Yeah. A CDC and u C. Berkeley report
from n talks about this time and says that toxic
shock syndrome emerged as a result of changes in industry
and personal behavior, but responded to rapid public health action,
(07:33):
including active surveillance. So all of a sudden, these people, men, women, children,
menstruating women, non menstruating women, women who used tampons, women
who didn't use tampons. People were all of a sudden
having this disease, this problem, and so people, researchers doctors
responded pretty pretty quickly to the outbreak. Yeah, and the
(07:54):
CDC investigation in some additional case studies implicated rely p
are brand of super absorbent tampons, and in September of
nine eight, rely pr Is pulled off the market voluntarily
because of this t s S problem. And the thing
in the tampons that the CDC suspected was causing the
(08:17):
problems was a polyester foam that was cross linked with
another synthetic fiber, and it's a combination that's no longer
used in tampons and in polyakrelate containing tampons were also
withdrawn from the market because of concerns over toxic shock syndrome.
(08:38):
And we should highlight yet again that those rely pair
tampons were the super absorbent kind uh and women may
have been leaving them in longer and and as a
result of this tampon tampon gate n eight, there was
a flurry of media reports about the dangers of tampons
(09:00):
because doctors still weren't entirely sure and really still aren't
today what the connection between tampons and toxic shock syndrome was.
They knew it had something to do with a super absorbancy,
perhaps women leaving them in their vaginal canals longer, and
also those synthetic fibers. But for instance, the New York
Times called it a baffling disease that was thought to
(09:22):
be linked to the reversal of blood flow, and in
November of nineteen eighty, the Times also reported toxic shock
amongst six hundred and fifty two people with sixty three fatalities.
But we should point out around this time that after
the Rely brand tampons were pulled, TSS cases continued to
be reported, so it wasn't like it was just Rely
(09:44):
or just super absorbent tampons. Up to sixteen percent of
the reported cases after the fact after Rely pulled its tampons,
up to sixteen percent of these cases we're in children, men,
and non menstruating women, and usually were associated the localized
staff infection, so it's not just like you know, leaving
(10:05):
a tampon in too long. There are also links to surgery,
especially like transplant type surgeries, but the legacy, the public
legacy of toxic shock syndrome isn't something about what happens
perhaps on the operating table, but more so continually linked
to tampon's kind of the same way that intra uterine
(10:27):
devices still battle a negative reputation that they got in
the seventies and eighties when one particular brand had a
negative impact on I forget what the specific uh side
effect was for women um. And in two for instance,
(10:48):
the first federal jury award of nineteen thousand dollars was
doled out to a woman who contracted TSSUM after using
plate Tex brand tampons. And there were more than four
d other victims of toxic shock who filed suit against
Procter and Gamble, which were the makers of the rely
pr campons. And I mean around this time, it was
(11:10):
sort of a cycle because all right, so people, men, women,
children start contracting this disease somehow, this this crazy disease
that has all of these scary symptoms, uh, and that
was fatal some of the time. So the media starts
reporting on it. Tampons are an interesting angle. The more
the media reports on it, the more cases are reported.
(11:30):
So it's the cycle of like, oh my goodness, so
you you do have to ask, and researchers did ask, like, uh,
is this a case of their being more or is
this a case of the reporting just kind of crystallizing
and coming together and realizing, Okay, what we may be
thought was something else is actually toxic toxic shock syndrome.
(11:50):
So they looked at the death rate, the fatality rate
of this disease, and it does, it does ramp up.
Eighty eight deaths were known who have occurred in nineteen
eighty two, which was the time of the Institute of
Medicine report being written about this. It was the first
major report about toxic shock syndrome. They found that before
(12:11):
nineteen seventy nine, fifteen people were reported to have died
from TSS, thirteen in nineteen seventy nine, forty four in
nineteen eighty and fifteen in n one. So there's definitely
like a bell curve, but a lot of that has
to do with increased awareness. So the increased awareness is
a double edged sword. More more cases are being reported,
(12:32):
but also more women are aware of how to safely
use tampons so and maybe go to their doctor when
they noticed symptoms. And it does improve the industry in
terms of getting products off the market that turn out
to not be so good hanging out inside of your vagina.
But one thing we have not addressed yet, Caroline is
(12:53):
what is toxic shock syndrome anyway? Yeah, so you know,
as much as there was a giant scare in the eighties, uh,
and a lot of people were talking about it. TSS
is actually a rare bacterial infection that is historically associated
with the use of super absorbent tampons and occasionally with
the use of contraceptive sponges um. Often it results from
(13:17):
toxins produced by wait for it, I'll pronounce it staphylo
caucus aureus staff bacteria, but the condition may also be
caused by toxins produced by group A strepped a caucus
bacteria or strep. So basically, if you have had doctors
say that if you have had a previous staph infection
(13:38):
or really severe strep infection, you just should not use tampons,
like as a general rule, like if you have had
a very severe previous infection of this type. And I mean,
you know, kids, we've all had strap before, but they're
talking about like, if you've had something really severe as
an adult, you should probably avoid tampons because of that bacteria.
And it's characterized by having a fever, the shock and
(14:02):
problems with the functions of several bodily organs, which is
why it is so fatal. It can be fatal enough
to of cases. And do I need to even go
through the symptoms because they're wide ranging and similarly upsetting, well,
one of them, one of them. Okay, yeah, this is like,
this reads like the worst webin D entry ever. You know,
(14:24):
webin D. It's always cancer. But so well, I guess
we don't need to go into everything. But one particular
sign of TSS is a widespread red rash that looks
like a sunburn with skin peeling that occurs one to
two weeks after the rash, particularly on the palms of
the hands and the bottoms of the feet. And this
occurs also you know, there's there's hypotension with a high fever, headaches,
(14:48):
So it does affect a large portion of the body. Yeah,
and that's why you know it can be challenging to
diagnose UM and why you know looking for rash is
important because otherwise, you know, you might have symptoms like headache, fever, diarrhea,
low blood, sugar, muscle eggs, which could be any number
(15:09):
of things. And like you said, if you get to
women D, probably cancer of your entire body. Um. But
one thing to emphasize is that yes, men can develop
it too. We've said it before in about of toxic
shock cases. It affects non menstreating women, which includes men, kids,
and post menopausal women. Now, as far as prevention, uh,
(15:34):
it's some common sense stuff that you should keep in mind.
If you use tampons and you know you're a menstuating
woman in general, Uh, you need to change your tampons frequently,
at least every four to eight hours, and consider using
the lowest absorbency tampons. You can't. I always use just regular,
non scented because you know, we all, we've all we've
(15:55):
talked about scented things in the podcast. To try to
alternate pads and tampons and avoid using tampons at all
when your flow is very light. And the thing is
and I'll rely re emphasize this toxic shock syndrome can recur,
so if you've had it before or a prior serious
strep or staff infection, just try not to use tampons.
And the reason why doctors will urge you to change
(16:17):
your tampons regularly is that left in place, they become
a breeding ground for bacteria. And with those super absorbent
fibers to the tampons might be able to scratch the
surface of the vagina, making it possible for bacteria or
their toxins to enter the bloodstream. So it can set
you up for some some bad stuff going on. But
(16:39):
if you're now saying, well, oh, I'm just gonna stop
using tampons, no, it's not a thing that you have
to stop using tampons. TSS is extremely rare. This shouldn't
be some kind of scare tactic, you know, away from
tampons um. But one other way, though, if you are
worried about toxic shock, menstrual ups might be a good alternative.
(17:02):
Go ask Alice that we've started many times over at
Columbia University and other sources will confirm that menstrual cups
might be one way to lower your risk of that.
But again, though, because of the fact that these cases
can happen outside of the realm of menstrual products, you know,
it's it's not just that that we need to pay
(17:24):
attention to. Even though when we think of toxic shock
a lot of times, the next thing we think of
is tampons and periods. Right, there's also reusable cloth paths,
but those don't really necessarily prevent toxic shock syndrome either.
It's just that the risk is probably slightly lower than
with tampons. Um glad Rags, who are the makers of
(17:45):
one type of reasonable cloth pad, say that their product
is a safer option because blood is not staying in
the vaginal canal where the development of TSS is most
likely to occur, while the risk is still minimal. Tampons
create more ideal opportunity for the growth of these bacteria
and dry out the vaginal canal by observing the vagina's
natural moisture, which can lead to minute tears and increase
(18:06):
the chance of t SS. Nowadays, though we don't hear
as much about toxic shock syndrome, it seems like when
we hear about it, it's things like you and I
were talking about, like, oh my gosh, you've hit peobody,
you started your period, you've started to use tampons, and
you just read about it as some weird, abstract, scary,
nightmarish thing in an insert and in reality it is
(18:28):
a bit of an abstract thing because it has such
a low incidence rate. For instance, in two thousand one,
according to stats from the CDC, the annual incidents rated
TSS was one to two cases per one thousand women
from fifteen to forty four years old, but that staff
doesn't say whether or not it was tampon related during
(18:52):
this time. A less common form, the non menstrual TSS,
did stay fairly constant from ninety nine to and like
we said, that's often associated with hospitalization and surgical procedures.
But what's up with the decline after the eighties? You know,
we talked about how you know, there's increased awareness you know,
women women uh no to maybe take better care when
(19:13):
they're using tampons um The c d C. You see
Berkeley report that we sat it earlier from cites the
decrease in tampon absorbancy, the standardized labeling required by the
US Food and Drug Administration, greater awareness like we said
about the disease, and the proliferation of educational materials for women,
including those scary tampon package inserts. However, of the minstrual
(19:40):
cases of TSS continue to affect women thirteen to nineteen,
and age group that maybe needs more education, maybe because
TSS has been out of the mainstream news for so long.
This younger group of women is more prone to get
it because they just haven't been hearing about it. Yeah,
and then we need to know about how to what
it is and how to prevent it. And not to
(20:02):
say that the only way you can prevent it is
to would never ever ever wear a tampon, But it's
just knowing how to take care of your body, you know.
It's it's simply not good for you to leave a
tampon in for a really long time. Right. You would
change a bandage on your arm frequently, wouldn't you. Yeah,
And that's actually one other tip that the Mayo Clinic
offers for t SS prevention because any place that you
(20:25):
have an open wound like that, you have the opportunity
for bacteria to get in there for some kind of
staff infection to develop into t s S. So it's
more than just tampons, hooray, but it's also tampons. It's
also tampons. So to to cal many fears, we can
(20:46):
say that t S S, while it does have a
scary range of symptoms and candy fatal, is extremely rare,
and that tampon technology has certainly improved and if you
are not comfortable with tampons. There are plenty of other
options out there, such as pads, uh, menstrual cups, reusable pads. Yeah. Maybe.
(21:10):
I mean, if if this is something that really worries you,
the next time you go talk to your doctor, just
ask him or her about it, maybe find out some
stats or some opinions or just some suggestions. Absolutely. So
I hope that answers and you know, all questions about
toxic shock. And remember men, you are not immune as well. Yeah,
(21:30):
so there you go, toxic shock, not just tampons. Uh.
So I would like to hear from other women, especially um,
whether or not they had similar experiences as Caroline and
I did with kind of being freaked out about what
is this t S S thing? Are these tampons gonna
kill me? Yeah? But I mean, hey, I'm I'm twenty nine.
(21:53):
I haven't had any problems with tampons. Knock on wood,
knocking on wood. Well, then, as your letters, mom, stuff
at Discovery dot com is the email address, so you
can also hit us up on Facebook and now here's
some letters. Well, I wanted to share a heartwarming letter
that we got from a vy in response to our
(22:15):
podcast from October about peggeria. A V writes the quote
you read from I think her name was Hayley was
a little girl in England with peggeria. It really rang
true with me. She said that if she had three wishes,
she would in fact not wish away her progeria. Personally,
I have something called Marfan syndrome, which is a genetic mutation,
(22:36):
and it affects the physical appearance and can be life
threatening in certain cases. I too have been asked would
I rather not have this mutation? If I had the choice, yes,
I would be better off physically, I'd be healthier, and
I would have fewer restrictions. But I would not be
the same person. I would not be as sensitive and
caring and kind as I am now, and I wouldn't
empathize with others in hard situations. So I wouldn't trade
(22:58):
my experiences for anything. My disease slash syndrome shaped me
into who I am today. I know it sounds a
little cliche. Lastly, I firmly believe that any hardship that
has put onto you can help you get where you
need to be and forces you to grow where otherwise
you wouldn't have. It's a little inspiration from Maybe Thank you,
(23:19):
and I have an email here from Robert about our
Black women at the Oscars episode. He says, near the
end of the podcast, I heard you guys mentioned Carrie
Washington as the star of the show Scandal. I thought
it might have been worth mentioning that one of the
show's producers is Shawna Rhymes, who is also the creator
of Grey's Anatomy and Private Practice, and Irene Kara, who
(23:39):
was the first black woman to win a Non Acting
Academy Award in for the Best Song Flash Dance. What
a fee then, and he says, keep doing what you're doing. Thanks, Robert,
You keep doing what you're doing with with feeling. I
wish you'd keep builting out that too, nice lebrato. Yeah,
(23:59):
I mean I do sing that song every night before bed. Well,
thanks to everyone who's written in to mom Stuff at
Discovery dot com. Keep your letters coming. You can also
find us on Facebook. I had only urge you to
go over to Facebook if you haven't been there already,
and check out all the fun and wacky things that
we were up to, especially our photo projects. That's right,
(24:20):
if you are curious at all as to what Caroline
and I look like in fifties housewife costumes. Well, you
can go to our Facebook, please like us all you're
at it, and follow us on Twitter at moms Stuff Podcast.
You can also find us on Tumbler. It's stuff Mom
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(24:42):
you can find it at our website, it's how stuff
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