By: Jessica Bethel MD, MPH & Megan Yanny, MD, FAAP

Your child has started her period and is curious about tampons. Tampons can be super useful as they can be used underneath
swimming or other activities where a pillow may not be practical or possible. Tampons are safe if used correctly. However, if left for too long, it can lead to a serious health condition called toxic shock syndrome.

Safe tampon use: tips to remember

If you choose to use a tampon, follow these tips to make sure you use them safely:

• Follow all instructions on the packaging.

• Wash your hands before and after going to the toilet and/or using menstrual products.

• Use the tampon with the lowest absorbency you need.

• Change your tampon every 4-8 hours (so consider using pads overnight if necessary!).

• Only use tampons when you have your period.

• Throw away your tampon after use – do not reuse tampons.

What is toxic shock syndrome?

Toxic shock syndrome (TSS) is a rare disease that can lead to organ damage (including kidney, liver and heart failure), shock and even death. TSS is caused by an infection where bacteria release toxins into the body.

The risk of toxic shock syndrome increases with unhealthy practices such as leaving a tampon in for more than 4-8 hours. Changes in how tampons are made and education about the safe use of tampons have reduced the rate of toxic shock syndrome.

Symptoms of toxic shock syndrome

Contact your doctor immediately if you feel you have symptoms of toxic shock syndrome, which include but are not limited to:

• Fever or chills

• Vomiting, diarrhea

• Headache

• Rash like a sunburn

• Confusion, fatigue

Other menstrual products: risks and safety tips

Menstrual cups

Recently, alternatives to tampons, such as menstrual cups, have become more widespread. These products are easy to find and use, like tampons, and can be used while swimming or playing sports. They are also reusable, which people may like as it can reduce waste and be more environmentally friendly than other menstrual products.

Often, menstrual cups are made with medical-grade silicon, which discourages the growth of bacteria. However,
bacteria can still grow on menstrual cups; toxic shock syndrome has been
reported in people who use these products.

See the specific guidelines for caring for your menstrual cup, but in general most products recommend:

• Wash the menstrual cup after each use with soap and water

• Boiling the menstrual cup between periods

• Removal of the product at least every 12 hours

Period underwear

Like menstrual cups, period underwear is a good option because of their reusability and is even easier to use. Because period underwear is outside your body, that’s it
not a risk of toxic shock syndrome. They still need to be cleaned or washed as directed on the packaging.

Remember

Tampons and other menstrual products are safe when used correctly. Refer to the product instructions if you are unsure of how best to care for or use them. Toxic shock syndrome is a rare but serious condition that can lead to organ failure, but the risk can be reduced with proper hygiene practices.

As always, talk to your pediatrician about any questions or concerns you have about menstrual products or toxic shock syndrome.

More information