You may have seen warning labels about TSS on a tampon box and wondered what it is, what causes it, and how to avoid it. To put it simply, toxic shock syndrome is a bacterial infection which can be dangerous and even life threatening. It’s not very common especially now that menstrual products are made of safer materials with clearer labelling for use, but it can be very serious! This post will talk through what it is, how to recognize it, and how to avoid it.
TSS can be caused by Staphylococcus aureus (most commonly referred to as staph) or streptococcus (commonly referred to as strep). TSS is most commonly thought to be caused from leaving tampons in for too long, but can actually also develop from wounds, surgeries, or having other foreign objects in the body like contraceptive sponges. While incorrect use of menstrual products can create an environment for bacteria to thrive and multiply in, it doesn’t mean you need to throw away your period products. Instead, be careful that you are using period products correctly.
Some symptoms of toxic shock syndrome are:
TSS shares symptoms with a lot of other illnesses, and might even start off feeling like a normal flu but it tends to progress pretty quickly. A high fever and vomiting are usually more obvious signs, especially if they happen while you’re on your period or are recovering from surgery.
Most cases of TSS occur in people who are menstruating. Menstrual products like pads and tampons can help bacteria in a vagina* grow which can create an infection. This is why tampon/pad safety is so important.
1. Understanding your products
When you get a box of tampons, pads, or liners, read the box to find out how much blood it was designed for. If you have lighter periods, consider sticking to lower absorbency pads and tampons and try only using heavy flow products when necessary. Heavier flow products tend to absorb more than just period blood, and can actually dry out your vagina*. With less fluid to lubricate things, the likelihood of tearing increases which can make it easier for bacteria to get into your bloodstream.
Some people might prefer to use heavy flow products and change them less frequently, but using any menstrual product for longer than recommended even if it’s not full of blood, can create an environment for bacteria to thrive. That’s why it’s safest to use the right product for your needs, and use it as directed.
Menstrual cups and tampons are usually the most common products associated with TSS, but all menstrual products may pose a bit of a risk if they’re used incorrectly. If you’re unsure which product might work best for you, check out our Period Products post to learn more.
2. Changing frequency
Frequently changing period products is an effective way to prevent the overgrowth of bacteria on a pad, tampon, or liner. It’s usually best to change your tampon every 4-6 hours. It’s never recommended to wear the same tampon for more than 8 hours at a time–the lack of airflow and warm environment can cause bacteria to thrive and multiply. Try your best to change your tampon regularly.
Pads follow similar guidelines with recommended wear between 3-4 hours. If you’re exercising or it’s especially hot out and you’re sweating, you’ll likely have to change them more often. If you find you’ve run out, many public washrooms will have tampon dispensers, especially at places like community centres, healthcare buildings, and universities.
While toxic shock syndrome is extremely uncommon, it can be very serious. Being diligent about period management and wound care is the best way to avoid TSS or other infections. Remember TSS is fairly rare–only a few cases of TSS are reported in Canada every year–but it’s also not often taught or talked about which means people might be unsure of how to avoid it. Posts like this are meant to spread awareness, not fear! Access to free or affordable menstrual products can also contribute to more TSS cases, thankfully resources like Period Pin exist to help Canadians find free menstrual products near them.
If you have questions about this topic, feel free to contact one of our peer educators. [Link]
*We know that these aren’t the words everyone uses for their bodies (eg. trans folks), and support you using the language that feels best for you
Last Edited: July 2026
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