Tampon Risks

Toxic shock syndrome is still a risk today, but a far lower risk than it was.

The exact link between toxic shock syndrome (TSS) and tampons has never been completely understood. Between 1979 and 1980, when cases peaked and alarm bells rang, it was found that some women who had used highly absorbent tampons had a toxin-producing strain of the Staphylococcus aureus bacterium. Proctor & Gamble took the lion’s share of blame for their Rely brand, though other super-absorbent tampons were also associated with risk.

Incidence dropped dramatically once tampons made from polyester foam and cellulose were taken off the market. In 1980 there were 813 reported cases, which included 38 fatalities; by 1997 there were only six reported cases.

“Currently, menstrual toxic shock represents only about half of all cases of toxic shock in the U.S.,” says Dr. Paula Hillard, professor of Obstetrics and Gynecology at the Stanford University School of Medicine. To lower your own risk, use tampons of the minimum absorbency your flow requires and alternate regularly with a pad. “Women should know signs and symptoms of TSS but not be freaked out by tampons,” says Hillard, noting that U.S. Food and Drug Administration regulations require warning signs to be included with tampon packaging.

Alternatives are available, though they’re not for everybody.

Silicone cups are an appealing alternative for some women. The cups hold menstrual blood rather than absorbing it like a tampon does—and, with no paper waste, they’re more environmentally friendly. “The Keeper” has been FDA-approved, though it is not as well-tested as tampons. Theoretically, it carries some risk of TSS as tampons do. If the cup fits you well and you experience no leakage, you may like it.

Another option is stop the flow at its source. The birth control pill Lybrel became available in July 2007; in addition to preventing pregnancy, it’s designed to virtually eradicate monthly periods (though not without some controversy). Speaking strictly in medical terms, Hillard says, “Current evidence indicates that the pills are not unsafe for most women, and for women with moderate or severe pain with periods … the reduction of [menstrual cycles] can be a major benefit.”

You are more likely to be exposed to dioxins by eating meat or fish.

A stubborn myth persists that dioxins in tampons—potentially cancer-causing chemicals—represent an ongoing threat to women’s health. Now, dioxins are pollutants, so unfortunately they exist in our air, water and soil. Animals are naturally exposed, and the dioxins stored in their fat cells can climb the food chain.

Because tampons are now manufactured using plant-based materials—cotton and/or rayon, which is derived from wood pulp—sensitive tests have detected trace amount of dioxins in tampons. The FDA maintains that the detected amount, which is between .1 and 1 part per trillion, is so small that “any risk of adverse health effects is considered negligible.” (For perspective, the FDA notes that 1 part per trillion is like 1 teaspoon in a lake 15 feet deep and one mile square.) Some of the raw materials used to make tampons are bleached to remove impurities, but the bleaching process that may have been a source for dioxins hasn’t been used for years.

Tampon manufacturers are not out to get you.

For a few months in 1999, email boxes lit up with a story about tampon manufacturers using asbestos in their products to make women bleed more (and therefore buy more tampons). It made a helluva story, but the Internet buzz was pure rumor.

Teens may be more apt to misunderstand how tampons are best used.

“The guidelines I give to teens are not to use them 24/7, and also to change them regularly,” says Hillard. “Some girls hate to use the public restrooms at school and will go for eight or more hours without changing. That’s not so good. Changing regularly, wearing a pad at night, using appropriate absorbency tampons, not forgetting the last tampon of each period, and knowing the signs and symptoms of TSS will help women and girls use tampons safely.”

Hillard notes that mothers should be reassured that tampons are safe for their teenage daughters. However, “There is a learning curve, so I tell a teen who wants to try tampons not to wait until five minutes before she leaves to go swimming to try it for the first time. It takes some practice.”

Tampon use does not affect virginity.

Says Hillard, “The hymen is very stretchy, and there’s no way to tell for sure if a woman has had intercourse by examining the hymen—which doesn’t really determine virginity anyway.” Women needn’t be concerned that using tampons will bring their chastity into question or keep them from getting into heaven.

Tampon Risks has been reviewed for accuracy by Dr. Paula J. Adams Hillard, professor in the department of Obstetrics and Gynecology at the Stanford University School of Medicine.

Confused by health myths and misinformation? Each week, Rich Maloof talks to leading health experts to bring you the straight facts on a broad range of health topics.

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Rich Maloof is a regular contributor to MSN Health & Fitness. He specializes in health as well as technology and music. Rich has also written for CNN, Yahoo!, Women's Health, Billboard and the “For Dummies” book series.