Truth About Menstrual Cups & TSS

The Truth about Menstrual Cups and Toxic Shock Syndrome

Since the 1980s, public awareness has grown about the connection between period care products and something called Toxic Shock Syndrome. Nasty name, nastier condition. Cases of the life-threatening condition have been directly linked to tampon use, motivating many women to switch to a tampon alternative like menstrual cups. Using a menstrual cup instead of tampons drastically reduces your risk of TSS, although there has been one documented case of TSS associated with menstrual cup use (NOT OUR BRAND). Here are the facts.

What Is Toxic Shock Syndrome?

It’s a condition that occurs due to infection with Staphylococcus aureus and the resulting toxin it produces. The toxin—or superantigen—prompts chaos in the immune system. Initially, TISS manifests in symptoms:

  • Fever
  • Aching muscles
  • Sore throat
  • Swelling
  • A rash that peels 1-2 weeks after onset

This initial burst of outer symptoms belies the absolute pandemonium inside the body. The organs may begin to shut down, and blood can cease to clot effectively. Serious cases have resulted in the loss of organs or limbs and even death.

What Causes Toxic Shock Syndrome?

TSS has been linked to a number of specific contributors.

  • Skin trauma and micro-tears from tampon insertion and removal, creating an opening for bacteria and toxins to enter the bloodstream
  • Blood accumulating in the tampon. Yes, that's what tampons are designed to do, but the natural culture media of a bloody tampon can act as a petri dish in the warm, wet, air-filled environment of the vagina. Higher absorbency tampons are associated with a higher risk of toxic shock syndrome.
  • Increased vaginal pH

While strongly associated with tampon use, TSS has affected women who have discounted tampon use, as well as four men who contracted the condition after surgery, a dentist visit, or staph infection.

Menstrual Cups Association with Toxic Shock Syndrome

Menstrual cups have an extremely low rate of TSS, but the condition has been observed in cup users. Menstrual cups are non-absorbent and do not have fabric that could alter vaginal pH or create vaginal tears. If inserted properly, your menstrual cup will not create vaginal tears that could lead to further health complications. In general, TSS linked to menstruation occurs at a rate2 of 69/100,000. When not menstruation-associated, its incidence rate is 0.32/100,000. Both rates are extremely low, but menstruation does increase the risk by a factor of two.

To reduce your chances of TSS:

  • Wash your hands thoroughly before and after inserting your cup
  • Insert the cup carefully and gently, being as kind to the delicate skin of your vagina as possible so as not to cause tears
  • Clean your menstrual cup carefully between uses, and sanitize thoroughly. Store the cup in the provided bag to allow moisture evaporation, and never in a sealed plastic container.