If you menstruate and use tampons, you’ve probably seen a warning label on or inside the box about the risk of “toxic shock syndrome.” Seeing that label for the first time can be jarring. “Wait, these things can be dangerous?” you might have wondered.
The good news is that while toxic shock syndrome (TSS) is serious, it’s also very rare, affecting fewer than one of every 100,000 tampon users in the U.S.
It’s also important to know that the Food and Drug Administration (FDA) regulates tampons as medical devices, which means they are held to more stringent safety standards. This is critical since tampons go inside the body and are in constant contact with delicate mucosal tissues.
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Are there other risks with using tampons, and how can you protect yourself? We break these questions down below.
What are tampons made out of?
Tampons cleared by the FDA are made of cotton, rayon, or a blend of the two. Both materials are considered safe for internal use. Tampon fibers are made with a non-chlorine bleaching process, which the FDA also says is safe.
Tampon safety concerns
Still, most tampons do contain very low levels of dioxin, a known carcinogen. While the FDA says dioxin levels in tampons are not harmful, some experts have expressed concern.
In 2021, a microbiology professor at New York University warned Time Magazine about the cumulative effects of dioxin, saying that low levels of exposure can add up over a lifetime of tampon use, increasing a person’s risk for disease.
The main issue is that chemicals in tampons can easily pass through delicate mucosal tissue inside the vagina and into the bloodstream without being filtered.
By contrast, chemicals that are swallowed (in foods, for example) go through a metabolic process in the digestive tract, which helps break them down before they pass into the bloodstream.
How to use tampons safely
So, is it safe to use tampons? The short answer is yes, when used properly.
There are things you can do to minimize your risk of developing toxic shock syndrome and other health problems (like bladder infections). Here are some guidelines, but be sure to talk to your doctor about any concerns you may have:
Wash your hands before inserting a tampon.
Toxic shock syndrome results from toxins produced by certain kinds of bacteria. Washing your hands thoroughly before and after inserting a tampon can help prevent the spread of these bacteria.
Change your tampon every 4 to 8 hours.
Tampons don’t have the bulkiness of pads, so it’s easy to forget about them. Yet it’s important to change your tampon every 4 to 8 hours. Bacteria can grow on a tampon that is left in for too long, increasing your risk of bladder infections and TSS.
If possible, use a menstrual pad at night when you sleep in instead of a tampon. If you must wear a tampon overnight, change it right before bed and right when you wake up.
Use the lowest absorbency tampon possible.
High-absorbency tampons (labeled “super” or “super plus”) can lead to vaginal dryness, which reduces the amount of protective lubrication in the vagina, increasing the risk of TSS. On days where your period is light, or if it hurts to remove a tampon, use a lighter absorbency.
Only use tampons when you have your period.
Using a tampon when you’re not menstruating can cause vaginal dryness, which can increase the risk of TSS.
Change your tampons after you go number two.
Even if you are diligent about wiping properly after a bowel movement, it’s still possible for fecal bacteria to contaminate the tampon string.
Lingering bacteria can lead to vaginal and urinary tract infections. Always change your tampon after going number two.
Only you can decide whether tampons are right for you. Talk with your doctor to understand the risks and benefits.
Want more great content?
Check out the Tigress podcast hosted by Nadya Okamoto—a champion for menstrual equity
and mental health. Nadya muses about where she’s been, where she’s going, and how she’s learning to channel her inner tigress.
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