TSS Information


What is TSS?

Toxic Shock Syndrome (TSS) is a rare but serious illness that may cause death. It is caused by a toxin (a kind of biological poison) which is produced by a type of bacteria (Staphylococcus aureus). These bacteria are found in the nose of about one-third of the population. They may also be found on the skin, and occasionally in the vagina, without causing harm.

Who is at risk?

TSS can occur in both males and females of any age but is more common in young women who use tampons during their period.

What are the symptoms of TSS?

The early symptoms of TSS may begin suddenly and are similar to the ‘flu’. Remember, early recognition of these symptoms is very important.


What must I do if I think I have TSS?

If, during your period or shortly after, you have any of the above symptoms, REMOVE YOUR TAMPON AND SEE A DOCTOR IMMEDIATELY. Remember it is very important to tell the doctor that you have been using tampons.

If you have ever had TSS, you should not use tampons until you have discussed the matter with a doctor. You may not have developed resistance to the toxin and could get TSS again.

How does TSS occur?

If the toxin is produced in the vagina or a wound, and absorbed from there into the bloodstream, a person who is not resistant to the toxin may become ill. Most people develop resistance to the toxin (that is why the illness is so rare) and in these people there is no harmful effect.

The symptoms of TSS may develop rapidly. Early recognition and treatment of these symptoms can usually prevent serious illness.

Do tampons cause TSS?

The simple answer is no. Tampons do not carry the bacteria which cause TSS. However, tampon use has been associated with an increased risk of TSS. Although TSS can occur with the use of tampons of any absorbency, the risk increases with the use of tampons of higher absorbency.

Please note that tampons are not sterile and neither are your hands or vagina. Tampons, while containing very small amounts of bacteria normally present in the air, have not been shown to carry the bacteria which causes Toxic Shock Syndrome (TSS).

Where can I get more information about TSS?

More information can be found on the Ministry of Health website or speak to your doctor.


Your Tampon Guide

  1. Select the lowest absorbency tampon needed to suit your flow.
  2. The first step before inserting a tampon is to wash your hands thoroughly with soap and water. Repeat this step after you have inserted the tampon.
  3. The green coloured ring on the tampon wrapper indicates the location of the tear strip - tear this open to unwrap the bottom half of the tampon, then unwind the tampon string.
  4. You can check the string is securely attached by tugging on the string.
  5. Now holding the bottom of the tampon, you can remove the remaining half of the wrapper.
  6. Before you insert the tampon, make sure you are in a comfortable position, take a deep breath and relax your muscles. Some people find a comfortable position is to stand with one leg propped up on the side of the toilet lid.
  7. Insert the tampon with your finger at an angle towards your lower back.
  8. If the tampon is inserted properly, you should not feel it.  If you can still feel the tampon, it may need to be inserted deeper or at a different direction.
  9. With the tampon now inserted and the withdrawal string hanging outside the vagina, you can leave it in for up to 4 hrs.
  10. Remember, you when you're finished wash your hands thoroughly!

How to change your tampon

  1. To withdraw your tampon, lightly tug on the string - if the tampon moves easily, it is ready to be removed. If it does not move, then there is no need to change. Tampons are easiest to remove when when they are fully saturated.
  2. Before you remove the tampon, take a deep breath and relax and then gently pull the tampon string. The tampon will slide out.
  3. Remember you must always remove your current tampon before inserting another one.
  4. When your period is over, remember to remove the last tampon.

Note: How often you need to change your tampon will depend on the heaviness of your flow but we recommend you change your tampon 3-6 times a day. Never leave a tampon in for more than 8 hours.

Note: If you cannot find the tampon string tampon it can usually be reached from a squatting position using your fingers.

How do I find the right sized tampon?

The heaviness of period varies from women to women, and may change from month to month. The Necesse tampons are available in size regular and super:

  • Our Regular Organic Tampons can absorb between 9 and 12 grams — they are suitable for medium flow
  • Our Super Organic Tampons can absorb between 12 and 15 grams — they are suitable for heavy flow
  1. Select the size that suits your individual flow and always choose the smallest size to lower your risk of developing TSS.
  2. If you need to change it more often than that, try a larger size tampon with a higher absorbency rating.
  3. If you experience discomfort when changing your tampon and the tampon still shows white after the recommended time, try a smaller tampon size.
  4. Never exceed 8 hours of use with a single tampon.
  5. Do not use tampons overnight.

Precautions for tampon use

  • You should use the lowest absorbency tampon for your comfort and level of blood flow. Use only one tampon at a time.
  • Wash your hands before unwrapping and inserting a tampon, and again afterwards.
  • Unwrap a fresh, clean tampon just before use—do not handle it more than necessary or place it on any surface.
  • Do not insert a tampon if it hurts to do so.
  • Removal of the tampon should be easy: if the tampon is dry and difficult to remove, the absorbency is too high or the tampon has not been in place long enough. Tampons should be changed as often as you need but should not be left longer than 8 hours.
  • Remove the used tampon before inserting the next one and do not forget to remove the last tampon used at the end of your period.
  • Only use a tampon when you are menstruating.
  • Ask a doctor if it is okay to use tampons if you have recently given birth, had a caesarean section, a miscarriage, an abortion or any operation on your reproductive system.