If you’ve learned about menstrual products in school, experienced menstruation, or purchased a menstrual cup or tampons, you’ve probably heard of toxic shock syndrome (TSS).

You may already know the safety protocol: follow the instructions of internal menstrual care products, clean and replace your product according to the hourly recommendation and speak to your doctor about any concerns related to TSS. Simple as that!

While the risk of TSS is low with the use of a menstrual cup, ensuring proper care of your menstrualcup and hygiene is important.

This blog will provide an overview of Toxic Shock Syndrome and menstrual cups. This blog is informational only and is not a substitute for medical advice. We recommend that you talk to your doctor about TSS-related concerns you may have prior to using the DivaCup.

What is Toxic Shock Syndrome (TSS)?

Toxic Shock Syndrome (TSS) is a rare, but serious syndrome caused when the toxin-producing strains of the Staphylococcus aureus bacterium gets into the bloodstream. In extremely rare cases, the strain may present itself with infection, linked to the use of internal menstrual care products or because of surgery or burns. When exposed to the strain, TSS may affect a small number of people.

Recent research shows that TSS is caused when both bacteria and oxygen are introduced into the vaginal canal. Menstruation changes the pH of the vagina and in rare cases this change in acidity could lead to an increase in the growth of bacteria, like that of TSS. Additionally, internal menstrual care products like tampons and menstrual cups introduce oxygen into the vagina, which may create a breeding ground for bacteria, and cause an infection like TSS.

Toxic Shock Syndrome and Menstrual Cups

Since menstrual cups are worn internally, the risk for TSS is present, but low. We recommend you follow the instructions in our User Guide. If you experience any discomfort, discontinue use of the DivaCup and contact your physician.   

There are several things you can do to ensure you are using menstrual cups safely and taking care of your vaginal hygiene. If you are new to menstrual cups, be sure to check out this blog post for some beginner tips.

Ensure Proper Care and Cleaning of your Cup

With every new DivaCup purchase it is important to boil the cup for 5-10 minutes before use. This instruction is noted both on our website and in our User Guide. This blog post has some great tips for cleanings dos and don’ts. Menstruators should use caution to thoroughly wash their hands prior to insertion and removal and wash the cup with warm water and the DivaWash at least 2-3 times a day (every 10-12 hours). While not a required step in the cleaning process, we do recommend boiling the cup in between cycles.

With regards to removal, it is important that you do not use any foreign objects to remove the DivaCup and to be careful when removing the cup if you have long or manicured fingernails. Always be sure to wash your hands thoroughly before removal and insertion!

Symptoms of Toxic Shock Syndrome

Below are a few of the toxic shock syndrome symptoms to watch out for:

• Sudden high fever
• Vomiting
• Diarrhea
• Dizziness
• Low blood pressure and rapid heartbeat
• Fainting
• Sunburn-like rash

If you experience any of the above while using an internal menstrual care product, we recommend discontinuing use immediately and seeking medical support.

In closing…

Toxic Shock Syndrome is serious and something menstruators should understand and be aware of. Proper hygiene, following usage guidelines and changing your cup often are all ways you can minimize risk. Using products by organizations who disclose ingredients and provide TSS warnings is also important.

Disclaimer: The content of this blog is based on research and information available at the time of writing. As new research is made available, we will work to update and adjust our content as appropriate. If you have general questions, or concerns related to your own individual circumstances, please contact our Consumer Support team, or speak to a healthcare practitioner for more specific questions about your individual circumstances.

Sources:

Vostral SL. (2011). Rely and Toxic Shock Syndrome: a technological health crisis. The Yale Journal of Biology and Medicine. 84(4), 447-459.

Vostral SL. (2018) Toxic Shock: A Social History. New York, NY: New York University Press.