By: Jessica Bethel MD, MPH & Megan Yanny, MD, FAAP
Your child has started their period and is curious about tampons. Tampons can be super helpful, since they can be worn during
swimming or other activities when a pad might not be convenient or possible. Tampons are safe if used properly. But if left in too long, can lead to a serious health condition called toxic shock syndrome.
Safe tampon use: tips to keep in mind
If you choose to use a tampon, follow these tips to make sure you are using them safely:
Follow all directions on the packaging.
Wash your hands before and after using the restroom and/or using menstrual products.
Use the lowest absorbency tampon you need.
Change your tampon every 4-8 hours (so, consider using pads overnight potentially!).
Only use tampons when on your period.
Throw away your tampon after use—do not reuse tampons.
What is toxic shock syndrome?
Toxic shock syndrome (TSS) is a rare disease that can lead to organ damage (including kidney, liver and heart failure), shock and even death. TSS is caused by an infection where bacteria release toxins into the body.
The risk of toxic shock syndrome increases with unhealthy practices such as leaving a tampon in for longer than 4-8 hours. Changes in how tampons are made and education about safe use of tampons have decreased the rates of toxic shock syndrome.
Symptoms of toxic shock syndrome
Reach out to your doctor immediately if you feel you are having symptoms of toxic shock syndrome, which include but are not limited to:
Fevers or chills
Vomiting, diarrhea
Headache
Rash like a sunburn
Confusion, fatigue
Other menstrual products: risks & safety tips
Menstrual cups
Recently, alternatives to tampons, like menstrual cups, have become more widely available. These products are easy to find and use, like tampons, and can be used while swimming or playing sports. They are also reusable, which people may like since it can lessen waste and be more friendly to the environment than other menstrual products.
Often, menstrual cups are made with medical-grade silicon, which discourages the growth of bacteria. However,
bacteria can still grow on menstrual cups; toxic shock syndrome has been
reported in people using these products.
Refer to the specific care guidelines for your menstrual cup, but generally most products recommend:
Washing the menstrual cup after each use with water and soap
Boiling the menstrual cup in between periods
Removing the product at least every 12 hours
Period underwear
Like menstrual cups, period underwear are a great option because of their reusability and are even easier to use. Because period underwear is outside your body, it is
not a risk for toxic shock syndrome. They still should be cleaned or washed as instructed on the packaging.
Remember
Tampons and other menstrual products are safe when used properly. Look at the product directions if uncertain about how best to take care of them or use them. Toxic shock syndrome is a rare but serious condition that can lead to organ failure but the risks can be reduced with proper hygiene practices.
As always, talk to your pediatrician about any questions or concerns you have about period products or toxic shock syndrome.
More information
About Dr. Bethel
 Jessica Bethel MD, MPH, is a pediatric hospital medicine fellow at the University of Wisconsin and has served as her program's lead advocacy resident. She has been involved in the AAP since medical school including in the Council on Immigrant Child and Family Health, the Section on Minority Health Equity and Inclusion, and Section on Global Health.
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About Dr. Yanny
 Megan Yanny, MD, FAAP, is a board-certified general pediatrician and assistant professor in the Department of Pediatrics at the University of Wisconsin School of Medicine and Public Health. She is involved in medical student and resident education and is a member of the WI AAP and the AAP.
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