A few years ago I was involved in discussion concerning menstrual products and the related health risks, which inspired me to do some research of my own. This is going to sound cliche, because it is. However, if I knew a few years ago what I am now aware of, I would have gone about choosing my menstrual products in a very different way.

Tampons do not only increase our risk of developing Toxic Shock Syndrome, but they can also harm us in countless other ways as well!

Toxic Shock Syndrome (TSS) first caught the attention of the media, and thus the world, in the early eighties, when an unprecedented number of women died from the illness. The deaths were traced to Procter and Gamble's "Rely" tampon that boasted super-absorbent fibers and quickly became popular. In 1986 Procter and Gamble removed "Rely" from store shelves. Since that point in time manufacturers of tampons have been required, by law, to warn users of tampons as to the danger of contracting TSS.

Since TSS has fallen out of the media spotlight, the majority of people are unaware of exactly how prevalent it still is, the symptoms of TSS and the many ways in which it can cause harm to your body.

Yes, TSS still exists, and it is not going anywhere any time soon. In 1993 the Center for Disease Control and prevention in Atlanta received 216 reports of TSS, and another 244 cases were diagnosed in 1994. Officials, however, estimate that merely 10%, if that, of all TSS cases are reported. This is due to the fact that many of the women who suffer from TSS only have very mild symptoms, similar to those of the flu.

Tampon related TSS is most prevalent in women under thirty years of age, and 60% of all women who die from TSS are aged between 15 and 24. The fatality rate is currently estimated at being around 6%. White women, it seems, are at greater risk of contracting the illness, with 98% of all women who die from the illness being white. While men can contract TSS as well, 99% of all cases are in women and 98% of these women suffer the onset of the disease during their period.

Why is this?

In a study conducted by Gilles R. G. Monif in 1993, published in the Infectious Diseases in Obstetrics and Gynecology Journal, tampon users were shown to be 18 times more likely to develop TSS as non-users. In the same journal a year later, James McGregor and James Todd found that of all TSS cases occurring in menstruating women, up to 99% were using vaginal tampons.

So why does tampon use significantly increase the risk of Toxic Shock Syndrome?

TSS is cause by a strain of the Staphylococcus Aureus bacterial toxin, which is known as TSST-1. This bacteria resides in most women's bodies and vaginas in small quantities and is usually harmless, due to the fact that the body has ways of keeping it under control. One of these ways is through the use of magnesium, which is found in our blood. Highly absorbent tampons deplete magnesium levels in the vagina, and thus the bacteria that produces the sometimes lethal toxin is able to produce up to twenty times its normal level. It is on days where your menstrual flow is lightest that the chances of this happening are the highest. This is one of the reasons that, since the early nineties, tampon manufacturers have been required to advise women to use the lowest absorbency tampon necessary to absorb their menstrual flow.

Not only do most major brand tampons deplete magnesium levels by absorbing other necessary vaginal fluids in addition to the blood, but they also contain rayon - a highly absorbent material made from wood pulp. Studies have shown that tampons containing rayon allow the toxin-producing bacteria to thrive. As Dr. Philip Tierno and Bruce Hanna, both of NYU Medical School, discovered through extensive testing, tampons containing rayon, that is all o.b., Playtex, Kotex and Tampax (not including Naturals, all cotton tampons), amplified the production of the potentially fatal TSS toxin, whereas tampons made exclusively of cotton did not.

Women now, specifically young women, could be at even greater risk of contracting TSS. Tampon manufacturers have recently staged an advertising campaign advising young women that it is now ok to leave your tampon in overnight, while you sleep. What these advertising campaigns do not tell you, however, is that eight hours is the uppermost limit of how long a tampon should be in your body (many women and girls sleep for longer than eight hours, or may insert a tampon during the early evening and leave it in overnight thinking that it is ok to do so), nor do they say that leaving a tampon in for even that long amplifies the risk of contracting TSS. Dr. Tierno has warned that using tampons overnight leads to an increased risk of serious disease, or even death and it is still advised by health care professionals that if you use tampons at all, you should use them for no longer than four to six hours, and never overnight.

What are the symptoms of Toxic Shock Syndrome?

TSS's symptoms can be very mild, or they can be fatal, and can include the following:

• A sudden onset of high fever
• Vomiting and diarrhea
• Dizziness
• Muscular Pain or weakness
• Fainting or near fainting upon standing up
• Disorientation
• Rash resembling sunburn on palms or soles of feet
• Peeling skin
• Headaches
• A sore throat
• Blood shot eyes; or
• Rapidly falling blood pressure

If you experience any of these symptoms together, or even if you suspect that you might have toxic shock syndrome, remove your tampon immediately! See your doctor and let them know you symptoms, and keep your tampon in case your physician wishes to examine it.

Toxic Shock Syndrome can lead to death. Women who survive Toxic Shock Syndrome suffer many additional health problems that can be devastating, among which are loss of limbs, paralysis, loss of hair and miscarriage