This Is How You Get Toxic Shock Syndrome

The Internet loves to present us with scary stories about women becoming seriously ill or even dying from Toxic Shock Syndrome (TSS). Although these cases are real, and they've significantly affected people's lives, we shouldn't take each narrative as gospel and convince ourselves that we too will get TSS simply by using tampons. Because while these stories are awful, the reality is that they're also not that common. That said, it is worth learning from them.

In 2012, L.A. model Lauren Wasser was a feeling a bit sick when she went to bed. She had a heart attack that night which caused her organs to shut down, and later suffered gangrene that eventually led to doctors having to amputate her leg. And just this month, a 20-year-old in the United Kingdom was put in intensive care for three days because she left her tampon in for nine days and subsequently contracted TSS. She was struck with common TSS symptoms: feeling faint and dizzy, fever, bloated stomach, and slurred speech. Luckily, she was cared for in time, and she's now in recovery.

These stories leave many of us feeling nervous about our risk of contracting this potentially deadly condition. Some women even claim that they're swearing off tampons forever out of this fear. But don't be so quick to run in the other direction. There are some things you need to know about TSS, things that may surprise you — in a good way. Here are five facts about how you really get TSS.

1. TSS Is Caused By An Overgrowth Of Bacteria Entering The Bloodstream

TSS results from an accumulation of bacteria called Staphylococcus aureus , more commonly known as "staph." When this bacteria grows quickly in large amounts, it releases poisonous toxins into one's system. However, staph isn't dangerous in and of itself. It can exist on its own without causing any damage to a human body. The bacteria have to band together and then be absorbed into the bloodstream in order to cause anyone serious harm.

2. You Need To Already Have Staph In Or On Your Body To Contract TSS

Dr. Mary Jane Minkin, clinical professor of OBGYN at Yale School of Medicine, told The Cut that not everyone can even get TSS. You need to have a specific strain of staph in your vaginal flora or on your skin in order for it to multiply and become harmful. There isn't a known figure for how many women have this staph in their vag, but 30 to 50 percent of people have it somewhere on their body. That still shouldn't scare you, though; again, staph itself isn't a problem unless it grows into harmful bacteria and gets into your bloodstream.

3. You Can Get TSS From Leaving Tampons In Too Long — But That Isn't The Main Cause

You're taught — well, should have been taught, anyway — that keeping a tampon in for too long is a no-go. They are incredibly absorbent, and if you don't change them often enough, they instigate rapid, uncontrollable bacteria growth. Leave one in your vagina for too long, and those bacteria may get transmitted into your bloodstream.

But although you've probably only heard of TSS cases that are linked to a tampon that's been left in for over a week, this isn't the main cause of TSS. Less than half of reported TSS diagnoses are due to incorrect tampon use. As long as you're following the proper directions, using the lowest absorbency possible, and changing your tampon often enough, you don't need to worry too much.

4. Tampons Aren't The Only Causes Of TSS

Most TSS cases have absolutely nothing to do with vaginas, menstrual bleeding, or tampons. People who get hit with this condition often come into the hospital with skin infections, surgical incisions, or small cuts or burns. Like tampons, these kinds of minor localized injuries can become breeding grounds for staph if they're not cleaned properly (but remember, only if you already carry that staph in or on your body). This can lead to toxins entering the bloodstream, making you sick.

Sara Gottfried, M.D., gynecologist and author of The Hormone Rest Diet, told HelloGiggles that it's even possible to get TSS from a menstrual cup if it's left in your vag for too long. In fact, any object you leave stranded in your vagina for an extended period of time stands a chance of breeding bacteria and emitting toxins into your system.

5. Getting TSS Is Not As Common As You Might Think

It doesn't happen often at all, actually. In 2014, the Centers for Disease Prevention and Control reported that there were only 59 cases of TSS altogether. Here's another perspective: only one or two out of every 100,000 women get TSS, according to Owen Montgomery, M.D., a spokesperson for the American Congress of Obstetricians and Gynecologists. All this is to say that TSS isn't something that should keep you up worrying at night. If you follow the normal tampon protocol, you should be in the clear.

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