A month ago, I made a post about Toxic Shock Syndrome and a site called “You ARE Loved” who promote education about TSS. They had a nice little site before, but recently, they have redesigned their entire site with a slick and intuitive layout. They also acquired a domain name so I would like to take the opportunity to provide a link to their new site:
The site is dedicated to the blog owner’s daughter, Amy Rae Elifritz, who last year passed away from TSS.
The authors and contributors of the site also put a lot of work into a TSS brochure they have made and over a twitter discussion, I was happy that they would allow me to share this great piece of work, in hopes that if even all our efforts would help save just one potential TSS death that it will be worth it. Whether it is your friend, sister, daughter or even mother, your knowledge about TSS may very well be that separation between life and death for them.
Please take time to read and pass on the brochure here:
I’ve just added You ARE Loved to my blog’s link and if you’re a blog-owner yourself, you should too!
I have been struggling to come up with topics to write about, or rather, maybe just unmotivated, hah… however, I decided to go today and write on a topic that I’ve been meaning to write and post for a while. Toxic Shock Syndrome is known for many tampon users, yet, how knowledgeable are we about TSS to help us make an informed decision for the good of our health? I’m not here to necessarily debate whether I think tampons are a “good” form of feminine hygiene product, but today, we will concentrate on TSS alone and while there may be references to tampons, I’m neither “against” them or “for” them.
So what is toxic shock syndrome and like many infections, the name “doesn’t sound good already.” TSS is potentially fatal and caused by a bacterial infection which is usually associated with tampon use. There are multiple viruses which may trigger TSS, however, the most common one for tampon-related TSS infections is called Staphylococcus aureus. Despite what has been said and the belief that TSS only occurs in women who use tampons, this is not true. In fact, men and women are both capable of being infected with this bacterium and tampons are not the only cause of TSS. TSS has surfaced since 1980 and even after 31 years, women are still dying from tampon-related TSS. We may not think much of TSS, because there is very little publicity on it and with enough taboo around menstruation, people are not open to aptly speak about menstrual/feminine hygiene related deaths. It takes a very brave woman (Lisa Elifritz), the owner of You ARE Loved to raise public awareness about TSS and tell a very personal story about the challenges she faced with TSS in the death of her daughter, Amy Rae Elifritz.
TSS infections caused by Staphylococcus aureus can occur in a healthy individual and usually show through flu-like symptoms, particularly with high-fever exceeding 38.9 °C (102.02 °F), along with low blood-pressure, confusion, vomitting, diarrhea, weakness, coma and in more severe/terminal stages, multiple organ failure. Tampon related TSS symptoms also include a typical skin rash which is characterized as being severely painful at the site of the infection. TSS can be managed if discovered soon and with proper treatment, recovery occurs usually in 2 to 3 weeks. However, because of the destructive nature of the bacteria and TSS, death can occur within hours of the onset of the symptoms. Treatment within the ICU (Intensive Care Unit) is necessary for full supportive care, along with antibiotic treatment and toxin-reduction drugs.
Reported TSS cases dropped off rapidly after 1981 when 40 women died of tampon-related TSS and stayed “under the radar” for many years, until the fear of tampons begin to taper off. Tampon-related TSS struck fear in many women at the time, however, as girls begin to get their periods at younger ages in this generation, more of them are opting to use tampons and thus, exposing them to the causative bacteria at a younger age and also increasing the likelihood that they may be candidates for bacterial growth leading to tampon-related TSS. The triggering point for attention towards TSS was in a controversial testing of a tampon usable for an entire menstrual period called Rely by Procter and Gamble (P&G) in 1978. The tampon would, by design, be able to last an entire period without leakage or replacement and is said to be capable of absorbing almost 20 times its own weight. After several reported cases of TSS in menstruating women, the spotlight turned to tampons as the cause and eventually the product was pulled off the shelf.
People under the ages of 30 are less likely to have the antibodies to fight off Staphylococcus aureus bacteria, making individuals more susceptible to contracting TSS. Even the most diligent individuals such as Amy Rae Elifritz can be infected by this bacterium, despite regular changing of the tampon, alternating of menstrual products and using the lowest absorbency necessary for the menstrual flow at the time. While detection of TSS symptoms might be more obvious while menstruating, TSS can also occur any time within the menstrual cycle and menstruation does not need to be present, as bacteria may take time to build up or if chemicals/materials are left behind in the body, such as leftover rayon fibers from a removed tampon. Because symptoms of TSS are too much like the common-flu and become deadly in a very short period of time, it’s so hard to determine whether or not it’s necessary to seek medical attention and of course, most people would not want to be too aggressive in thinking they have TSS every time they get some flu-like symptoms. Nevertheless, some would argue that because of the severity of the infection, it’d be better to be on the “safe side.”
So how can one mitigate or avoid the risk of TSS? With over half the reported TSS cases being attributed to tampons, it is a reality, not just a myth. For those who have never bothered to heed the warning of tampon pamphlets, here’s a rundown with some of my input and additional tips offered by the You ARE Loved team:
- Use the lowest possibly absorbency to handle your menstrual flow
- The higher the absorbency of the tampon, the greater the risk of TSS
- Change tampons frequently and look for signs of any tampon remnants which might be left behind (such as shredding as you withdraw)
- Avoid using tampons overnight
- Tampon-related TSS bacteria require 8 hours to dissipate, therefore, use other products whenever possible throughout the day
- Tampons are NOT meant to absorb discharge, vaginal fluid or ‘just-in-case’ situations; Tampons should only be used when menstruation has begun
- Tampon choice should allow for comfortable insertion and removal, such as being saturated enough to remove easily and comfortable enough to put in. Forcing a tampon in or out may cause minute scratches in the vaginal wall, giving the bacteria an entry for further infection
- Be hygienic and wash your hands before touching your vaginal area, including clean-handling method for your tampon
- Remember to remove the last tampon of your period
- Do remember that as “very rare” that tampon manufacturers may want you to feel about the use of tampons associated with TSS, it is a very serious and real risk
- Consider alternate menstrual products, such as sanitary napkins (pads), sea sponges, menstrual cups or natural tampons (usually made from cotton, non-bleached and not composed with rayon)
- Don’t let TSS-risk slip you over time; Just because TSS hasn’t affected you yet, it doesn’t mean it never will
So what do you do if you believe you or someone else you know has been compromised or showing symptoms of TSS?
- If using a tampon, remove it immediately as this eliminates the source of the bacteria infection
- Seek medical attention and alert the emergency operator and/or emergency crew that the illness may be toxic shock syndrome related
- Avoid using tampons in the future as reinfection is a high possibility
Certainly in the future if I have a little girl, I would certainly give her the choice of using any menstrual product she prefers. Nevertheless, should tampons be her choice of products, I would make sure to educate her on proper tampon handling and hygiene, along with ensuring that cotton tampons are purchased over conventional rayon-based ones. If each and every one of these women fallen can make the world aware of TSS, then at least their deaths will not be for naught.
I would recommend anyone who is interested in learning more about TSS and the story of the Elifritz, please visit: http://www.you-are-loved.org/ and also considering making a DONATION to their cause (due to the site design, I cannot directly link to the donate section).
Options of Preventing Pregnancy
So you may wonder why I have such an odd “non-related” topic on my blog – but in reality, the likelihood is if you’re pregnant, that you’re not going to be getting your period, so I guess in a way, it IS a related matter, lol. What inspired me to write this little blog post (and yes it will be “little” because there is just way too much to cover) is that I was listening on the radio on the drive to work and one of the hosts mentioned that in Canada, they found that many women are actually unaware of the many contraceptive choices that are available to them. I would dare wager that the 2 most well-known contraceptive methods are the pill and condoms. I have done my best to do proper research, but feel free to correct me if mistakes are found as I am more than happy to learn, particularly from those with anecdotal experiences. I have yet to be with a girl who uses such contraception, particularly with a lack of knowledge about the pill and administering techniques other than by hearsay, so my knowledge may be iffy on that.
Suffice to say, while those two methods are well-known and used by many who choose not to have children at the moment (or never), they are not the only options available at this day in age. In this entry, I hope to gain some insight myself and also help open the world of contraceptive options to men and women. Where do men come into play? Well obviously contraceptive choices between couples or consenting adults is recommended when there is no intention to cause pregnancy. I should mention before I start this post that I’ll be concentrating on avoiding pregnancy in this posting, but should point out that most contraception forms do not protect against Sexually Transmitted Infections (STI) and Sexually Transmitted Diseases (STD).
Birth Control Pill (or “the pill”):
The basis of “the pill” is to prevent ovulation through a mixture of hormones, estrogen and progesterone. By suppressing ovulation, there is no egg released by the ovaries to to be fertilized by male sperm, therefore eliminating the risk of becoming pregnant. In addition to inhibiting the ovulation process, the pill also works by thickening the mucus around the cervix, reducing the likelihood that sperm is able to enter the uterus in the event that a female egg has already been released. Due to the combination of hormones present in the pill, even if fertilization does occur, the changes to the uterus lining much harder for the fertilized egg to attach to the uterus wall.
Most of “the pill” packages come in a 21 or 28 day-use cycle. The pill is administered orally (I should make that clear that “orally” means through the MOUTH) daily and at the same time every day. Users of the 21-day pack is taken 21 days continuously where the user will then stop for 7 days before starting the next 21-day pack. Users of the 28-day pack will continue to take all the pills in the package, but the last 7 pills of the cycle are actually hormone-less, usually called a placebo, which really has no effect on the body other than maintaining regularity and familiarity in maintaining the habit of taking the pill daily. If a single dose is missed (other than the placebo pills), then the chances of contraceptive protection drops considerably, so it is imperative that the pill be taken effectively. For women who start using “the pill” – it takes up to 7 days for it to take effect, therefore those who are sexually active within that 7-day window should continue to use alternate contraceptive methods such as a condom.
There are variants of “the pill” (such as progesterone-only), and your health-care professional will be able to give you the best advice on which suits you the best. There are of course benefits and risks for using “the pill” and making it important for you to consult a professional and to research what is in your best interest to use as contraception. For some women, the use of “the pill” is highly discouraged if they have certain medical conditions, so “the pill” is not recommended for everyone. There are also emergency contraceptives, such as “Plan B” for those “oopsies, we had unprotected sex” scenarios that prevent an embryo from attaching the the uterus wall after fertilization. “The pill” requires a prescription to acquire, but “Plan B” is available over-the-counter.
The contraceptive patch works similarly to “the pill” by delivering the combined hormones through the skin. A “bandage-like” adhesive is applied to the abdomen, buttocks, upper arm or upper torso. The scheduled usage of the product is like “the pill” and carries generally the same benefits and negative side effects, only that the method of which the hormones enter the body is different.
IUD’s are devices implanted into the uterus to prevent pregnancy by preventing sperm from fertilizing an egg. These “T-shaped” devices can be left in the uterus for several years and are usually composed from plastic and copper. Recent ‘enhancements’ to IUD’s also allow them to be loaded with a hormone-containing device which slowly release hormones over time to help alter the menstrual cycle and suppress conception. The IUD acts as a “physical barrier” which hinders the ability for sperm to meet with an egg and also due to a foreign object (the IUD) irritating the uterus lining, it prevents an embryo from implanting onto the uterus wall. This device is not suitable for those who have reactions to copper as it may cause increase menstrual cramps and flow. On the contrary, hormone-releasing variations of the IUD have been known to reduce menstrual flow and regulate periods. Nevertheless IUD’s have the potential of being pushed out of the vagina due to natural contractions. IUD’s are a great contraceptive choice if a user wants to be able to quickly become fertile again (assuming one was fertile in the first place). IUD’s should be implanted with the skills of an expert practitioner.
The vaginal ring works similarly to “the pill” by delivering the combined hormones through the vagina. A “ring-like” device is inserted into the vaginal which stops ovulation, thickens cervical mucus and creates a barrier to prevent sperm from fertilizing an egg. The scheduled usage of the product is like “the pill” and carries generally the same benefits and negative side effects, only that the method of which the hormones enter the body is different. It is possible for the ring to fall out and may cause vaginal irritation. If the ring is left outside the body for more than 3 hours, pregnancy once against becomes a risk and requires a 7-day window to become effective again. The vaginal ring can be inserted/removed without professional intervention.
Contraceptive injections containing synthetic hormones can be absorbed into the body via intramuscular injection. The hormones contained within prevent ovulation, thickens the mucus in the cervix and also makes the womb lining thinner to prevent an embryo from attaching to the uterus wall. Initial injections prevented pregnancy from 8 to 12 weeks, however, newer shots are said to last up to several months. Unfortunately, because hormones are injected directly into the body, they may stay resident in the body for up to 2 years, therefore resuming fertility is not as fast as other methods. Also, there have been riskier “aftermaths” even after discontinued use of contraceptive injections. With the use of contraceptive injections, menstrual periods completely stop (other than spot-bleeding) and do not become regular until a year or more of discontinued use of the product.
Capsules which release fertility-inhibiting hormones were implanted into a woman’s arm which could prevent pregnancy for up to 5 years. It was highly effective, however, side-effects were not properly communicated to customers which resulted in several class-action lawsuits. I’m not going to talk a lot about this method since it has been pulled off the shelves in North America.
A diaphragm is the “female equivalent” of a condom, a barrier contraceptive method. A diaphragm is a latex or silicon device shaped in a dome which is inserted into the vagina to “block off” the contact of sperm and a released egg. Just like a condom, a diaphragm is inserted prior to sexual intercourse, however, unlike a condom, the device should be left in the vagina for another 6 to 8 hours (although debated due to lack of evidence/conclusion) from the last male ejaculation within the vagina. It is common that spermicide be applied to the rim and/or dome of the diaphragm prior to insertion. Diaphragms can be reused as long as they are properly cleansed and can be reused immediately if required. Care should be taken to avoid contact with oil, whether it is oil-based vaginal medication of lube as it causes the deterioration of the diaphragm. Depending on the material used to make the diaphragm, it may be used from anywhere between 1 to 10 years.
A fitting appointment is recommended with your health-care professional to assist in finding a diaphragm that fits each woman’s size and needs. Whether a diaphragm is too large or too small may affect the woman’s health and may increase the risk of pregnancy if a seal is not properly formed. The diaphragm covers the cervix and physically prevents sperm from entering the uterus. It should be noted that like tampons, diaphragms are susceptible to causing TSS (Toxic Shock Syndrome) when it is worn for periods of greater than 24 hours. A diaphragm does not affect future fertility opportunity and does not affect hormones or regular menstrual cycle in any way.
I hope this helps shed some light on the various birth-control options for everyone. For those of us who are in relationships, please be reminded that birth-control is not a one-sided decision and it’s best made with both parties involved. If you are having sex outside of a monogamous relationship, then it’s a totally different story. While it is rightful and legal for a woman to make a sole decision on birth-control methods, please do be considerate and include or at least consult with her partner on his/her feelings and objectives.
Your choice of birth-control may have irreversible or long-term effects, thus, it is advisable to also seek the opinion of your health-care professional. Also, some medical conditions you may have may exempt you from the opportunity to safely utilize some of these methods. There are many risks and rewards to using the above options and I have hardly even touched on the advantages and side-effects of the choices. It is also in your best interest to do prior research and then consult your medical specialist to help make the best decision, fitting to your scenario.