Menstrual discs are flexible, non-absorbent devices designed to collect menstrual fluid inside the vaginal fornix, the space around the cervix. They are an alternative to traditional absorbent products like tampons and pads. Because of their unique design, many users question their safety profile regarding the rare but severe illness, Toxic Shock Syndrome (TSS). This article explores the current scientific understanding of the relationship between menstrual disc use and TSS.
What is Toxic Shock Syndrome?
Toxic Shock Syndrome (TSS) is a sudden, severe condition caused by toxins released by certain bacteria. Most menstrual-related cases are linked to toxins produced by the bacterium Staphylococcus aureus, primarily Toxic Shock Syndrome Toxin-1 (TSST-1). This toxin acts as a superantigen, causing a massive, uncontrolled activation of the immune system that rapidly overwhelms the body’s defenses.
TSS onset is abrupt, manifesting as a sudden high fever and a drop in blood pressure. Common symptoms include a diffuse, sunburn-like rash, confusion, and severe muscle aches. Patients may also experience vomiting or diarrhea early in the illness. If not treated quickly, this condition can progress rapidly to shock, organ failure, and death, requiring immediate medical intervention.
Assessing the Risk of Menstrual Discs
Any device inserted into the vagina creates a theoretical risk for TSS by introducing a foreign object and potentially altering the vaginal environment. The historical link between TSS and menstruation was established due to highly absorbent tampons, which created a favorable environment for S. aureus to multiply and produce toxins. The non-absorbent composition of menstrual discs, often made from medical-grade silicone, distinguishes them from these absorbent products.
Menstrual discs collect fluid rather than absorbing it, meaning they do not wick away the natural moisture that helps maintain the vaginal microbiome. This design is less likely to create the oxygen-rich conditions thought to promote the growth and toxin production of S. aureus. Furthermore, discs sit high in the vaginal fornix, minimizing contact with the vaginal walls and reducing the potential for micro-abrasions that could allow toxins to enter the bloodstream.
While the risk is not zero for any internal menstrual product, the risk associated with menstrual discs appears low compared to the risk historically linked to high-absorbency tampons. Research suggests that non-absorbent products may not provide the same conditions for bacterial overgrowth that super-absorbent materials do. Case reports specifically linking TSS directly to the use of a menstrual disc are rare, supporting the view that they are a lower-risk option.
Essential Prevention and Usage Practices
Minimizing the low risk of TSS depends on proper product maintenance and hygiene. Users must thoroughly wash their hands with soap and water before insertion or removal to prevent introducing bacteria into the vaginal canal.
Users should never leave a menstrual disc in place longer than the manufacturer’s recommended wear time, typically a maximum of 12 hours. Prolonged wear allows bacteria to colonize the device and collected fluid, increasing the potential for toxin production. Between cycles, reusable discs must be properly sanitized, usually by boiling them in water.
Users should regularly inspect their disc for signs of degradation, such as tears, punctures, or changes in material texture, and replace the device if damage is present. If an individual is experiencing genital irritation, sores, or cuts, they should refrain from using any internal menstrual product.
If sudden symptoms of high fever, rash, or dizziness appear while using a disc, it must be removed immediately. Emergency medical attention should be sought without delay.