Today someone on Reddit's 2XChromosomes group polled everyone to ask whether or not you use a tampon overnight. Apparently she read the instructions (something I haven't done for… I don't know, probably at least 20 years) and they said not to, they said you should use a pad, because of the risk of Toxic Shock Syndrome (TSS).
So here is the lowdown on TSS. As with rabies and airplane crashes, this is a problem that we are afraid of far out of proportion to its actual occurrence. An independent study put the number of cases (not deaths - cases) at about 3 or 4 per 100,000 tampon users per year.
What is TSS?
TSS is caused by staph bacteria. It is essentially a systemic staph infection, and there are many ways it can start. Relevant to this topic, it's possible for a tampon to basically become infected and serve as a breeding ground for the staph bacteria.
Once the staph get into your bloodstream they can cause havoc. If you experience a sudden high fever or a mysterious rash when you are using tampons, take the tampon out and consider visiting the emergency room. TSS is nothing to fool around with, and even though it's incredibly rare, nevertheless five or six women die from it every year.
As for your tampon becoming a breeding ground for staph: obviously the longer you leave it in, and the more, um, "full" it is, the more welcoming it will be to the bacteria. This is why many manufacturers recommend you switch to pads overnight. But honestly, as long as you put in a fresh one before you go to bed and you change it as soon as you wake up, you really should be fine.
TSS was a huge thing in the 1980s. This was almost exclusively thanks to a new kind of tampon that hit the market in 1978. Called Rely, it was made of polyester beads, and it promised to absorb your entire menstrual flow. That's right: one tampon for your whole entire period.
This, unsurprisingly, turned out to be kind of a bad idea.
In hindsight, it seems obvious that using one tampon for your whole period would cause you to go septic. Also: super gross. Also: a lesson about how little corporations actually care about their customers. Rely tampons were on the market for about two years before the FDA was finally pressured into forcing their recall.
As a matter of good hygiene, therefore, you should always change your tampon at least every eight hours, regardless of your flow. It may seem wasteful to change a tampon that isn't, strictly speaking, "full." But it is definitely a critical health issue! However, if you are good about keeping them fresh, you should not have any worries about TSS.
Photo credit: Flickr/mag3737
* Before the comments start, let me head off the Internet Diva Cup Brigade at the pass.
I will never use a Diva Cup. They aren't appropriate for everyone - for every body, or for every flow pattern. But I don't begrudge anyone else from using them. And if you're curious, you should give it a try.
People who love their Diva Cup REALLY love their Diva Cup. Enough so that the mere mention of the word "tampon" brings the campaigners out of the woodwork, bless their hearts.