Article list

Mr David Nunns - Consultant Gynaecologists

P&G Everyday

Header

Always_header

Always

Contact Us

Welcome on Tampax Contact Us page. How can we help you?

TAMPAX Contact US Page

Country selector

TAMPAX products are available in many countries. Select your country and language here.

TAMPAX Country Selector

Sign In

Sign in

My profile

Register

Register with us and find a wide selection of hygiene products for women as well as useful menstrual infromation!

Create Profile

Search

Toxic Shock Syndrome (TSS): causes, symptoms and treatment

What are the causes and symptoms of endometriosis? - article body

Which tampon sizes do you need? Know your flow

What are the causes and symptoms of endometriosis? Releted articles

Toxic Shock Syndrome: Symptoms & Causes

What are the causes and symptoms of endometriosis?

Articles reviewed by this expert: David Nunns

Articles reviewed by this expert:

Period health

Safety Promise

What are the causes and symptoms of endometriosis? Related articles

Period Calendar

Period Tracker & Know your flow

Period Tracker & Product Recommender  - Fireworks

Period Tracker & Flow Combo

Our tampons are designed to give you the comfort and protection you need. Learn more about product details with the comparison chart below.

Compare

Compare Tampax products

Dr David Nunns

Dr David Nunns, Consultant Gynaecologist

All content within this page has been reviewed by

Fireworks - Article Detail - Inline Video

What Everyone Should Know about Toxic Shock Syndrome (TSS)

Close-up of a woman's abdomen, hips, and hands as she zips up a pair of dark blue jeans.

Light, regular, super and super plus Tampax tampons

Severity of endometriosis

Mr David Nunns

# What are the causes and symptoms of endometriosis?

<h2 id="diagnosing-endometriosis">How is endometriosis diagnosed?</h2>
<p>The diagnosis of endometriosis cannot be made only on the basis of the symptoms presented by the patient. In many cases, in order to arrive at a correct diagnosis, the gynaecological examination should be supplemented by other tests to confirm the endometriosis and determine its degree of severity. These examinations may include gynaecological ultrasound and blood tests and, in some case a laparoscopy (an daycase operation that allows the inside of the abdominal cavity to be seen through small incisions of just a few millimetres, through which the working instruments are inserted) or other special diagnostic techniques such as an magnetic resonance imagin scan (MRI).</p>

How is endometriosis diagnosed?

<h2 id="treatment-endometriosis">How is endometriosis treated? Endometriosis: hormone treatment</h2>
<p>The treatment of endometriosis requires a holistic view of a woman. Age, symptoms and desire for pregnancy must be taken into account before deciding on treatment. In adolescence, the priority is generally to relieve the pain. Medical treatments with medicines, mainly pain killers and hormonal contraceptives, may be sufficient. However, other patients will require combined medical and surgical treatment. Day case surgery is sometimes indicated to make a diagnosis and treat any areas of disease. The purpose is therefore to eliminate the disease as far as possible while preserving as much healthy tissue as possible.</p>
<p>Although some women with endometriosis may experience reduced fertility rates and, treatment may improve the chances of getting pregnant in future.</p>

<h3>Is endometriosis cancer?</h3>
<p>Endometriosis is a benign (non-cancerous) condition!</p>

<h3>Endometriosis and menopause</h3>
<p>Most symptoms of endometriosis resolve with the menopause, but this is not always the case. In the absence of hormonal secretion, the disease remains dormant. However, it should be noted that it can reappear if hormone replacement therapy is administered when menstruation stops. </p>
<p>Endometriosis remains a complex condition, but there is hope on the horizon. Ongoing research into diagnosis and treatment is advancing rapidly, and medical professionals are continuously learning more about how to effectively manage this condition. With time, these efforts will pave the way for better outcomes and improved quality of life for those affected.</p>
<p>If you are experiencing symptoms that may indicate endometriosis, such as persistent pelvic pain, painful periods, or fertility challenges, it’s important to seek medical advice. Don’t hesitate to consult a healthcare provider who can guide you through appropriate tests and treatment options. Early diagnosis can make a significant difference, so trust your instincts and reach out to a professional if you have concerns.</p>

How is endometriosis treated? Endometriosis: hormone treatment

<h2 id="tampon-myth">Myth about tampons causing endometriosis</h2>
<p>Tampons have no impact on endometriosis. Many facts remain to be discovered about this disease, but one of its causes is linked to the fact that the menstrual fluid flows backwards outside the fallopian tubes. Some people think that a tampon could block the cervix and cause the menstrual fluid to flow backwards into the uterus and out of the fallopian tubes, which is simply not possible. Tampons cannot block the cervix and once they are full, menstrual blood that can no longer be absorbed is evacuated through the vagina. It does not pass into the uterus. Consequently, <a href="/en-gb/our-tampons/">tampons</a>, and more specifically the use of tampons during menstruation, cannot be considered a cause of the development of endometriosis.</p>


Myth about tampons causing endometriosis

__So, what's a ‘normal’ cycle anyway?__

First of all, stop thinking about normal. Every girl is different. What’s important is that you find out what’s normal for you; a period [tracker](/en-gb/period-tracker-and-calendar/) will help you to do just that. All cycles are unique, but between pre-period, period and ovulation, there are a few things we all have in common: 

__Pre-period__

The dreaded [premenstrual syndrome](/en-gb/period-health/what-is-premenstrual-syndrome-pms/). Some common symptoms of PMS are headaches, bloating, irritability and crying more than usual. In other words, that urge to sit on the couch in joggers with a tub of ice cream and cry over ‘The Notebook’. We’ve all been there. 

It’s common to experience PMS in the three days leading up to your period. And just so you know: diet, caffeine and [stress](/en-gb/period-health/stress-and-period/) can increase the intensity of PMS symptoms. 

While these symptoms can be painful and uncomfortable, the good news is there are ways to help manage them: 

- Resist the urge to have an extra cup of coffee 
- Take an over-the-counter painkiller 
- Use a hot water bottle. 

__Period__

This is the start of your cycle and when bleeding begins. But why do we bleed in the first place? Since your egg wasn’t fertilised, your womb lining sheds and leaves your body. Thus, blood. 

Here are some facts about periods: 

- Healthy periods generally last between four and seven days, with the heaviest days being the first and second 
- An average cycle is 28 days, but can range from 21 to 35 days (to work yours out use a [period cycle tracker](/en-gb/period-tracker/)) 
- Bleeding usually amounts to somewhere between 10-80 grams, or 1 to 6 tablespoons of fluid (not that we’re measuring, but it’s good to know for keeping track of tampon changes). 

See your doctor if you find yourself bleeding through six or seven regular tampons a day, or if you’re on your period for more than seven days. 

__Peak ovulation__

This is the time when you’re ovulating and at the highest risk for pregnancy. This fertile time lasts about six days. In a 28-day cycle, ovulation typically occurs on day 14. 

__How to track your period__

To calculate your period, you'll need to count the days in between your last few periods. Start counting on the first day of your period and stop counting on the day before your next period. This is the number of days in one menstrual cycle. Do this for a few cycles, then add up the total number of days and divide them by the number of cycles. This will give you the average number of days in your cycle, and once you know this number, you'll be able to track your period easily. 

Have more [period questions](/en-gb/period-health/period-health/signs-and-stages-of-puberty-for-girls/)? We have answers. 

Period Calendar Bottom Text

<ul>
  <li><a href="#what-is-toxic-shock-syndrome">What is Toxic Shock Syndrome (TSS)?</a></li>
  <li><a href="#what-causes-toxic-shock-syndrome">Know the facts about Toxic Shock Syndrome</a></li>
  <li><a href="#rare-and-treatable">TSS is rare and treatable</a></li>
  <li><a href="#who-is-at-risk-of-tss">Who is at risk of Toxic Shock Syndrome (TSS)?</a></li>
  <li><a href="#whre-in-body-could-the-bacterium-causing-tss-be-found">Where in body could the bacterium causing TSS be found?</a></li>
  <li><a href="#reducing-the-risk-of-toxic-shock-syndrome">Reduce your risk</a></li>
  <li><a href="#will-organic-tampons-reduce-my-risk-of-tss">Will organic tampons reduce my risk of TSS?</a></li>
  <li><a href="#is-it-possible-to-get-tss-more-than-once">Is it possible to get TSS more than once?</a></li>
  <li><a href="#how-long-can-i-wear-a-tampon-safely-and-not-get-tss">How long can I wear a tampon safely and not get TSS?</a></li>
  <li><a href="#lets-recap">Let’s recap</a></li>
</ul>

Toxic Shock Syndrome is a rare


Toxic Shock Syndrome (TSS) is a rare, but serious bacterial infection that has been associated with tampon use. Although TSS is serious, it’s very treatable – especially when treated early. In rare cases, it can be fatal. The incidence has been unchanged since 1980s: only 0.7 in 100,000 menstruating women in the UK are affected.

<h2 id="what-causes-toxic-shock-syndrome">Know the facts about Toxic Shock Syndrome</h2>

Toxic Shock Syndrome is caused by bacteria, not tampons, specifically Staphylococcus aureus. In the 1980s, TSS became more well-known because it was associated with highly absorbent tampons (those highly absorbent tampons were quickly taken off the market). However, tampons aren’t required for TSS. You can get it while using pads or menstrual cups, or no period protection at all. Anyone can get TSS. Even men and children can get TSS, and only about half of TSS infections are related to menstruation. Some other ways people develop TSS include insect bites, skin infections, or surgery.

<h2 id="rare-and-treatable">TSS is rare and treatable</h2>

Fortunately, Toxic Shock Syndrome is rare. To put it into perspective, you are more likely to die from being struck by lightning than you are from Toxic Shock Syndrome. There are also things you can do to prevent TSS. In a lightning storm, we take cover and get out of swimming pools. Similarly, there are things you can do to reduce your risk for TSS (keep reading to learn more!).

The [Toxic Shock Information Service](https://www.tssis.com/toxi_shock_syndrome/#prevention) states that __treatment may involve__:
- Antibiotics to treat infection
- In some cases, pooled immunoglobin (purified antibodies taken out of donated blood from many people) may also be given to fight the infection
- Oxygen to help with breathing
- Fluids to help prevent dehydration and organ damage
- Medication to help control blood pressure
- Dialysis if the kidneys stop functioning
- In severe cases, surgery to remove any dead tissue - rarely, it may be necessary to amputate the affected area

With early diagnoses TSS can be treated with antibiotics to kill the Staphylococcus aureus bacteria, and other medicine which help counteract the symptoms. Most people will start to feel better within a few days, but it may be several weeks before they're well enough to leave hospital.

<h2 id="what-are-the-signs-and-symptoms-of-toxic-shock-syndrome">What are the signs and symptoms of Toxic Shock Syndrome (TSS)?</h2>

The [Toxic Shock Information Service](https://www.tssis.com/toxi_shock_syndrome/#prevention) states that some of the signs and symptoms of TSS are much like severe “flu” and usually include all or some of the following: 
- High temperature (fever) of 39C or above
- Vomiting
- Sunburn-like rash
- Diarrhoea
- Fainting or feeling faint
- Muscle aches
- Dizziness
- Confusion
- Breathing difficulties

Sometimes you may also have a wound on your skin where the bacteria got into your body, but this isn't always the case and it may not look infected.

Consult your doctor at once if you, or anyone you know, has some of these symptoms and suspect TSS.

If a tampon is being worn it should be removed and the doctor should be told. Do not worry about being alarmist - it is important to rule out the possibility of having TSS and if necessary, your doctor will them be able to begin treatment early.

<h2 id="who-is-at-risk-of-tss">Who is at risk of Toxic Shock Syndrome (TSS)?</h2>

TSS can affect anyone, including men, women, and children. It can occur in a variety of situations, including after childbirth, surgical infections, insect bites, burns, barrier contraceptives and menstruation.

<h2 id="whre-in-body-could-the-bacterium-causing-tss-be-found">Where in body could the bacterium causing TSS be found?</h2>

Staphylococcus aureus is commonly found in the vagina, but also in other warm, moist body areas, such as the nose or armpits. Most people have antibodies in their blood, protecting them from the toxin, if it is produced.

<h2 id="reducing-the-risk-of-toxic-shock-syndrome">Reduce your risk</h2>

TSS is rare, but you can prevent it and reduce your risk even more by following a few recommendations:

- Always use the [lowest absorbency tampon that will manage your flow](/en-gb/how-to-use/which-tampon-sizes-do-you-need/). If it hurts to remove after a few hours, go down a size.
- Know the symptoms of TSS mentioned above, and get immediate medical attention if you are worried you may have it.
- The risk of tampon-related TSS can also be reduced by interrupting tampon use with pads from time to time.

[Choose the right Tampax tampon absorbency for your changing period flow.](/en-gb/how-to-use/tampons-absorbency/)

<p>Endometriosis can often go undiagnosed in teenagers and women, even if they experience common symptoms such as severe menstrual cramps, abdominal pain in between periods or heavier periods. </p>
<p><strong>Table of content:</strong></p>
<ul>
  <li><a href="#what-is-endometriosis">What is endometriosis?</a></li>
  <li><a href="#causes-of-endometriosis">What causes endometriosis?</a></li>
  <li><a href="#symptoms-of-endometriosis">What are the symptoms of endometriosis?</a></li>
  <li><a href="#confused-diseases">What diseases can be confused with endometriosis?</a></li>
  <li><a href="#tampon-myth">Myth about tampons causing endometriosis</a></li>
  <li><a href="#diagnosing-endometriosis">How is endometriosis diagnosed?</a></li>
  <li><a href="#treatment-endometriosis">How is endometriosis treated? Endometriosis: hormone treatment</a></li>
</ul>

 What are the causes and symptoms of endometriosis? - Table of contents

<h2 id="symptoms-of-endometriosis">What are the symptoms of endometriosis?</h2>
<p>The symptoms of endometriosis are also highly variable. In some cases, there may be no symptoms at all (endometriosis is diagnosed by accident during abdominal surgery for other reasons). However, in other cases, internal inflammation of the abdomen and adhesions may be the cause of:</p>
<ul>
  <li>Severe <a href="/en-gb/period-health/menstrual-cramps-causes-treatments/">menstrual cramps</a> (dysmenorrhoea).</li>
  <li>Abdominal pain in between periods.</li>
  <li>Pain during sexual intercourse (dyspareunia).</li>
  <li>Increased menstrual flow (menorrhagia).</li>
  <li>Fertility problems.</li>
  <li>Less commonly pain when passing stools (dyschezia).</li>
</ul>
<p>The intensity and frequency of these symptoms vary from case to case. A woman may suffer from a single symptom or several symptoms at once. In more rare cases, endometriosis can even affect the bladder - causing difficulty in urination and small amounts of blood loss - and the intestine - where it can cause spasmodic abdominal pain and diarrhoea.</p>

<h3>Endometriosis and fatigue</h3>
<p>The chronic pain of pelvic endometriosis and its other effects on the body lead to a feeling of chronic fatigue. There is also a general weakening of the body. All these sensations intensify during menstruation.</p>

<h3>The endometrium and menstruation</h3>
<p>The symptoms of endometriosis can affect <a href="/en-gb/period-health/period-questions/">menstruation</a>. Bleeding from the endometrium causes a number of symptoms. In the cases of most patients, menstrual bleeding is very painful and heavy, sometimes accompanied by blood clots. Periods may last longer than usual. The period is often preceded by premenstrual spotting or bleeding. Moreover, patients with uterine endometriosis may experience irregular menstrual bleeding.</p>

<h3>Endometriosis and tampon-related pain</h3>
<p>Women with endometriosis who use tampons can often experience additional discomfort and pain. The reasons for endometriosis and tampon-related pain can be varied. Firstly, endometriosis itself can lead to increased sensitivity and pain in the pelvic area, which can be intensified when inserting or <a href="/en-gb/how-to-use/how-to-remove-a-tampon/">removing tampons</a>. Secondly, tampons can cause tension in the pelvic muscles which also contributes to discomfort and pain.</p>
<p>In addition, endometriosis and pain caused by tampons may be due to anatomical changes caused by the disease such as adhesions or scars.</p>
<p>As a result, women with endometriosis may prefer other methods of menstrual protection that may be less painful and more comfortable for them. It is important to consult your doctor to determine the best method, taking into account your individual needs and your pain experience.</p>

<h3>Endometriosis and fertility</h3>
<p>Endometriosis can impact on fertility by causing scar tissue on the pelvis around the fallopian tubes. Ovarian endometriosis may cause cysts and adhesions. Furthermore, deep endometriosis is caused by scarring of tissues, for example in the ovaries, which leads to ovulation problems and reduces the chances of getting pregnant.</p>

<h3>Endometriosis and bloating of the belly</h3>
<p>Symptoms of endometriosis also include a feeling of bloating, heaviness and swelling in the lower abdomen. These sensations cause pain which generally occurs during menstruation, but over time can become constant and uncomfortable, even in between periods. One of the symptoms of endometriosis can be a intermittent bloating of the belly. This is a condition in which the abdomen becomes enlarged and tense, often as a result of the presence of extensive endometrial lesions in the pelvic region and the inflammatory response caused by these lesions.</p>
<p>Patients often experience uncomfortable bloating during their periods. Due to the disease, bloating in this area may stop you from wearing clothes in your size during menstruation.</p>

What are the symptoms of endometriosis?

<p>It is important to start treating the disease as early as possible to prevent its progression. Treatments for the minimal and mild stages give the best results.</p>

<h2 id="causes-of-endometriosis">What causes endometriosis?</h2>
<p>One theory is that part of the menstrual fluid flows through the fallopian tubes and falls into the abdomen instead of being lost as a period. However, this phenomenon occurs in many women who will never develop endometriosis, so this explanation does not completely solve the problem.</p>
<p>Another theory suggests a possible immunity defect responsible for 'cleaning' microbes and abnormal cells in the abdomen. Defences would not be reduced, just of poorer quality. This would prevent endometrial cells (normally present only inside the uterus) from being recognised as foreign, leaving them free to implant themselves in internal organs. In addition, research shows that first-degree relatives of women with endometriosis are more likely to develop it, so hereditary factors are probably involved in its genesis.</p>
<p>As for its evolution, endometriosis is an unpredictable process. For example, some women have small implants that do not change over the years, while in others, they can grow widely in the pelvis.</p>

What causes endometriosis?

<h3>Endometriosis and diarrhoea</h3>
<p>Chronic endometriosis can manifest itself as intestinal discomfort. Problems passing stools are particularly intense during menstruation. In addition, stool frequency is altered: diarrhoea or constipation are frequent.</p>
<h3>Endometriosis and weight gain</h3>
<p>Weight gain is not a direct symptom of endometriosis, although certain aspects of endometriosis and its treatment can lead to overweight.</p>

<h2 id="confused-diseases">What diseases can be confused with endometriosis?</h2>
<h3>Endometriosis and fibroids</h3>
<p>Fibroids are the most common benign tumours  of the uterus when it comes to women of childbearing age. The symptoms of these two conditions can be similar, with painful, heavy periods and pain in the lower pelvis.</p>
<h3>Endometriosis and polycystic ovaries</h3>
<p>Endometriosis and polycystic ovary syndrome are often the cause of infertility. Both diseases can be treated with pharmacological means which improve the chances of getting pregnant.</p>


What diseases can be confused with endometriosis?

<h2 id="what-is-endometriosis">What is endometriosis?</h2>
<p>Endometriosis is a common condition that affects millions of women worldwide. It can start during adolescence and continues throughout the reproductive years. Besides causing physical symptoms, it can also have an impact on a person's mental well-being.</p>
<p>Endometriosis occurs when the endometrium (the mucous layer that covers the inside of the uterus) moves out of its original location in the uterus. The usual place for the endometrial tissue to settle is the pelvis. </p>
<p>The tissue settles in the form implants which are small. When they settle in the ovaries than form cysts also known as endometriotic cysts or endometriomas. These contain blood, giving them a dark reddish-brown colour. Their size may vary but are usually a few cm in size. When endometriosis infiltrates the uterine wall in the form of roots, it is called adenomyosis. This leads to an increase in the size of the uterus, which becomes redder, more flexible and more painful.</p>
<p>Moreover, this disease can have an inflammatory component that causes adhesions, i.e. tissue bridges or scar tisseue, which cause organs such as the uterus, ovaries, fallopian tubes and intestines to stick together.</p>
<p>The exact cause of endometriosis is still unknown despite extensive research. However, there are several theories about its origin, including the following:</p>

<h3>Severity of endometriosis</h3>
<p>Depending on the stage of the disease, there are four degrees of severity of endometriosis:</p>
<ul>
  <li>Minimal</li>
  <li>Mild</li>
  <li>Moderate</li>
  <li>Severe</li>
</ul>

What is endometriosis?

<h2 id="what-is-toxic-shock-syndrome">What is Toxic Shock Syndrome (TSS)?</h2>

What is Toxic Shock Syndrome (TSS)? Heading

David Nunns

At Always, we make sure that information we provide regarding menstruation and menstrual cycle is accurate. This is why we cooperate with healthcare specialists. 