Toxic shock syndrome, tampons and laboratory standard–setting

Abstract

I n 1980, the Centers for Disease Control and Prevention (CDC) in the United States implicated Rely tampons, produced by Procter & Gamble, as the single tampon most contributing to the onset of toxic shock syndrome. Pressured by the US Food and Drug Administration (FDA) and threatened with a recall, the company withdrew unpurchased boxes from store shelves. The urgency was reinforced through television, radio and newspaper advertisements that instructed women to stop using Rely and seek refunds. 1 The CDC urged all women to minimize use and avoid, if possible, superabsorbent tampons because this category had the greatest association with toxic shock syndrome. However, without accurate and standardized labelling about absorption, women could not easily follow this recommendation.

Toxic Shock Syndrome in an Adolescent Girl Who Had Previous Hematometrocolpos

“…TSS is caused by staphylococcus aureus or streptococcus pyogenes. These bacteria are able to produce superantigens, which bypass normal antigen presentation and cause a clonal T-cell expansion and uncontrolled release of pro-inflammatory mediators, which results in severe multiple organ failure [14] Despite high morbidity and mortality, TSS remains underdiagnosed. The development of TSS requires a lack of antibodies to neutralize toxic shock syndrome toxin 1 and the presence of Staphylococcus aureus in the vaginal flora [15].…”

Menstrual Technology Innovations and the Implications for Heavy Menstrual Bleeding

“…The Task Force chose gram weight of saline absorbed as the metric, although this remains controversial because heparinized blood is more absorbable than saline. 17 Despite this limitation, one commonly accepted threshold at which an evaluation for heavy menstrual bleeding should be considered is when patients report saturating a tampon more frequently than every 2 hours or experiencing flooding around tampons. [18][19][20][21] Recent surveys still demonstrate that just less than half of menstruating individuals report that tampons are their preferred product for menstrual management.…”

A feminist in the academy

“…Research and standard-setting can similarly invalidate women's experiences and knowledge, as evidenced by the history of tampon standardization. 6 Flexner's pivotal report systematically excluded women and African-Americans from medical training, as a result of his recommendations to close socalled underperforming schools. 7 Medical education, through its silences, can erase history -a history replete with examples of participation in colonial practices, the transatlantic slave trade and misogyny.…”