Tampons or menstrual cups: all internal intimate protection presents a rare but serious risk of toxic shock, said ANSES in a report published on Monday, calling on manufacturers to provide "clearer information" on the hygiene rules to be observed .
The agency, which had already looked into the health security of female protection in the summer of 2018 (tampons, sanitary pads, panty liners and menstrual cups, or "cups"), also reiterates its recommendation made to manufacturers " eliminate or reduce as much as possible the presence of chemical substances "found in these products, even if none, again, exceeds the health thresholds.
Twenty cases each year in France
"From a health point of view, the main risk of female protections is the risk of toxic menstrual shock syndrome which, although rare, can have dramatic consequences", insists AFP Aurélie Mathieu, who coordinated this scientific expertise.
About twenty cases are recorded each year in France, but this number is undoubtedly underestimated, the declaration of this disease due to a bacterial infection with staphylococcus aureus not being compulsory. Only 1% to 4% of women are carriers of the staph strain involved in menstrual toxic shock syndrome (TSS), and therefore potentially at risk.
Detected early, SCT can be cured by taking antibiotics, but it can also cause significant digestive, muscular, renal, etc. damage. The first symptoms (fever, rashes, lowered blood pressure) can resemble an influenza state, the diagnosis is often difficult to establish.
More transparency
On January 9, a 17-year-old girl first treated for gastroenteritis died in Belgium of a staph infection, according to federal health authorities. His death was due to "the septic shock from his tampons," his family reported in Belgian media.
The case of an American model amputated in both legs following a TSS had also been widely publicized in 2015, leading to the launch in France of a petition asking for more transparency on the composition of the pads.
But "in the current state of knowledge, the SCT is not linked to the material used in the composition of these protections," said ANSES in the update of its expert report.
Respect the rules of hygiene
"The risk of developing this disease (...) is linked to the conditions of use of intimate protection," she adds, observing that information on this risk is too often absent, especially on menstrual cups. "All of the internal female protections block the flow of the menstrual flow, which then behaves like a kind of culture medium," explains Aurélie Mathieu.
In women carrying this particular strain of staphylococcus, the bacteria can then sometimes "grow until reaching a sufficient bacterial load so that the toxin" responsible for TSS "is produced and passes to the blood level". Also, the agency "reminds users of the importance of respecting the hygiene rules related to the use of protections", in particular the maximum wearing time and hand washing before changing protection.
"No specific regulations" in the EU
A survey carried out in 2017 by Opinion Way for the health security agency underlined that these rules were far from being generalized: only 61% of the women questioned said to wash their hands before changing protection (24% with water, 50% with soap and 7% with hydroalcoholic gel) and many declared that they kept the same protection for more than 5 hours (22% of tampon users, 26% for towels and 75% for menstrual cups).
Unlike the United States, where periodical protection is considered to be a medical device, in the European Union, "there are no specific regulations governing the composition, manufacture or use of personal protective products", which fall under the regulations that apply to all everyday consumer goods, recalls ANSES.
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