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Toxic-shock studies look at contraceptives as risk factors.


 The results of a recent study suggest that women who use oral contraceptives (OCs) may possibly be less likely to develop toxic shock syndrome (TSS) than women who do not use OCs. Researchers are uncertain as to what to make of this negative association. According to the Tristate Toxic Shock Syndrome study conducted in Minnesota, Wisconsin, and Iowa, fewer cases than controls used OCs. Of women who used contraceptives, about 36% of cases used OC compared to 61% of the controls. The Tristate study compared possible risk factors in 80 women who had TSS to 160 women who did not. Most of the women were quite young; the median age was just over 19 years. Only 34% of cases and 33% of controls used some form of contraceptive. As yet, the data are not sufficiently strong to suggest that the use of OCs protects a woman against TSS. None of the other major studies have uncovered this association. According to Art Reingold, M.D., medical epidemiologist at the Centers for Disease Control, in general there is no evidence that contraceptives have any effect on the risk of developing TSS. 1 hypothesis about TSS centers around the affects of hormonal action on the risk of developing TSS. Osterholm surmises that a woman's hormonal status at certain times in her cycle may place her at greater risk of developing the illness. Of the women who had recurrent episodes, over half developed the recurrent episode on the same day of their menstrual cycle. No studies thus far have shown any positive association between TSS and IUD use. Studies thus far have erased any suspicion of increased risk of developing the illness after performing any type of sexual action. Other factors that have not been shown to have any effect on a woman's risk include the following: the use of vaginal suppositories, douches, or feminine hygiene products; the use of pantyhose or tight jeans; the frequency of bathing or the comparison between bathing and showering; the use of saunas or whirlpools; and the average flow of menstrual blood, the method of inserting a tampon, or the number of tampons used each day.
