Editor’s note: Friends, Love and ... is a semi-regular column about relationships and sex. If you need insight into your love life or your relationships with the people in your life (from family members to co-workers, boss or others) or have questions about sex, send us an email with your question to moliver@yakimaherald.com. Please include your name and email or phone number. All inquiries are kept confidential.

Question: Is it really possible to get toxic shock syndrome from a tampon? What is toxic shock syndrome anyway? Is it really as dangerous as I’ve heard?

Answer: Toxic Shock Syndrome (TSS) is one of those really scary illnesses that continues to pop up in the news every once in a while. In fact, there was just recently a story about a healthy teen in Canada who died in her sleep from TSS, so it makes sense that women have questions about it.

We grow up hearing about and fearing TSS, but the question remains: In a world where there is so much to worry about, is TSS really one of those things?

TSS is a bacterial infection in the body and it’s true that it can be really dangerous and even fatal. It’s also true that over half of all TSS cases are found in menstruating women and thought to be related to tampon use, although men and children can also get TSS.

That said, TSS remains extremely rare — occurring in only about 1 out of every 100,000 people. In 2016, there were only 40 cases of TSS in the U.S. (Compare that to about 11,000 gun-

related homicides in the same year.)

There was a time in the 1970s when incidence of TSS spiked and almost all of these cases were directly related to the use of a new super-absorbency tampon. This tampon was made with a new product ingredient that was so absorbent that it could actually cause tissue damage and change the natural bacteria in the vagina, leaving room for “bad” bacteria to overgrow and cause the infection. That particular tampon was removed from the market and since then the incidence of TSS has remained pretty stable.

It’s still not clear what the exact cause of TSS is or why some people get it and others don’t. What we do know is that you can lower your risk by using the lowest absorbency tampon you can (for example, try to stick to “regular” absorbency if you can and avoid the “supers”) and making sure you always change your tampon every few hours. Experts recommend that you change tampons every four to six hours and don’t use them overnight.

Bottom line: Yes, TSS is real and it’s scary, but it’s also really rare. While it’s definitely worth taking the basic precautions mentioned above, it’s probably not worth spending too much time fretting over.

Corinna R. Michels earned a Masters of Science in Nursing at the University of California San Francisco. She was a Fulbright grant recipient in Colombia in 2013 and now works as a nurse practitioner in Yakima, where she lives with her family.