Vagina MuseumToday, we'd like to show you what is probably the most deadly object in our collection: a tampon. Specifically, a Rely brand tampon, on sale between 1975 and 1980 in the USA.
In the 1970s, a combination of new synthetic materials and huge market competition led to an arms race among tampon manufacturers. There was a drive to be the most absorbent, the most leak-proof. Rely tampons, manufactured by Procter & Gamble, were highly absorbent, and expanded wide to prevent leaks. They quickly became a market leader owing to the innovative design and super absorbency.
Meanwhile, in the late 1970s, something else happened: a new syndrome was identified and named. Paediatrician James K. Todd reported an illness among childen aged 8-17. The childen had developed a condition after infection with Staphylococcus Aureus. He suspected toxins caused by the bacteria. He called the disease Toxic Shock Syndrome (TSS)
Once TSS was named and described, physicians across the USA began to notice it. And they spotted something unusual: the vast majority of cases were recorded in women, and onset of symptoms tended to take place within a few days of their periods.
An investigation was launched in 1980, and identified that menstruation-related TSS was caused by tampons. And a September 1980 report by the CDC identified that up to 75% of these cases were caused by one specific brand of tampon: Rely.
The thing about Rely brand tampons is that the manufacturers had inadvertently designed the perfect medium for helping S. aureus proliferate, and get its toxins into the bloodstream. A number of factors contributed to this.
An important thing to know about S. aureus is that it is frequently found in the vagina in small quantities. This isn't an infection, per se. The population is kept in check by the vaginal microbiome, and it lives there reasonably harmlessly. However, something very absorbent going into the vagina can shift the balance of the natural moisture of the vagina, which affects vaginal flora.
Rely brand tampons were *incredibly* absorbent. They could reportedly hold 20 times their own weight in fluid. They also had a unique design which essentially prevented anything getting out of the vagina while wearing it. (image from Rely's own leaflet)
The high absorbency of Rely tampons dried the vagina out fairly comprehensively, and due to dryness and the girth and flared tip of the tampons when expanded, this caused small abrasions in the vaginal walls - the perfect entrance for toxins produced by S. aureus to get into the bloodstream.
In addition, Rely's unique design consisted of a gel-like substance called carboxymethylcellulose and beads of polyester. It later turned out that the gel-like substance acted like a plate of agar jelly for S. aureus to grow, and the beads provided increased surface area for bacterial growth.
Bacteria can't proliferate quite so well if the tampon doesn't stay in for too long. However, given its super absorbency (and being reportedly very uncomfortable to remove), these tampons likely weren't changed very frequently.
Rely's own information leaflet suggested changing "at least once a day", i.e. leaving it in for up to 24 hours.
By September 1980, when the CDC released its report, almost 300 cases of TSS had been recorded, mostly linked to tampon use. On 22nd September 1980, Procter & Gamble recalled the product.
Three lawsuits were brought against Procter & Gamble for TSS deaths relating to Rely tampons.
In the present day, we now know enough about tampon-related TSS that it is relatively rare. Mass public information campaigns means that most of us know to use the lowest possible absorbency for your bleeding, and change tampons every 4 to 8 hours. Materials used to manufacture tampons have also changed to minimise the risk.
To be fair to Rely tampons, at the time they were created, they genuinely didn't know about TSS. But it's tragic that they ended up being learning experience by causing sickness and death.
The pack of Rely tampons was gifted to the Vagina Museum by Rosemarie Rung in 2020.
Affienia@vagina_museum ooh I feel all educated. I remember my mum not allowing me to use tampons in 1991 due to her fears over TSS, but this is fascinating to know how it came about and how things changed so tampons weren’t all dangerous. Thanks!
Leanne J@Affienia @vagina_museum I’m really sad that even by the time I started my periods in 1993 or so, that information still wasn’t common knowledge and we weren’t taught in school (or by my mother). Thankfully I happened upon a relevant news article in a library!
DB SchweinThis is fabulous. I read all the warnings on the boxes but, that being the 80s, I couldn't find any more information about it. It wasn't mentioned in my encyclopedia (likely printed before they knew what it was) and it's not like I could go online to read medical papers back then!
Christine Burns MBE 🏳️⚧️📚⧖@vagina_museum This is so interesting. I remember around this time reading about TSS in the Reader’s Digest (don’t judge me). The RD carried lots of ads for tampons (I remember seeing them in the mid sixties) and I remember feeling sceptical about the TSS coverage because tampons were frowned on by conservatives types and a health scare seemed like the thing they would come up with. Now, 40 years later, I’ve learned from you that there was a ‘there’ there.
Jesse McClure 
@christineburns @vagina_museum
Conservatives using fear tactics to make a category of oppressed people skeptical of the very healthcare they need and thus more likely to die needlessly?
I'd love to say that stood out as noteworthy. I'd love to, but I can't.
Dana das Grau 🧙🏻🧝♂️@christineburns @vagina_museum indeed there was. My brother-in-law was an orderly in a rest home. He told me they had a young woman as a patient who was a TSS patient. She was stricken to the point that she had to be cared for, for the rest of her life.
Neville Park@vagina_museum thanks for the thread! I wonder if this is news to younger generations? I was born in the 80s and remember reading warnings about it in packaging.
This was also long before menstrual cups and period underwear were widely available. I wonder if these products have "changed the game" much. (Have been out of the game for a long time myself and don't have kids or anything, so I am behind the times.)
Stlex 
@vagina_museum the Rely/TSS fiasco is why my mom refused to buy any tampons for her daughters, even into the 90s!
Estarriol, Terrorist Dragon@vagina_museum it sounds like a perfect storm scenario.
食 Shoku the Umbreon@vagina_museum And here I was expecting them to find the materials themselves to be inherently toxic. I hope this sort of scientific investigation is a skill that we don't end up losing.
@vagina_museum interestingly, I think that material is a generational product of nitrocellulose and celluloid. So I guess it could have been worse?
Ψ*Ψ@TheMNWolf @vagina_museum oh, no, that study came out much more recently
https://factor.niehs.nih.gov/2024/8/feature/3-feature-metals-in-tampons
Pandro@vagina_museum Thanks for this informative and extensive post! I learned something new.
David@vagina_museum This is fascinating. TSS is an ever present worry in someone who might use tampons presenting with sepsis of unknown cause, but I didn't know the history of this particular brand.
dodothedev🦤💻
lafnlab@vagina_museum I read a book many years ago called "The Coming Plague" by Laurie Garrett, iirc. It was mostly about relatively new conditions (at the time it was written), like AIDS, hantavirus, ebola, etc. and it had a chapter on TSS. It was a very interesting book.
Mello@vagina_museum Damn, they caused a lot of pain to the society but we can't really blame them.
angst-ridden wanderer@vagina_museum the ads for the brand completely saturated pop radio in Los Angeles. I can still hear the jingle in my head “Remember, they called it ‘Rely’” 45-some odd years later.
MárciaW 🇸🇩
Maggie Maybe@vagina_museum whenever someone talks about defunding Planned Parenthood I like to tell the story about how they saved me from potentially getting TSS when I accidentally inserted a tampon when I already had another one in there.
I immediately realized I made a mistake and I tried to get it but I couldn’t. My ER co-pay would have been $100, plus in Los Angeles you can sit in the ER for 14 hours and still not be seen. My doctors office couldn’t see me for three days. But Planned Parenthood had an STI walk-in clinic that afternoon, so after work I went up there, they got it out in three seconds. I like to tell everyone that they saved my life.
Joe (TBA)@maggiejk Stories like yours could fill multiple volumes of women's lives that Planned Parenthood has positively changed. It's that they get tied to abortions that have spoiled them for too many people. That is by far the least of what they offer. Thanks for sharing. I'm sure that was a frightening moment in your life. @vagina_museum
Globalement inoffensive@vagina_museum latest data suggest to change every 4 to 6 hours (8h may be too long in some cases). And you can get TSS from a menstrual cup if worn too long. Any internal protection can be dangerous on this issue, not just tampons.
(Scientific opinion from Anses in 2018-2019 https://www.anses.fr/en/content/assessment-safety-feminine-hygiene-products)
Lauma Pret ♡ ᪲᪲᪲🌈@vagina_museum
What do we know about TSS in relation to menstrual cups? I've heard mixed takes and I do wonder if their convenience also endanger me somehow.
What do we know about TSS in relation to menstrual cups? I've heard mixed takes and I do wonder if their convenience also endanger me somehow.
@laumapret There's been one documented case of TSS linked to a menstrual cup, which had been left in for much longer than advised. While cups don't dry you out like a tampon, microabrasions can happen from time to time if you snag with a nail getting the cup in or out.
Keeper of the orb@vagina_museum im kind of relieved you didnt reveal they were also full of asbestos (tho my nonstop concern for ppl who freshen vaginas w talcum powder still marches strongly on)
Richard Degenne@vagina_museum Oh god... I can't imagine how bad keeping the same tampon for 24 hours must feel, and I don't even have a vagina!
Kevin Karhan 
@richarddegenne @vagina_museum +1
To me this soulds like asking for trouble (in hindsight) and TSS being unknown up to that point is completely inacceptable.
Kevin Karhan :verified: (@[email protected])
@[email protected] and now realize that bacteria under ideal conditions have a *"Generation Time"* (aka. average time until they double) of 5-30 minutes, and if we assume 30 minutes for example, we get 2 generations per hour or a 4x increase. - Which means 24x2=48 generations per 24 hours = 2^(48) bacteria ( or 281.474.976.710.656 to be precise) from a single one. Making TSS a statistical inevitability worse than shoving uncleaned, repeatedly used anal toys into a vagina. (Which noone should do!) - This is also why there are hygenic stickers espechally on underwear aiming at women!
@kkarhan @vagina_museum It's definitely interesting to see how fast common sense has evolved over the past couple of decades. Like, my *parents* were around my age back in 1980.
@richarddegenne @vagina_museum granted we also don't do experiments without proper informed consent anymore...
Kevin Karhan :verified: (@[email protected])
Content warning: NSFW, but scientific. STIs / STDs
nachtet@richarddegenne @vagina_museum okay, don't try to imagine pulling something out that's too dry and sticking to the walls 😝
@vagina_museum @richarddegenne not as bad as taking out a dry one, I bet
@vagina_museum and now realize that bacteria under ideal conditions have a "Generation Time" (aka. average time until they double) of 5-30 minutes, and if we assume 30 minutes for example, we get 2 generations per hour or a 4x increase.
- Which means 24x2=48 generations per 24 hours = 248 bacteria ( or 281.474.976.710.656 to be precise) from a single one.
Making TSS a statistical inevitability worse than shoving uncleaned, repeatedly used anal toys into a vagina. (Which noone should do!)
- This is also why there are hygenic stickers espechally on underwear aiming at women!
Did you misplace a trillions indicator and / or powers of 10?
Using your numbers of (unchecked) doubling every 30 minutes would, after 24 hours, result in 248 TRILLION times as many bacteria.
[NB bacterial overpopulation would make the conditions not "ideal" for the bacteria itself, and thus this doubling rate probably wouldn't continue throughout a full day.]
@jmcclure @vagina_museum thanks for picking that up.
Granted, that number of bacteria could not exist within a tampon as they'd exceed the volume of it and the very finite amount of "growth media" and increasing amount of toxic metabolic products of said bacteria will naturally impose caps on their population.
@vagina_museum ANXIOUS EMOTION READING THIS
@vagina_museum yeah, as useful as Carboxylmetylcellulose is, this is the wrong application for it!
SomeVeganCheeseIsOk@vagina_museum oh my God. This is amazing.
mtc_uk@vagina_museum
Fortunately, the CDC and other investigative agencies are being gutted and brought to heel in the service of greater profits and fascism, so we won’t have that problem in future.
Fortunately, the CDC and other investigative agencies are being gutted and brought to heel in the service of greater profits and fascism, so we won’t have that problem in future.
Bliss ☀️🐈@vagina_museum holy smokes!
Angela Glansbury 🚽@vagina_museum
any figures on the number of people proctor killed on this occasion?
any figures on the number of people proctor killed on this occasion?