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Toxic Shock Syndrome (TSS)

How to Use Herbox Tampons
Herbox tampons are comfortable, hygienic and they are an
effective sanitary protection product. It is common for women using
them for the first time to have to try several times to insert the tampon
easily and comfortably. If you are using a tampon for the first time, we
advise using the Herbox Regular or Super tampons. Just relax
and follow the instructions. Also, look at the illustrations for further

1 – Each tampon has its own individual, sanitary wrapping. Wash
your hands and remove the lower part of transparent wrapping
(from the part with the string) by removing the middle section. Hold
the lower part of the tampon with the string in your hand. Unroll the
string of the tampon fully from where it is coiled and ensure the
ends of the strings are connected or tied (knot on the string)
2 – Hold on to the string securely. The rounded tip is in your other
hand, still in its wrapping. Turn the string directly underneath the
tampon so that the lower part enlarges a bit.
3 – Place your index finger against the lower part and hold the
bottom of the tampon securely between your thumb and middle
finger. This guarantees good control during insertion.
4 -Now, with your other hand, remove the sanitary wrapping that
covers the outer part of the tampon.
5 – Relax and place your foot on a chair; if necessary, slightly bend
the knee of the leg supporting you to assure that the muscles are
absolutely relaxed.The first time you insert a tampon may be a bit
uncomfortable. If you breathe calmly, you won’t have any
problems. Gently push the tampon – with the rounded tip – as far
into your vagina as possible. If you feel any discomfort, remove it.
Then insert a new tampon in the same way described above, but
insert it a bit further.

Herbox Tampons
Choose the type best suited for you: Herbox Regular, Super, or
Super Plus. The Herbox Regular is for light flows, the Super for
days when your flow is neither too light nor too heavy, and the
Super Plus for heavy flows. Always use the tampon with the least
amount of absorption needed for your menstrual period. Thanks to
their benefits, all types of Herbox tampons offer excellent
protection and answer your needs. They are made of 100 %
organic cotton and offer comfort and security. Herbox is also very

Use the chart to select the minimum absorbency to control your menstrual flow

JUNIOR (less than 6)
REGULAR (6 to 9)
SUPER (9 to 12)
SUPER PLUS (12 to 15)
ULTRA (15 to 18)


Approx 8g absobency. (Suitable for light flow)
Approx 11g absobency. (Suitable for medium flow)
Approx 14g absobency. (Suitable for heavy flow)

When to change the tampon
You should change your tampon every 4-8 hours. To remove the
tampon, bend your knees slightly with your legs open and relaxed.
Pull the string outside your body, in the same direction in which you
inserted the tampon. If you feel discomfort when removing the
tampon and you can see white fibres, it may be that it is not
saturated. Always use a tampon with an absorption capacity that
is less than your flow. During the night, we suggest to you Herbox
pads or pantyliners. Always make sure that you have removed the
last tampon before inserting another. Make sure that you remove
the last tampon at the end of your period, and do not use tampons
before or between periods. Never use two tampons at the same
time. Do not flush your used tampon down the toilet – dispose it in
the household refuse.

What you should know about Toxic Shock Syndrome (TSS)
TSS is a rare but serious illness. It is caused by toxins produced by
Staphylococcus aureus, a bacteria that is commonly found on the
skin and inside the nose and vagina. TSS can appear in women,
men and children. The risk of contracting TSS is higher in
adolescents and women under 30 years of age than in older
women. Although it is infrequent, it is important to know what to do
if necessary. Recognition of the symptoms and early treatment is
important. The symptoms that indicate possible TSS infection are
the following: Sudden, high fever (39°C/102°F or higher),
dizziness, vomiting, fainting, muscle aches, skin irritations similar to
sunburn. Not all symptoms may be present, just some. In more
advanced stages of the illness, the skin can begin to scale. TSS
can appear during the menstrual period or a little while later. It can
advance rapidly with flu-like symptoms, to a serious illness with
fatal consequences. If you have one or more of these symptoms,
remove the tampon immediately and see your doctor. Tell your
doctor that you have been using tampons and that you are
concerned about TSS. You should consult your doctor before
resuming the use of tampons. You can reduce the risk of menstrual
TSS by using tampons with the lower absorbency necessary to
cover your needs and by changing your tampon regularly every 4-8
hours. You can also alternate with use of a sanitary napkin instead
of a tampon at least once a day. If you don’t use tampons the risks
of TSS is reduced but not entirely eliminated.

What is TSS?
Toxic Shock Syndrome (TSS) is a rare but serious illness that may
cause death. It is caused by a toxin (a kind of biological poison)
which is produced by a type of bacteria (Staphylococcus aureus).
These bacteria are found in the nose of about one-third of the
population. They may also be found on the skin, and occasionally in
the vagina, without causing harm.
Who is at risk?
TSS can occur in both males and females of any age but is more
common in young women who use tampons during their period.
What are the symptoms of TSS?
The early symptoms of TSS may begin suddenly and are similar to
the ‘flu’. Remember, early recognition of these symptoms is very

What must I do if I think I have TSS?
If, during your period or shortly after, you have any of the above
IMMEDIATELY. Remember it is very important to tell the doctor that
you have been using tampons. If you have ever had TSS, you
should not use tampons until you have discussed the matter with a
doctor. You may not have developed resistance to the toxin and
could get TSS again.

How does TSS occur?
If the toxin is produced in the vagina or a wound, and absorbed from
there into the bloodstream, a person who is not resistant to the toxin
may become ill. Most people develop resistance to the toxin (that is
why the illness is so rare) and in these people there is no harmful
effect. The symptoms of TSS may develop rapidly. Early recognition
and treatment of these symptoms can usually prevent serious

Do tampons cause TSS?
The simple answer is no. Tampons do not carry the bacteria which
cause TSS. However, tampon use has been associated with an
increased risk of TSS. Although TSS can occur with the use of
tampons of any absorbency, the risk increases with the use of
tampons of higher absorbency. Please note that tampons are not
sterile and neither are your hands or vagina. Tampons,while
containing very small amounts of bacteria normally present in the air,
have not been shown to carry the bacteria which causes Toxic
Shock Syndrome (TSS).

Precautions for tampon use
-You should use the lowest absorbency tampon for your comfort and
level of blood flow. Use only one tampon at a time.
-Wash your hands before unwrapping and inserting a tampon, and
again afterwards.
-Unwrap a fresh, clean tampon just before use-do not handle it more
than necessary or place it on any surface.
-Do not insert a tampon if it hurts to do so.
-Removal of the tampon should be easy: if the tampon is dry and
difficult to remove, the absorbency is too high or the tampon has not
been in place long enough. Tampons should be changed as often as
you need but should not be left longer than 8 hours.
-Remove the used tampon before inserting the next one and do not
forget to remove the last tampon used at the end of your period.
-Only use a tampon when you are menstruating.
-Ask a doctor if it is okay to use tampons if you have recently given
birth, had a caesarean section, a miscarriage, an abortion or any
operation on your reproductive system.

Where can I get more information about TSS?
More information is available, free of charge, from the Toxic Shock
Syndrome Information Service a web-based service at