Blush: TSS and menstrual cups

I am a huge supporter of the use of menstrual cups. I have used a Diva Cup since 2008, and cannot imagine switching away from it. I talk about my foray into postnatal products here, as it is not safe to use insertable menstrual products after delivery, no matter the method of delivery.

The other day, one of my friends tagged me in a link to an article describing how cups are linked to increased bacteria. At first, I just brushed it off. ONE article does not concern me. But as I was thinking about what to write this week, I realized that I was biased. I should actually sit down and do the damn research myself.

And do you know what I found? Not much.

Not only is there next to no research done on the prevalence of bacteria found on cups, there doesn’t seem to be any plans of doing any research on this. Get on this, scientists!

Moving on…

Let’s examine what Toxic Shock Syndrome (TSS) actually is. If you’re like me about an hour ago, you would say, “oh, TSS has something to do with leaving tampons in for a long time.”

You’d be partially right, but mostly wrong.

Yeah, I was surprised too.

TSS is actually caused by bacteria (specifically Staph and Strep) getting into the bloodstream and releasing harmful toxins.

This is a Giant Microbe of Staph. You can buy them here.

This means something super important: Toxic Shock Syndrome is NOT limited to tampon users.


That was my reaction. Anybody can get TSS. Jim Henson died from TSS, and as far as I know, he did not use tampons.

Tampons are a pretty good breeding ground for bacteria, and in the 70’s, there was a chemical compound in the “super absorbent” tampons that really increased this. Once that compound was eliminated, the number of TSS cases reported dropped drastically. Removing tampons when directed helps, too.

Also, using a higher absorbency tampon than required can cause micro-abrasions inside the vagina, leading to a higher likelihood of the bad bacteria finding a way inside the bloodstream.

Okay. Now that we’ve cleared that up, what about bacteria on cups causing TSS?

According to my research (thanks Dorothy Ann), there has been one reported case of a person getting TSS while using a cup. It was in 2015, and it was reported that there was an abrasion inside the vagina at the time of use of the cup.

We already have Staph and Strep bacteria all over our bodies at all times. They’re mostly harmless. If they are allowed to grow as a colony, breed, and then slip into our bloodstream, there is STILL a pretty high likelihood that our white blood cells will fend them off. It’s once the bacteria release the poisonous toxins that there’s a problem, and scientists still don’t know what causes that!

Without any real hard scientific evidence to prove one way or another, we can’t say that Cups are better or worse than tampons at breeding bacteria. If you look at the original article I mention again, there’s a diagram showing the amount of bacteria found on tampons and cups, with the control being just a regular vagina. Look at how much Staph they found in a regular vagina, and compare it to the rest. There is almost as much or more Staph bacteria in a regular vagina as there is on a cup or tampon! Remember, this is NORMAL. The decreased amount of bacteria on the tampon is probably due to the change in pH of a vagina from the substances on the tampon. This is not necessarily a good thing. The pH of a vagina should be balanced. You WANT to find bacteria in there! (The good kind, obviously.)

This diagram is one of the reasons why I wanted to dismiss the article immediately. It doesn’t really show anything important.

But I’m glad I did the research, if only to realize how little research has actually been done. I’m surprised, even though vaginas are apparently a dirty word in research.

I will keep using my cup, washing it thoroughly with soap after every use. But honestly, I’m not too worried.


If you’re enjoying the Blush blogs, consider learning more with Blush: The Card Game from Renaissance Press.

Blush: Rim shot

A couple of weeks ago, an article popped up on my news feed (I like to write posts about topics that come up in conversation online or in person, especially if they are ones that I don’t know much about, so I feel like I’ve said this opening sentence often) and out of curiosity, I clicked on it to read it. It was about a gastro parasite contracted by rimming. Here it is, in all it’s graphic detail.

Image from youtube video screenshot.

So there’s a couple things that I’d like to talk about in this article.

The first thought that came into my head as I was reading was, “I’ve only really thought about STIs being transmitted!”

The second thought, almost immediately following the first, “It makes complete sense that bacteria could be transmitted as well. Why isn’t this discussed more often?”

And third, “Why wasn’t this guy using a dental dam?”

I’ve talked about dental dams before, so I won’t repeat myself. However, I hadn’t mentioned that they are a good barrier method for oral-anal (or analingus) sex. I’ve now done some research, and yes, they are safe (and recommended!) to be used on the anus.

My search history is quite varied and unusual.

My first attempt at finding out more information on bacteria transmission via analingus didn’t turn up anything about bacteria. I found a lot of confirmation (references #1-6) that dental dams are safe for anal use, but only that they protected against STI infections.

Reference #7 finally mentioned bacteria, but only in reference to anal sex, and didn’t go into any detail about it.

Finally, references #8-10 discussed the topic I was interested in, and I was able to learn a bit more about what the original article described.

Parasites in the gastrointestinal tract invariably leave it in one direction: via the anus. Cleaning, even as thoroughly as one would before sex play, will NOT get rid of all the bacteria. Any time anal play is involved, protection should be used, even in an exclusive relationship.

(Side note: reference #9 suggests plastic wrap as a barrier method – THIS IS NOT A GOOD IDEA! Plastic wrap is porous, and is not a viable method of protection.)

The fact that it was so difficult to find references (at all, not just good ones) on the subject means that very few people have considered the consequences of not using protection while rimming. That’s kind scary.

To sum up, use protection!



    If you’re enjoying the Blush blogs, consider learning more with Blush: The Card Game from Renaissance Press.