Tampon characteristics and menstrual toxic shock syndrome

Abstract

<h3>In Reply.</h3> —Rome et al discuss several points that relate to three aspects of the lack of standardization of tampon absorbency, a situation that has existed for seven years, since the association between increased risk of toxic shock syndrome and increased tampon absorbency was first discovered. I agree with their conclusion that proper standardization of sampling prior to testing tampons for absorbency should require that tampon samples be taken from various retail shelves to represent the true variation in absorbency that might exist between different lots of the "same" tampon but that might be obscured if all samples were taken from the same lot. Another issue concerns standardization of the absorbency testing itself. Although there are demonstrated differences between tampon absorbencies using heparinized blood as opposed to saline, the impossibility of standardizing heparinized blood because it would come from different sources precludes its use and favors the saline solution, as