Here are a few conditions which can lead to Toxic Shock Syndrome (TSS): 1. Presence of Staph (Staphylococcus Aureus) in the vaginal canal- it is normally not present there and can be introduced through our hands while inserting, hence washing hands before inserting is important 2. Presence of a cut or bruise inside the vaginal canal 3. Staph to release toxins If any menstrual hygiene management product is used mindfully and changed/emptied every 6 to 8 hours, TSS should not happen. If used correctly as per the instructions, menstrual cups do not elevate the individual's risk of TSS. Theoretically, since menstrual cups have blood on the inside and silicone forms a physical barrier between the blood and the vaginal walls, the odds are less in the favour of TSS.