Which practice is NOT recommended for preventing toxic shock syndrome?

• A. Wash your hands before inserting a tampon.
• B. Use super absorbent tampons.
• C. Wear cotton underwear.
• D. Douche every month following menstruation.

Answer: (D)

Preventing toxic shock syndrome relies on keeping the vaginal environment balanced and avoiding practices that disrupt it during tampon use. Douching after menstruation is not recommended because it disturbs the normal vaginal flora, can alter pH, and may push bacteria toward the bloodstream, increasing TSS risk. In contrast, washing your hands before inserting a tampon helps prevent introducing bacteria, using an appropriate tampon absorbency and changing it regularly reduces the chance for bacteria to multiply, and wearing cotton underwear helps keep the area dry and breathable. So the practice that should be avoided is douching.