When sociology senior Kate Hardin gets her period, she sets an alarm to take out her tampon. She worries she could get Toxic Shock Syndrome, a potentially deadly bacterial infection, if she doesn’t.

Toxic shock syndrome is a rare condition caused by a toxin most commonly released by the bacteria Staphylococcus aureus and is associated with tampon usage. If the condition is not identified and diagnosed right away, it can cause complications that can lead to loss of limbs or death.

Toxic shock is also incredibly rare, with only about three to four women out of 100,000 affected by the bacterial infection, according to the National Organization for Rare Disorders. But Hardin said the warning signs on her tampon box remind her of the possibility of getting the condition every month when she’s on her period.

“The whole week I’m thinking about it,” Hardin said. “I have an alarm set to make sure that I don’t have any prolonged exposure that could potentially make me get (toxic shock syndrome).”

Last month, the UT Real Beauty Campaign invited keynote speaker and model Lauren Wasser to share her personal story of how toxic shock affected her life. Wasser lost both of her legs due to the condition and is known as the “girl with golden legs” because of her golden prosthetics.

Toxic shock syndrome causes multisystem issues, including low blood pressure, high fever, rash and gastrointestinal distress, such as bloating, cramping and pain, said Lauren Thaxton, obstetrician and gynecologist at the Women’s Health Institute at UT Health Austin. But symptoms of toxic shock syndrome can be vague and associated with many other disease states, Thaxton said.

“I think it is important to be aware that this condition exists,” Thaxton said. “However, this is an extremely rare condition and it is important to keep that in mind.”

Using highly absorbent tampons is one of the biggest risk factors for toxic shock because they may be changed less often, which gives more time for bacteria to flourish, Thaxton said. But other feminine products that are typically considered to be safe, such as diva cups, can also raise the risk of toxic shock, according to a study in the journal, Applied and Environmental Microbiology.

The most common scenario for toxic shock is a woman using a highly absorbent tampon, but it can also occur in men and children through skin wounds and surgery, Thaxton said.

Hardin said the fact not a lot of women know about toxic shock syndrome speaks to a larger problem of not talking about women’s health.

“Menstruation is treated as such a taboo that we often don’t know about things like toxic shock syndrome, endometriosis or polycystic ovary syndrome,” Hardin said. “There really needs to be more open communication about menstruation and women’s health to ensure that all women are making smart and healthy decisions. That includes providing higher access to these resources and those affected by it.”