Following a controversial period of test marketing in Rochester and Fort Wayne, in August 1978 Procter and Gamble introduced superabsorbent Rely tampons to the United States market in response to women's demands for tampons that could absorb more menstrual flow without leaking or replacement.
Unlike other tampons, which are made with cotton and rayon, Rely was unique: it used carboxymethylcellulose and compressed beads of polyester for absorption - the company released the new product after having conducted extensive research on its safety. This tampon design could absorb nearly twenty times its own weight in fluid. Further, the tampon would "blossom" into a cup shape in the vagina in order to hold menstrual fluids. Because of this, its advertising slogan was "It even absorbs the worry!", and claimed it could hold up longer than the leading tampon, because it was made differently. "Remember, They named it Rely" was the last line of most commercials.
The superabsorbent properties of Rely caused vaginal dryness by absorbing the natural humidity of the vagina. Often this led to ulcerations in the vaginal wall when the tampon was removed, offering pathways for bacteria to infect the bloodstream. Further, the tampons' superabsorbency meant that the viscosity of vaginal fluids was enhanced, providing a good environment for bacteria growth.
Procter and Gamble recalled Rely in September 1980 after the Centers for Disease Control released a report that summer, explaining the bacterial mechanisms which lead to TSS, and that Rely tampons were associated with TSS more than any other tampon. As part of the voluntary recall, Procter and Gamble entered into a consent agreement with the Food & Drug Administration "providing for a program for notification to consumers and retrieval of the product from the market". The recall cost Procter and Gamble over USD $75 million.
One very important effect of the attention to TSS in the 1980s was that the FDA implemented regulation of tampons as medical devices and forced manufacturers to standardize tampon absorbencies and include package inserts that warn tampon users of TSS risk. On the market today are tampons made both from synthetic materials, especially rayon, and from cotton only. The key ingredients used in Rely, carboxymethylcellulose and polyester, were removed from the market in 1980.
Reported cases of TSS have decreased dramatically since the 1980s.
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