Summary of Menstrual Cups
What are menstrual cups?
Menstrual cups collect menstrual blood and prevent it from leaking out of the vaginal canal. They come in two forms — vaginal and cervical — although the cervical cup is commonly known as a menstrual disc rather than a cup. Vaginal cups are bell shaped and made of medical grade silicon, rubber, latex, or elastomer. They come in a variety of sizes and firmness levels, and are reusable for up to 10 years. Cervical cups are disc shaped, are made of silicon or medical-grade polymers, and may or may not be reusable.
While both forms rest in the vaginal canal, the cervical cup sits higher and is “tucked” behind the pubic bone in the vaginal fornix. The vaginal cup, by contrast, stays in place by creating a seal between the cup’s rim and the vaginal walls.
Upon insertion into the vagina, a menstrual cup is worn for 4 to 12 hours, depending on flow rate and cup size, at which time it is removed. It is then either discarded (if disposable) or emptied, cleaned/rinsed, and reinserted (if reusable). Reusable cups are also sanitized in boiling water between cycles before being stored away for future use.
Menstrual cups are designed for insertion into the vagina, where they collect menstrual flow for 4 to 12 hours. While they come in a variety of shapes, sizes, and materials, the majority are bell shaped and made of medical grade silicone. After removal, they are emptied, cleaned, and reinserted. Between cycles, they are sanitized in boiling water. With proper care, one cup lasts up to 10 years.
What are the benefits of menstrual cups?
Menstrual cups have certain benefits when compared to tampons and pads. As most are reusable, they cost less over time and reduce plastic waste. Some people find them more comfortable and convenient, with fewer changes per cycle and less concern regarding leakage.
Additionally, because they are nonabsorptive, they do not alter vaginal pH or soak up vaginal secretions, a drawback of tampon use that can lead to irritation and vaginal dryness. The majority of people who try out a menstrual cup report that they will continue to use it and recommend it to others.
Compared to tampons and pads, reusable menstrual cups cost less and create less waste. They also require fewer changes per cycle and are less likely to alter vaginal pH or cause vaginal dryness, as they are nonabsorptive.
What are the risks related to menstrual cups?
Possible adverse events related to menstrual cup use include removal difficulties that require professional assistance, infections and vaginal injuries, IUD expulsion, and, in rare cases, hydronephrosis (swelling of a kidney due to build-up of urine). The majority of these adverse events are uncommon and can be avoided in some cases. For example, removal difficulties are often related to broken cup stems and improper cup sizes, highlighting the importance of finding a cup with a sturdy stem that fits well. Infections may be largely mitigated by careful cup cleaning and sanitizing between cycles.
If using a cup along with an IUD, extra caution is needed during cup removal, as the IUD strings may be accidentally pulled or suctioned out along with the cup. Some cup users find that having a doctor cut their IUD strings shorter helps solve this potential issue. Additionally, if using a vaginal cup, breaking the seal prior to removal likely reduces the risk of IUD expulsions.
Menstrual cups come with a learning curve and are not as immediately intuitive as pads or even tampons. It may take more than one purchase before a user finds the best cup for fit, comfort, and activity level. It also takes some time to develop preferred techniques for insertion and removal. However, most users have few to no cup-related issues by their third cycle with the cup.
Overall, menstrual cups are safe to use, especially when worn and cleaned properly. The majority of adverse events are uncommon, but there are some reports of removal difficulties requiring professional assistance and accidental IUD expulsion. Awareness of the signs and symptoms of possible adverse events helps to ensure timely recognition, should they occur.
Can you have sexual intercourse while using a menstrual cup?
Unfortunately, this is not a simple “yes or no” answer. It depends on a few factors, one being the cup that you choose. The majority of available vaginal cups manufacturers do not recommend sexual intercourse during use, but there are some softer vaginal cup options with shorter stems and/or disposable vaginal cups that may be easier to use during sex. Another factor is the length of your vaginal canal (which does increase when you are aroused)[1] and the length of the object inserted into the vaginal canal. You also must determine your own personal comfort level with “period sex”. Ultimately, if you are interested in a menstrual care product designed with sexual intercourse in mind, a disc (cervical cup) is a better recommendation. In one disc study, over 60 women reported having sex during a menstrual cycle with the disc in place. Nine reported discomfort, and 13 reported male partner discomfort.[2]
Most menstrual cups are not recommended for use during sexual intercourse. If you are looking for a product designed for sexual intercourse, a disc (cervical cup) or a disposable menstrual cup are better options.
Are there ways to make insertion and removal easier?
Some menstrual cup users find that trying different relaxation techniques, body positions, cup positions, cup folds, and even the use of lubrication can help reduce discomfort during insertion. For removal, squatting in the shower may be helpful. If it is a vaginal cup, wiggling the cup back and forth gently after grasping the bottom may help users break the seal and slide the cup out. If it is a cervical cup/disc, bearing down (as if having a bowel movement) may improve the removal process. Changing to a different cup is another strategy, as preferred cup sizes and firmness levels vary and play a role in ease of use.
There are some tips and tricks to make using a cup easier. Don’t be afraid to try out different cups and body positions to see if these changes improve insertion and/or removal.
Are there other reusable menstrual care products besides the cup?
As awareness of the financial and environmental toll of menstrual care products increases, the idea of reusable products is appealing. For those who prefer not to use a cup, there are reusable undergarments (“period panties”) which absorb menstrual blood much like a sanitary pad.
If you are looking for a reusable menstrual care option other than cups, you can try out reusable undergarments. They absorb blood and can be washed and worn again.
