Menstrual Cups

For years, women have used either tampons or pads to collect blood and protect clothing during their periods. But a menstrual cup provides women with an alternative to these traditional methods. Some are long-lasting and reusable, while others are disposable.

Menstrual cup basics and advantages

Aren’t sure what a menstrual cup is? It’s a flexible cup designed for use inside the vagina during your period to collect menstrual blood. The cup actually collects the menstrual flow rather than absorbing it like tampons or pads do.

Most menstrual cups are made of silicone or rubber. I always remind my patients that if they’re latex-sensitive, they should make certain to purchase a cup made entirely of silicone.

You can use a cup all the way through your cycle, but you might need to change it more often on heavy flow days to guard against leaking. Remove and rinse your cup after 12 hours, or when leaking occurs.

Advantages of menstrual cups include:

  • Lower costs and less landfill waste. Some cups are designed for long-term use – even years – providing a significant cost savings over tampons and pads. Since you can reuse them, there’s less waste to clog up our landfills and fewer trees sacrificed to make the paper-based alternatives. Keep in mind that some cups are designed to be disposable. Make sure you read the box label carefully before buying if you want a reusable one.
  • Less embarrassing odor. You won’t have to worry about embarrassing menstrual odor wafting out at the most inopportune times, since the fluid doesn’t get exposed to air as it does with pads and tampons.
  • Vaginal pH and beneficial bacteria stay in place. Tampons absorb all your vaginal fluid along with the blood, which may disturb the delicate pH and bacterial balance in your vagina.
  • Fewer visits to the pharmacy. Even if you replace your cup once a year, you’ll still make 11 fewer trips to the pharmacy than you would if you used the disposable paper-based methods.
  • More time between changes. You need to change tampons every four to eight hours, depending on flow. You can go up to 12 hours with a menstrual cup before emptying.
  • Intercourse is possible with the cup in place. It’s possible to have intercourse while the cup is in your vagina. It’s really a personal choice whether you want to remove it first or not.
  • Easy to use. Anyone who has used tampons, especially the kind without applicators, should have little trouble learning how to insert a menstrual cup. If you’ve ever used a diaphragm for birth control, you’ll have even less trouble learning how to use your new cup. Simply fold it so it looks like a tampon, aim it toward the back of the vagina and give a little push. It should actually draw itself up. When inserted properly, you shouldn’t feel its presence at all.

Menstrual cup disadvantages include:

  • More mess. The main disadvantage that my patients note is that cup emptying can be messy. With practice, most women will work out a suitable technique and quickly get over the “ick factor.” Also, cleaning it in a public bathroom may cause embarrassment to some.
  • Difficulty of insertion for some. Younger girls and those who’ve never had intercourse may find it difficult to insert the cups. And, if you have an IUD in place, using a menstrual cup could pull the IUDstrings and dislodge it. Ask your OB/GYN or primary care physician about his or her preferences in these instances.
  • Possible fit problems. Sometimes individual anatomy can make proper use of the cup difficult. For instance, if you have fibroids or a dropped uterus, it may not fit in place properly.
  • Cup removal issues. Removing the cup can sometimes present more of a learning curve. You shouldn’t pull on the stem. Instead, pinch the base and pull. The collected fluid then empties into the toilet. Rinse under tap water and reinsert.
  • Maintenance. After each cycle, sterilize the cup using boiling water or a sterilizing solution used for baby bottles.

The only way to know if a menstrual cup is the right device for you is to buy one and give it a try! They come in various formations and sizes, so sometimes, if the first one doesn’t suit you, the next one will do the trick. You can find them at drug stores or buy them online.

By: Elisa Ross, MD
Elisa Ross, MD, is a obstetrician and gynecologist in Cleveland Clinic’s Women’s Health Institute. She loves caring for and educating women.