A menstrual cup is one of the many female hygiene products used during menstruation. It is a small, flexible, funnel-shaped plastic device that is designed to be fitted into the vagina and collect menstrual blood. What makes them stand out from other hygiene devices is that they are completely reusable.

Once full with menstrual blood, menstrual cup can be easily removed, cleaned and reinserted. This makes it quite a cheaper alternative to tampons or sanitary pads. Despite this, menstrual cups or rubber cups are less popular among women because of the myths related to their use and due to lack of knowledge.

This article is meant to guide you on how to use a menstrual cup and states its advantages. Disadvantages or risks of menstrual cups have also been discussed along with availability and price in India.

  1. Menstrual cup use
  2. Menstrual cups
  3. Menstruation
  4. How to use a menstrual cup: Important considerations
  5. When to remove a menstrual cup
  6. How to remove a menstrual cup
  7. Menstrual cup price in India
  8. Menstrual cup advantages
  9. Menstrual cups disadvantages
  10. Menstrual cup dangers

Menstrual cups are quite easy to use despite the contrary belief. It requires you to relax and follow the instructions below:

  • Thoroughly wash your hands before inserting the cup to prevent the risk of any vaginal infections.
  • Comfortably sit with your legs spread out and identify the opening of your vagina with the help of your fingers.
  • Hold the menstrual cup in your hands and apply a lubricant to its rim. Make sure to use a water-based lubricant meant only for the vagina. Using an oil-based lubricant, oil, lotion or any cosmetic products can interfere with the functioning of the cup.
  • In case of unavailability of a lubricant, you can simply use water along the rim of the cup or run it under cold water prior to insertion.
  • Now, squeeze the cup into half or a C-shaped form.
  • Slowly advance the cup into your vaginal opening. It should rest just a few inches below your cervix.
  • Once the cup is placed successfully, you have to rotate it within the vagina. This will help to form an airtight seal, which will hold the cup in place. This will prevent its dislodgement and will also avoid a leak.
  • After the cup is properly inserted and is kept in place, you may not feel it. It should not be irritating, painful or pinching and must be absolutely comfortable.
  • Standing, sitting, walking and other activities may be easily performed. If not so, the cup has not been rightly inserted or there is an underlying medical concern.
  • If after repeated trials, the cup is causing discomfort, you may be requiring a different size or type of a menstrual cup. It is recommended to visit your gynaecologist if the discomfort is severe.
    (Read more: Causes of Vaginal pain)

Menstrual cups are small cup-shaped devices, which are inserted into the vagina to collect menstrual discharge. They are generally reusable and are made of silicone. Menstrual cups fit well inside the vagina and can be left for longer hours than a pad or a tampon, which makes their use favourable.

(Read more: Period hygiene tips)

Menstruation, commonly known as periods, refers to the duration during which women experience bleeding along with the discharge of mucosal tissue from the vagina. This occurs due to disruption of the uterine lining or the endometrium owing to lack of conception.

(Read more: Vaginal bleeding causes)

It can last anywhere between 2 to 7 days on an average, and is experienced differently by different women.

(Read more: Period pain remedies)

Using a menstrual cup can be tricky. It may be a gruesome experience for some. You need to take care of the following things:

  • Buy the right menstrual cup
    Not all menstrual cups are the same. There is no one particular cup that suits all women. Before buying a menstrual cup, it is essential that you be familiar with your body’s anatomy, which will help you in choosing the right size and material of the cup.
    You can measure your cervix with the help of the fingers before making a purchase. The strength of pelvic floor muscles also has a role in this. Those with stronger pelvic floor muscles need a firm menstrual cup since a regular or soft cup may shift. However, those with sensitive skin require a more soft and flexible cup.
    It is also important to note the type of menstrual cup that you are using. While most of the menstrual cups are designed to be reused, a few of them are disposable. They must not be reused at all to avoid infections.
    Although these variations exist, most women are able to find the right type of menstrual cup, which is the most suiting, without the need for fitting.

  • Use only water-based lubricants (the relevance of which has already been discussed). It is also important to not overuse a lubricant covering the entire surface area of the cup.

  • Do not ‘try on' a menstrual cup while not on your periods
    Menstrual cups are specifically meant to be used during the time of menstruation. Using it otherwise serves no purpose, rather poses a risk. If you have bought a cup and your periods have not yet begun, it is best to wait till your periods rather than performing a device test run.
    This is because menstrual cups are easier to fit during periods when the vagina and its opening are naturally more lubricated than the normal days. So, you may have more trouble inserting a cup otherwise. It is also likely to cause irritation; the fear of which may hinder you from using it when you actually need to
    Also, a menstrual cup is more easily removed during menstruation because it is heavily filled with blood. Removing it otherwise may also take longer because your cervix is much higher on normal days than while on your periods. Regular days have the risk of the cup tightly suctioned with the cervix, making it very hard to remove. So, it is highly recommended to not test menstrual cups otherwise and use them only during your periods.

  • Do not panic
    This is the most important point to be noted while making the use of a menstrual cup, particularly among the first time users.
    You need to really calm down and relax while using a menstrual cup for it to seal in your cervix. For this, you can either take a relaxing shower before putting on a cup in or you can perform a squat. These activities allow your pelvic muscles to relax.
    At all times, it is important that you do not stress. This will cause your pelvic muscles to tighten, which will make the insertion and removal quite difficult and uncomfortable.
    Most women are panicked at the very sight of a menstrual cup and wonder if it is too large to fit inside the vagina. It is important to relax and note that the device is entirely flexible and will fit by itself in the vagina. The large size is meant for the menstrual contents to fill in.

  • Keep on trying
    If you don't succeed at first, just keep trying on inserting the menstrual cup because this process requires time. You may try different sitting positions and see which one is the most comfortable for you. Ensure that there is enough lubrication of the vagina each time you try.

A menstrual cup needs to be removed and reinserted when it is full. It can be left on for 6 to 12 hours in your vagina. However, you must not exceed the 12-hour limit because the cup is mostly full by then. Exceeding this time may increase the likelihood of a leak and make it a possible source of infection. Menstrual cup can be left overnight safely.

If you have a heavy flow, it is better to remove the cup at 6-8 hours to prevent a leak. If you have a normal or lesser flow, you may keep it on for 12 hours. This also depends on the day of your period. On initial days with heavier bleeding, emptying may be required more often than the last days of your cycle with reduced flow. But, menstrual cups must be emptied at least twice daily.

Like with insertion, this process requires you to wash your hands thoroughly. After that, insert your fingers into your vagina to identify the tip or stem of the cup. Pull this stem gently until you reach the base. Now, pinch the base to release the seal and carefully remove the cup out of your vagina. Empty the contents into the sink. 

If your cup is disposable, you have to throw it after use. If not, you can rinse it with water and wipe it clean before reinsertion. Depending on the level of care, a menstrual cup may last from 6 months to even 10 years.

It is quite rare to find a menstrual cup in India due to its limited use. However, you can buy them online if not available at your nearby pharmacy. Few of the best menstrual cups in India are:

  • Moon cup- Rs. 1577
  • Wow skin- Rs. 699
  • She cup- Rs. 996
  • Silky cup- Rs. 200
  • Sirona- Rs. 228
  • Diva cup- Rs. 2674
  • Ruby cup- Rs. 1999

Some of the users have suggested that the moon cup is longer and firmer and can be used for athletic women and those with higher levels of physical activity, possessing strong pelvic muscles.

Following are some of the advantages of using menstrual cups:

  • They are cheaper than pads and tampons in the long run.
  • They do not require frequent changing and can be worn for long hours (10-12 hours).
  • They are more comfortable than pads. Once inserted, the body does not even feel its presence. On the other hand, sanitary pads can cause irritation at times.
  • It is not dislodged by movements and can thus be used by women with high levels of physical activity.
  • It is more environment-friendly since you do not need to dispose of it each day.
  • It helps you become more familiar with your body (which is very important).
  • You can easily urinate while wearing a menstrual cup.
  • It is more hygienic and sanitary since you do not get the feeling of ‘wetness’ commonly experienced with pads.
  • Infections are less likely to occur with menstrual cups when compared to tampons.
  • It can also be used by women who are using an intrauterine device (IUD).
  • It is safe to insert and remove.
  • It is easy to clean.
  • You do not have to worry about carrying packets of sanitary pads while travelling since menstrual cups are reusable.
    (Read more: Urinary tract infection treatment)

Following are the disadvantages associated with the use of menstrual cups:

  • They can be difficult to insert and remove, especially for beginners.
  • They may seem to be messy and a trouble to clean. Some people may even find this gross.
  • It may be difficult to find the right fit of menstrual cups.
  • It may cause vaginal irritation or in some cases, an allergic reaction due to the silicone material being used.
  • Very rarely, it may leak or cause discomfort if worn for long hours.

Though generally considered safe for use, menstrual cups do have certain risks, which have been mentioned below:

  • Since it collects menstrual blood, it is not safe to keep menstrual blood on for a duration longer than 12 hours. This may provide a medium for bacterial growth and infection.
  • One study has reported the case of a woman suffering from toxic shock syndrome with the use of a menstrual cup. Toxic shock syndrome is caused due to bacterial growth, releasing harmful toxins, which can be life-threatening.
    Several other studies have also hinted at the risk of toxic shock syndrome with the use of menstrual cups and recommend taking precautions.
    Another study published in Applied and Environmental Microbiology stated that the bacteria responsible for these toxic symptoms may remain viable even after the menstrual cup has been washed.
  • A few cases have reported extreme difficulty in removing a menstrual cup, requiring medical help. So, it is important that you choose the right type of cup and insert it safely.

References

  1. New South Wales Government. Menstrual Cups. [Internet]
  2. Barbara B. North, Michael J. Oldham. Preclinical, Clinical, and Over-the-Counter Postmarketing Experience with a New Vaginal Cup: Menstrual Collection . J Womens Health (Larchmt). 2011 Feb; 20(2): 303–311. PMID: 21194348
  3. Courtney Howard et al. FLOW (finding lasting options for women). Can Fam Physician. 2011 Jun; 57(6): e208–e215. PMID: 21673197
  4. Jane Juma et al. Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study . BMJ Open. 2017; 7(4): e015429. PMID: 28473520
  5. Wiebe ER, Trouton KJ. Does using tampons or menstrual cups increase early IUD expulsion rates? Contraception. 2012 Aug;86(2):119-21. PMID: 22464406
  6. Michael A Mitchell et al. A confirmed case of toxic shock syndrome associated with the use of a menstrual cup . Can J Infect Dis Med Microbiol. 2015 Jul-Aug; 26(4): 218–220. PMID: 26361491
  7. National Health Service [Internet]. UK; Toxic shock syndrome.
  8. Nonfoux L et al. Impact of Currently Marketed Tampons and Menstrual Cups on Staphylococcus aureus Growth and Toxic Shock Syndrome Toxin 1 Production In Vitro. Appl Environ Microbiol. 2018 May 31;84(12). pii: e00351-18. PMID: 29678918
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