Menstrual Cups

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Menstrual cups are increasingly finding its way into the lives of young girls and women in India. Menstrual cups provide several advantages compared to other menstrual hygiene options available for women to handle their periods. Before going further, let us see

What is a Menstrual Cup?

As the name indicates, it is a cup like structure that is inserted into the vagina during menstruation to collect menstrual discharge and prevent it from leaking onto the clothes. Unlike tampons and sanitary pads, which absorb menstrual fluid (blood from uterine lining), menstrual cup collects and holds it. Menstrual cups are made of flexible and medical grade silicone and come in a bell like shape with a stem at the bottom for insertion and removal.

The biggest advantage is that menstrual cups are reusable. The cup can be removed, emptied, rinsed and reused. One menstrual cup can be reused for upto 5 years and this makes it cost effective in the long term and also eco-friendly compared to sanitary pads which are marked as hazards for our environment. Being reusable, it prevents tons of sanitary pads being dumped in our planet on a daily basis. Menstrual cups come in various sizes to suit the varying needs of women. 

How it works?

To put it simply, menstrual cups collects menstrual fluid, while tampons and sanitary pads absorb it. Menstrual cups are flexible and are usually made of silicone or latex.

-       Before the beginning of periods, menstrual cup needs to be inserted by tightly folding it. This is somewhat similar to inserting a birth control ring in place.

-       Once inserted into the vagina, the cup will spring open and settle against the vaginal wall quite firmly. It makes a perfect seal against the vagina to prevent leaks.

-       The discharging blood drips into the cup.

-       Being firmly held against the vaginal wall, the entire menstrual discharge is held inside the cup.

-       To remove it, the stem sticking out of the bottom should be pulled and base to be pinched to release the seal.

-       Then menstrual cup can be emptied, washed with soap and water and then replaced again.

-       At the end of the period, the cup can be sterilized in boiling water and then kept safely for the use during the next period.

Are menstrual cups safe?

Menstrual cups are generally regarded as safe by the medical community. Though there are some risks, they are considered minimal and are preventable when it is used as recommended. There are many factors that keep menstrual cups above other menstrual hygiene products that are currently available.


Advantages of using Menstrual Cups:

Wallet Friendly – A reusable menstrual cup can last upto 5 years and more. Unlike tampons and pads, there is no need to spend month-on-month cost. This provides phenomenal saving in the long term as users can only make one-time cost.

Eco-friendly – As it is reusable, there is nothing to dump in our landfills and this is going to save our planet from constant accumulation of tampons and sanitary pads, which are categorized as eco-hazards.

Lasts longer – Menstrual cups can be kept for upto 12 hours depending on the flow. However, tampons need to be replaced every 4 to 6 hours, depending on the flow. As cups can stay longer, it is good for overnight protection.

Holds more – It is estimated that a menstrual cup can hold upto two times the quantity of menstrual discharge compared to a super-absorbent pad or tampons. It can comfortably hold even during a heavy flow day.

No need for backup – As cups get fixed firmly onto the vaginal wall, there need not be any worry even when the flow is larger. There is no need to wear a backup pad or liner.

Less odour – As the menstrual cup forms an airtight seal, there is less odour as the menstrual blood being to smell bad only when it is exposed to air.  

Safety – Menstrual cups are generally safe as long as it is inserted properly with clean hands and removed carefully and cleaned appropriately before reinsertion. For those who are bothered about cleaning, there are disposable menstrual cups available.

IUD Safe – Menstrual cups are safe to use even when you are using an IUD. There is no evidence to prove that process of insertion or removal will dislodge your Intra Uterine Device (IUD).

Sleep longer and convenient – As the menstrual cups can hold for 12 hours, it helps the user to sleep longer and without any worry during periods.

Great during heavy flow – Menstrual cups work perfectly during days of heavy flow. It is proven to hold more menstrual fluid than tampons and sanitary pads. As it is firmly rooted to your vaginal walls, you need not worry about any leakage.

No stains – No need to worry about stains on underwear or clothing. One cannot discount the fact that there is greater chance for stains while using sanitary pad, particularly during sleep in the night.

Vaginal pH – As the cup holds the menstrual fluid, there is no change in the vaginal pH and all beneficial bacteria remains in place. Thus, menstrual cup ensures no irritation.

No stress during heavy periods – Users need not worry during times of heavy bleeding as they can be sure of managing it with the menstrual cup. This removes the stress of managing heavy flow. This makes periods pain-free and hassle-free

Travel compatible – Menstrual cups are more comfortable that it allows women to travel comfortably even during periods.

Swim – Menstrual cups allow even the user to swim and do a bike ride during periods as the menstrual cups are leak-proof.

Safe for use - The cup is latex-free, plastic-free, BPA-free and odour-free and free from chemically induced artificial colours / dyes.

Different shapes and colours – Menstrual cups are available in smaller and larger size, so a woman can choose the one that fits her best. Both coloured and colourless / translucent menstrual cups are available.

User-friendly – This is usually made of medical grade silicone. Menstrual cups are tested for biocompatibility (body safe) and are appropriate to be used inside the vagina during menstruation.


How to Use a Menstrual Cup?

Tips for Beginners

Practice – Inserting a menstrual cup inside your vagina requires some amount of practice. There are numerous videos available for you to watch. You can make few attempts to inserting and removing the cup during your non-period days to make yourself comfortable to use a menstrual cup. Making an effort during your period can become little clumsy, if you don’t get it right.

Find your cervix – The position of cervix varies with every woman. Know that the cup should be placed below the cervix, otherwise the menstrual fluid will leak down. So, you need to locate your cervix with your finger – cervix will feel like a firmer area of tissue inside your vagina and you should position the cup below it.

Use lubricant – You can use a lubricant, if required, to make the insertion easier.  You can use a water-based lubricant.

Trim the stem – If you feel the stem sticks out of your vagina or find it uncomfortable, you can trim it short. Cut it short before inserting the menstrual cup. Never trim the stem after inserting the cup.

Wear a panty liner – Until you find 100% comfortable with your menstrual cup usage, you can wear a panty liner so that you need not worry about leaking.


What are some potential risks involved with menstrual cup usage?

These are the potential risks identified with menstrual cup usage. 

  1. Irritation – Irritation can be experienced by users for various reasons such as wearing wrong cup size, inserting the cup without proper lubrication and the cup not cleaned properly between uses. But these are preventable.
  2. Infection – Infection is rare due to use of menstrual cup. It is identified that infections happen as a result of bacteria in the hands which gets transferred to the cup. The incidence of infection can be prevented by washing hands thoroughly with warm water and antibacterial soap before and after handling the cup.


How to identify the right menstrual cup size for you?

Menstrual cups are generally available in different sizes for the use of girls and women. There are basically three sizes of cups available right now.

Small Size: Smallest menstrual cups are for those women who are under 30 and not had a vaginal birth or teenager.

Medium Size: Medium menstrual cups are for who are under 30 with heavy flow.

Large Size: Large menstrual cups are for who are over the age of 30 and had given a vaginal birth or have a heavy menstrual flow.

As a general rule, you should select a cup based on your age, body size and history of childbirth rather than anticipated flow. Although the volume the cup can hold is important, but it is much more important that the cup is wide enough to fit into the walls of your vagina. A smaller cup is best for teen and young girls who never had intercourse and / or already using tampons. For those women who had a vaginal delivery or have a weak pelvic floor, then larger cup is ideal for them.

It is important to identify the right size of menstrual cup, even it happens through trial and error. Using the wrong size may lead to lot of discomfort.

Material

Most menstrual cups are made from silicone. However, some are made from rubber or contain rubber components, which means, if you are allergic to latex, that type of cups could irritate your vagina. Make sure you read the product label carefully before use to avoid irritation or other discomforts.

How much does a cup cost in India?

Menstrual cups come in various costs, the cheap ones are available even at Rs. 200. You should be careful about not buying low-cost cups as they may be made using low-grade silicone. But the ones that are made using medical-grade silicone falls in the price range from Rs. 450 to Rs.3600 depending on the brand. Menstrual cups provide a huge saving compared to the costs involved in buying sanitary pad month-on-month.


Tips for proper usage of menstrual cup

First step: Before using the menstrual cup for the first time, you should sterilize it thoroughly by submerging it in a pot of boiling water for 5 to 10 minutes. Then the cup should be taken out and allowed to be cooled.

Second step: Your hands should be washed with warm water and antibacterial soap. Cup should be washed with water and oil-free soap thoroughly. Dry the cup with a clean towel.

Third step: Read the manufacturer’s recommendations thoroughly before using it.

Fourth step: Apply a water-based lube on the outer side of the cup to make insertion easier and comfortable. Never use a silicone-based or oil-based lubricants, which can react and may cause certain cups to degrade.

Fifth Step: Now, you are ready to insert. 

-       Tightly fold the menstrual cup in half, holding it in one hand with the rim facing up.

-       Insert the cup, rim up, into your vagina like you would insert a tampon without an applicator. Make sure it sits a few inches below your cervix

-       Once the cup is in your vagina, gently rotate it. It will start to expand to create an airtight seal that stops leaks. Twist it or slightly reposition it if you are not comfortable. Make minor adjustments until you find it fits inside your vagina comfortably.

Sixth step: You can wear the cup for upto 12 hours depending on the flow. It should be removed by 12-hours and not longer. This will help in preventing a buildup of bacteria.   

Seventh step: It is all about removal.

-       Use your index finger and thumb into your vagina and pinch the base of the cup and pull it. If you pull the stem directly you could have a mess on your hands.

-       Once the cup comes out of your vagina, empty the menstrual discharge into the sink or toilet.

-       Rinse the cup under tap water and wash it thoroughly.

Eighth Step: Wash your hands thoroughly and reinsert.

After the period is over, sterilize the cup again with boiling water for 5 to 10 minutes and store it safely for the next period. This will help prevent contamination during storage.


Tips for Storage of Menstrual Cup

The menstrual cup should not be stored in an airtight container, because it won’t allow moisture present in it to evaporate. The moisture that is present in the cup can attract bacteria or fungi and this can lead to infections.

Most manufacturers recommend storing the menstrual cups in a cotton pouch or in an open bag.

When to discard a cup?

A menstrual cup can be used comfortably for upto 10 years. However, there would be wear and tear upon regular use.

If you find some portions of it appear damaged or thinner or totally discoloured or begin to emit foul smell, then you should throw it out and buy a new one. Using a cup in such a state may only increase your risk of infection.


Frequently asked questions (FAQs)

How long can I wear a menstrual cup?

A menstrual cup can be work for up to 12 hours. But to be on the safer side, it should be drained after every 4 hours.

How much menstrual fluid can it hold?

In general a cup can hold anywhere between 24ml to 30ml of menstrual discharge. However, it can vary with one brand to another. Check the manufacturer’s instructions to know the exact quantity before buying.

Will I able to feel the cup inside me?

Yes, you can certainly feel it. But when you get used to it and keep it for long hours, it may feel like in-built and you will not have any problem doing your daily activities.

How does it manage heavy flow?

Menstrual cups have proven to work well during days of heavy flow. Even during heavy flow, menstrual cups can be used for long hours. However, it is recommended to be emptied every 4 hours during heavy flow days.

How deep can a cup go inside the vagina?

The cup can comfortably sit inside your vagina. You can keep it inside in such a way that not even the stem sticks out. The cup can cover up the top of the cervix.

Can I wear during non-period days?

No. It is not recommended during non-period days. However, for practice and to get yourself comfortable using a menstrual cup, you can try wearing it during a non-period day. During non-period days, menstrual cup can create some stress on the vaginal walls and you could feel some level of discomfort during non-period days.

Will it alter the vaginal pH?

No. Menstrual cups don’t alter the pH value as it only collects the menstrual fluid.

Can I sleep with a menstrual cup?

Yes. You can certainly sleep with your menstrual cup. As the cup spreads and holds onto the cervix, there is no way the menstrual blood spilling over and spoiling your dress and mattress.

My daughter is 12 year old. Can she use a menstrual cup?

Yes, she can. Menstrual cups are used by young girls and women across all ages. You need to choose the appropriate size for her and then you daughter can use it comfortably.

Do they cause UTI’s?

Menstrual cup has nothing to do with urinary tract infections. It only holds your menstrual discharge. So, menstrual cups doesn’t cause UTIs. However, it is better to consult your gynec when you are undergoing treatment for a UTI, to be on the safe side.

Do you get Toxic Shock Syndrome (TSS) by using menstrual cups?

No. TSS is not reported by women due to the usage of menstrual cups. Toxic Shock Syndrome is widely prevalent with tampons and sanitary pads as the blood gets absorbed and soaked in them, which can attract a lot of harmful bacteria leading to TSS. So, you need not worry about TSS while using menstrual cup.

Will the blood flow back?

No, the blood will never flow back as the cervix is designed only to flush the blood out and it doesn’t take it back.

Can I use it before marriage?

Yes. You can. Menstrual cups can be used before marriage as it doesn’t alter the pH value of the vagina. Menstrual cups are ideal for teen girls, unmarried women and married, elderly women.

Which cup size should I choose?

Menstrual cups are available in 3 sizes basically. The small ones are for teens and young girls. The medium one is for women who haven’t given vaginal birth. The large one is for women who have given vaginal birth. Menstrual cups should be chosen based on the body type and whether you have given vaginal birth or not. Choosing the one based on your expected vaginal discharge volume is not a good idea.

How long does a menstrual cup last?

A good quality menstrual cup can last upto 10 years. But after consistent usage, the cup might get stained or discoloured – and that is completely fine. You can decide when to discard after looking at its condition. When you begin to feel that edges have become weak and foul smell emanates from it, then it is time to discard and buy a new one.

Can I use a menstrual cup during sex?

No. It is not recommended. Don’t indulge in vaginal penetrative sex  with a menstrual cup on.

I am a virgin. Will my hymen get ruptured when I use a menstrual cup?

Inserting a menstrual cup may rupture the hymen. But hymen has nothing to do with your virginity. Hymen is a thin and soft tissue that covers the vagina. It gets torn with little stressful physical activity even during the very early stage. So, using the cup will actually tear the hymen, if it is present. But, in no way, it affects virginity. By medical standards, virginity is not defined by the condition of the hymen. Virginity gets lost only when you indulge in a sexual intercourse.

Can I use a menstrual cup with an IUD (Intra Uteriene Contraceptive Device / Copper T)?

Yes, you can. Menstrual cups can be used with an IUD. There is no way menstrual cups come in the way of your IUD.

Will I get blood on my hands when removing the cup?

Yes, a little. While removing the cup, you might get a few drops of blood on your fingers, but certainly not more than what you get while removing a tampon. If you follow the instructions and release the suction as recommended, then you may not get blood stains. When you pull the stem directly, you can get lot of mess flowing into your hands.

Can I urinate while using the cup?

Yes, you can. You can urinate without any problem. You can squeeze it a little higher for the urine to get out of the urethra. You just need to do it few times to get it perfect.

Can I indulge in sports with a menstrual cup?

Yes. You certainly can. As it can give you leak-free protection and holds on to your vaginal wall, you can indulge in any sporting activity with a menstrual cup on. Your periods should not stop your ambitions and menstrual cups offer a sure shot way to go all guns even during days of heavy flow.

Can the cup get stuck or disappear inside my vagina?

No. the cup can never go inside your vagina and disappear completely. But, sometimes it can move slightly up. Your vagina is designed in such a way that nothing gets lost inside it. If you have problems in reaching the cup, you should first relax and then breathe. If the menstrual cup has worked its way higher inside the vagina, it’s important to relax the muscles as tensing up will only make removing it more difficult. You can squat and gently push the cup downwards using your abdominal muscles until you are able to hold the stem of the cup. Then you can gently pull down the stem until you hold the bottom of the cup and pinch it to release the suction and remove it out gently.

What happens when I find it difficult to remove menstrual cup?

You shouldn’t get tensed first. You should know to relax your muscles and then try removing it. Please be informed that cervix works by hormonal controls. When you are tensed or anxious, hormones make the cervix tissues harder and this will make removal of menstrual cup lot more difficult. So, you should relax yourself completely and then squat and make gentle abdominal pushes. This can ensure smooth and easy removal of menstrual cup.

Will it hurt while inserting a menstrual cup?

You might find it little uncomfortable during your first few times. If you are not used to inserting a tampon, then you might find it little uncomfortable initially. If you are comfortable with your body and period, then you can find inserting a menstrual cup easy and comfortable. The point is, if you feel uncomfortable, you shouldn’t force it inside you. You just have to take a break and try it again after a while.

Remember, the entrance of the vagina is smaller in width compared to the rest of the vagina. So, you might need little practice in the beginning to insert it into your vagina. If you find it too difficult to insert, then you can try the next size and then try. You don’t need any special skill or expertise to insert a menstrual cup. You just need to be little patient during your first few times.

While laying down or doing yoga (standing upside down on hands) will the blood go inside?

No. The blood never flows back into the womb – even if you are standing upside down. The menstrual discharge simply stays in your cup and never flows back or trickles down your thighs. You can comfortably complete your daily yoga or other physical workouts with your menstrual cup. Even you can swim or do any type of physical activity wearing a menstrual cup as it provides a perfect sealing and there is no way that your menstrual fluid flows out of the cup.

How to use a menstrual cup in a public bathroom?

You can use it comfortably. If the sink or tap water is out of reach, you can simply empty the cup in your toilet and wipe it clean with a dry tissue and rinse it with bottled water for a while and re-insert it.


CAUTION

Who shouldn’t use a menstrual cup?

Menstrual cups are generally regarded as safe and can be used by women of all ages, both young and old, including teenagers. However, users are prone to infections if they don’t handle it properly or if they don’t follow hygienic practices mentioned in the packaging of menstrual cups.

Though there are no general guidelines with regard to who can or who cannot use a menstrual cup, it is better to consult your physician when you are suffering from:

-       Vaginismus, a condition which can make your vaginal insertion painful

-       Uterine fibroids, which can cause heavy periods and pelvic pain

-       Endometriosis, which can result in painful menstruation and penetration

-       Variations in uterine position, which can affect cup placement

Having one or more of the above mentioned illness doesn’t mean that you can’t use a menstrual cup at all. But you may experience more discomfort during use.

When to see your physician?

Although getting infection because of menstrual cup usage is highly unlikely, there is always a possibility. You should immediately consult your physician if you begin to experience the following:

-       Unusual vaginal discharge

-       Pain in vagina or soreness

-       Burning sensation during urination or intercourse

-       Foul odour from your vagina

-       A high fever

-       Dizziness or vomiting

-       Rashes resembling sunburn