To be honest, I didn’t realize inflation was hitting pads and tampons until the large number of articles about it. That’s because I’ve been using a menstrual cup for almost a decade and haven’t bought pads or tampons in almost that long. There are other reusable menstrual products like absorbent underwear, reusable sanitary pads, and menstrual pads, but I still love my menstrual cup. Although it was intimidating at first, I will never go back to a life of mishaps with soggy tampons and pads.
Menstrual cups cost more up front than a pack of pads or tampons, typically $10 to $30, but they can be reused cycle after cycle for a decade, which could add up to thousands of dollars in savings.
Ready to take the plunge? Here are some criteria to consider before embarking on your menstrual cup journey.
What is a menstrual cup?
Menstrual cups are bell-shaped devices that are inserted into the vagina during a period. Most have a stem or loop for easy insertion and removal. They are often made of silicone, but can also be made of latex or rubber. The cups collect, rather than absorb, the blood as it is spilled. Once full, simply remove the cup, pour the contents down the toilet, rinse the cup and reinsert. Depending on your flow, they can be worn for up to 12 hours at a time. Cups can last for years if they are cleaned and cared for regularly.
Established brands like DivaCup and The Keeper have been popular for decades. Now newer designs like MeLuna, Ruby Cup, Cora, Flex Cup, Intimina Lily Cup, Saalt and Lunette offer more options for shape, size, softness and capacity. You can choose the shape and stem length of the menstrual cup to fit your taste. With so many options, it can be overwhelming knowing which one to choose. Let’s start with the basics.
Find a way that works for your body
To find the best mug for you, ask yourself a few questions.
Is your cervix low or high?
Your cervix is the lowest point of the uterus, where the uterus and vagina meet. Depending on where your cervix is located, you may want a shorter or taller cup.
You can do a self-exam if you want to find your own cervix. Insert clean fingers into your vagina until you feel something firm. Although your vaginal tissue is soft, your cervix feels harder and has a dimple or small opening.
Pamela Berens, MD, who works as a professor of obstetrics and gynecology at UTHealth Houston’s McGovern School of Medicine, says that most people who haven’t given birth have fairly high cervixes, which means they may want to start with a higher cup. If she tried a cup that was tall and found it uncomfortable, she may want to try a shorter, smaller, or more flexible cup.
Have you given birth?
If you’ve given birth, brands like DivaCup and Ruby offer models that better fit your body. Cybill Ruth Esguerra, MD, an assistant professor of obstetrics and gynecology at Johns Hopkins University in Baltimore, recommends talking to her provider at your six-week postpartum checkup about when it’s safe and comfortable for you to use a menstrual cup again.
“The cervix tends to enlarge after pregnancy, and in particular after vaginal delivery,” says Dr. Esguerra.
Your period will take a while to come back, but when it does, the cup you used before you gave birth might not fit as well after you give birth. If it causes pain or irritation, you should reevaluate what would be most comfortable for your new body.
On the other hand, “if you’ve never been pregnant or had a vaginal birth,” says Esguerra, “you can probably use a smaller menstrual cup.”
How long have you had a period?
Your period, like the rest of your body, changes as you age.
“It’s quite common for women to have heavier cycles as they approach menopause,” says Dr. Berens. “Usually later in your 30s and 40s, you will tend to have more intense cycles than in your younger years.”
A cup that can hold more volume may work better for someone approaching menopause, and a smaller cup may be more suitable for a teenager.
Is there anyone who shouldn’t use a menstrual cup?
In general, most people who have periods can use menstrual cups comfortably and safely. However, it should be noted that for people who have IUDs, a menstrual cup may slightly increase the chances of the IUD being expelled, according to a study of copper IUDs published in the journal. Obstetrics and Gynecology in May 2020.
If you are allergic or sensitive to silicone, be sure to find a cup made from latex or rubber, or vice versa. If you have an active genital infection, such as herpes, gonorrhea, or even a yeast infection, you should refrain from using a menstrual cup until the condition clears up.
“Give your body the opportunity to let [itself] expel pathogens,” says Esguerra.
Lastly, you must agree to the insertion of an object into your vagina. This can be difficult or painful for people with vaginismus or other vulvar sensitivities. Those conditions are treatable, so talk to your health care provider.
“You have to be comfortable touching that part of your body and manipulating things down there,” says Berens.
Inserting an object into your vagina can also be a trigger for people who have experienced sexual assault or other trauma. You know your body best: don’t force yourself to try something if you don’t feel well.
Try different insertion techniques
All menstrual cup insertion techniques involve bending the cup and inserting it into the vagina. You can adapt the way you do it according to your body and the shape of the cup you are using. Before inserting, rinse your cup; it will slide in more easily if it is wet.
I asked my friends who also use menstrual cups to describe their method. They describe doing a C-fold, a 7-fold, a rose twist, and other variations of squeezing and folding the cup. Use your fingers to hold the fold in place and insert the cup into your vagina just below your cervix. After inserting the cup, twist it to create a seal.
Anyone who has tried to remove a tampon too soon knows the discomfort of pulling out a rough cotton plug that hasn’t been soaked in blood. Because menstrual cups are made from soft materials that don’t change with use, you can easily remove them to try again, painlessly. So experiment to find the method that makes sense to you.
Removal is easy
Depending on how heavy your flow is, you should remove the cup every 2 to 12 hours, once it is full. The weight of the blood will push the cup down as it fills, and over time you’ll learn to recognize the sensation that it’s time to empty. You can sleep with a cup as long as you empty it before bed and once you wake up in the morning.
Wash your hands well before emptying your cup. To remove, pull the stem until you can touch the base of the cup. Gently pinch the cup to release the suction, then pull it down and out of your vagina. Be careful not to let the cup slip from your fingers and return to a firm ring or it may hurt a bit. Once you’ve removed the cup, flush the contents down the toilet, rinse the cup in the sink, and clean any blood or debris from your genitals. Then you can insert the cup again.
It shouldn’t be painful
Your menstrual cup should never cause you pain or discomfort. If you feel pinching or bumping against your cervix, try re-inserting the cup at a different angle. If the problem persists, you can try a shorter cup or a different shape.
Esguerra says that if you bring your menstrual cup to your next gynecologist appointment, your provider can help you insert it and show you how to do it.
“There is often coyness around these issues because menstrual cups are a newer option on the market. But there are no questions that are off limits in the gynecologist’s office,” says Esguerra.
What if I don’t have access to a private bathroom?
While it’s usually more convenient to empty and replace a menstrual cup in a private bathroom with a sink, it’s still possible to use a menstrual cup if you’re away from home and a public bathroom is your only option.
First, wash or sanitize your hands before entering the booth. Put some toilet paper on top of the dispenser. Remove the bowl as usual, flushing the blood down the toilet. Use some toilet paper to wipe any excess blood from the bowl. Place the cup on top of the clean toilet paper you previously put down while using the bathroom. Then insert the cup again. Rinse and wash your cup the next time you have access to a private bathroom.
Clean your menstrual cup after each cycle
When your monthly flow is over, thoroughly clean your menstrual cup by washing and boiling it. After final use, rinse cup and wash with mild, fragrance-free soap. Some cups come with little brushes to remove blood and debris from the little holes in the rim that create suction.
Boil some water on the stove and place your clean cup inside. Boil for several minutes, giving the cup a push every few minutes to get an even clean. In a pinch, you can put the cup in a cup of water and microwave it for several minutes. Each brand has guidelines on how to clean your device, so read the manual that came with your mug to confirm brand-specific instructions.
Rinse the mug under cold water and let it air dry. Then store it in the breathable cloth bag that comes with most cups. When your period arrives, rinse out the cup and insert it as usual.
Expect a learning curve
When I started using a menstrual cup years ago, it took me a few months to get used to using a new type of product. But once I did, I loved it and will never go back. I often forget that I have my period because I don’t have to think about it as often. Everyone leaks from time to time, and that’s okay. It takes time to learn. Maybe you’ll even become a menstrual cup evangelist like me.
