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Menstrual Cups - How to Choose, Use and Remove Them?

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Menstrual Cups - How to Choose, Use and Remove Them?

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Menstrual cups are gaining popularity as reusable menstrual hygiene products. Read the article to know more about menstrual cups and their proper use.

Written by

Dr. Sameeha M S

Medically reviewed by

Dr. Sunita Kothari

Published At July 22, 2022
Reviewed AtJanuary 23, 2023

Introduction

Menstrual cups, otherwise called period cups, have become a popular choice among women as an alternative to tampons and pads during their periods. Menstrual cups are reusable and sustainable as compared to other menstrual hygiene products. Plastic waste produced from disposable menstrual products like pads and tampons contributes a major share to plastic pollution and environmental damage. Thus growing concern over the plastic pollution caused by menstrual hygiene products boosted the shift towards using reusable period products like menstrual cups. Compared to other options like pads and tampons, menstrual cups are able to hold more blood and avoid concerns regarding leakage during periods.

What Are Menstrual Cups?

A menstrual cusp is a flexible, funnel-shaped cup made from rubber, latex, or silicone that is placed inside the vagina to collect blood during periods. They are usually bell or funnel-shaped with a ring or stem. A ring or stem is used for proper insertion and removal of the cup. The bell-shaped cup placed inside the vagina collects menstrual fluid. Several popular menstrual cup brands are available in the market, which provides cups in different sizes and colors based on customer needs. Menstrual fluid flow rate and frequency are different for each woman depending on their body conditions. Menstrual cups are able to collect comparatively more blood than pads and tampons. It can be used for long durations ( 4 to 12 hours) as compared to other menstrual hygiene products. Depending on the product quality, the majority of menstrual cups can be reused for up to ten years (if used carefully). Thus they are cost-effective and also help to reduce solid plastic waste generated from menstrual products.

How to Choose a Menstrual Cup?

Every woman has a unique body. Every woman has different periods flow rate and duration. Menstrual cup size is selected based on the menstrual flow, cervix height, and some other factors. It includes the following.

  • Menstrual Flow - First thing to consider in selecting menstrual cup size is menstrual blood flow. The amount of blood lost during periods is different for each woman, depending on their body. It can be identified based on the number of tampons and pads that one uses during each period. Based on the rate of blood flow, it is divided into two.

    • Heavy Flow - In a woman with heavy menstrual flow, they change their tampons and pad every one hour. These women usually use large maxi pads and super size tampons. Most menstrual cup brands offer cups in two sizes, and some brands have three sizes. It will be labeled as small, medium, and large. Every brand will have its own sizing chart for the cup sizes they are providing. For a woman with heavy blood flow, a cup with higher capacities is needed.
    • Light Flow - Some women will have light menstrual flow, and they use normal pads and regular tampons. For those, a menstrual cup with a normal capacity is needed (small size).
  • Cervix Height - It is an important factor in choosing a menstrual cup. Menstrual cups are placed in the vaginal canal, below the cervix. Thus cervix length plays an important role in the proper fitting and placement of menstrual cups. Cervix height is usually measured during periods or a few days before it (this time, the cervix will be in its lowest position). One can measure her cervix height by placing the longest finger inside the vagina and feeling the cervical wall. Based on that, it is of two types.

    • High Cervix - In a woman with a high cervix, the longest finger will go all inside the vaginal wall to reach the cervix. A menstrual cup with a long length is recommended in high cervix cases for proper fit.
    • Low Cervix - For a low cervix, the longest finger will touch the cervix around the middle knuckle mark region. A shorter model menstrual cup will give more fit in low cervix cases.
  • Bladder - In women with bladder irritation and sensitivity, softer cups are suggested to avoid discomfort.

  • Active Lifestyle - Women with an active lifestyle will have strong vaginal and pelvic muscles. A firmer menstrual cup is suitable for them for a good seal.

How to Use a Menstrual Cup?

  • Clean Your Hands and Menstrual Cup - Before using, the menstrual cup must be cleaned and disinfected to avoid infections. Clean your hands thoroughly using soap and water before placing the menstrual cup.

  • Fold the Menstrual Cup - The wide opening portion of the menstrual cup is made small by folding it, with the rim portion facing up. Two types of folding are commonly used.

  • C - Fold ( Half-Fold or U Fold) - In this type of fold, the top rim of a menstrual cup is folded in half to create a tight U or C shape.

  • Push Down Fold (Tulip Fold or Tip Fold) - A narrow point is created by pushing one side of the rim down into the menstrual cup.

  • Insert the Menstrual Cup - Achieve a comfortable position by standing or sitting on the toilet. Hold the folded menstrual cup using one hand and, with the other hand, locate the vaginal opening and try to slowly insert the menstrual cup into the vagina. Try to maintain the folded position during insertion.

  • Open and Rotate the Menstrual Cup - After placing the cup inside the vagina, the folds are opened and slightly rotated for a tight seal.

  • Check for Proper Placement - Once inserted, we can check for proper fit and seal to avoid leakage and irritation.

How Can We Remove Menstrual Cups?

  • Wash your hands with soap and warm water before removing the menstrual cup.

  • After achieving a comfortable position, gently pull the stem portion of the menstrual cup down the vagina until you reach the base portion of the menstrual cup.

  • Pinch the base portion of the menstrual cup to break the seal.

  • After breaking the suction seal, it will be easy to gently remove the menstrual cup by pulling it down.

  • Once it is removed, empty the menstrual blood into the toilet or sink.

  • Wash the menstrual cup thoroughly with soap and water and clean the edges.

  • Menstrual cups must be cleaned and sterilized properly to avoid infection. After periods, it must be cleaned and kept in a sterilizer or boiling water for a few minutes.

  • Most menstrual cups are sold with a bag or pouch for storage. After proper sterilization, cups must be placed in these storage bags and kept in a safe, dry location.

Conclusion

A menstrual cup is a reusable and sustainable alternative for other menstrual hygiene products. Compared to other menstrual hygiene products like pads and tampons, they are cost-effective and can be used for a long period of time. Based on their needs, one can select the perfect menstrual cup size by using the cup size chart available in the product description (it differs based on the brand we are using). Proper handling and storage of menstrual cups must be done to avoid vaginal infection.

Frequently Asked Questions

1.

How Do Menstrual Cups Function?

Menstrual cups are small cups that can be flexed and are made of either silicone or latex rubber. Unlike tampons or pads, which absorb the flow, menstrual cups catch and collect the flow. A menstrual cup has to be folded tightly, just like a tampon without an applicator, and inserted just before the period begins.

2.

How to Detect When It Is Time to Empty a Menstrual Cup?

It can be detected when:
- There is a heavy feeling because the pelvic muscles can no longer hold a full cup.
- Menstrual cups that are full create a bubbling sensation.
- One might notice signs of leakage when the cup is full.
- If the well-fitting cups that were intact initially tend to slip, then it is a sign that it is time to unload the cup. Ideally, it is advisable to empty the menstrual cup every 10 to 12 hours, irrespective of the flow.

3.

Do Menstrual Cups Hurt?

It might take time for one to practice inserting a menstrual cup. Once mastered, the majority of them neither feel that the cups have been inserted nor feel pain while inserting. However, a large cup or a cup that is very long for the body can cause pain and discomfort if it is situated too high on the vagina or if it exerts pressure on the vaginal walls or cervix. Other reasons for pain could be due to insufficient lubrication and issues with the cup’s folded size. 

4.

Is It Fine to Sleep With a Menstrual Cup?

One can sleep comfortably with a menstrual cup without the necessity to wake up in the middle of the night, unlike using pads or tampons. It is advisable to empty the cup every ten to 12 hours. So, it is better to empty the menstrual cup just before going to bed so that one can sleep uninterruptedly.

5.

Is It Mandatory to Boil the Menstrual Cups?

It is not mandatory to boil the menstrual cups, but if one prefers to have the cups fully sanitized before and after use, they can do so, and it is recommended by many brands as well. Many women prefer steaming to boiling the cups. Steaming and sterilizing tablets are alternatives to boiling and are efficient in sterilizing.

6.

Which Is Considered More Hygienic- Pads or Menstrual Cups?

Menstrual cups are durable, reusable, and eco-friendly when compared to sanitary napkins. Menstrual cups are hygienic if one uses them with clean hands, cleans them properly, and removes them carefully. Pain, urinary problems, or infections are rare with menstrual cups. If one finds it difficult to keep the menstrual cups clean, one can prefer using pads or tampons.

7.

Are Menstrual Cups Better Than Pads?

Menstrual cups are durable, reusable, and eco-friendly, which reduces the cost that one has to spend during a menstrual period. Since they can be reused, there is less landfill waste. Other advantages include no embarrassing odor, more time between changes, ease to use, and fewer visits to the shop to purchase, unlike pads.

8.

Can a Menstrual Cup Leak if It Gets Filled?

If the menstrual cup is inserted properly, leakage due to overflow is very rare. The common reason why a menstrual cup may leak is that the edges of the cup are still slightly folded and are not fully open to form a seal with the vaginal walls. It is advisable to empty the menstrual cups every ten to 12 hours to be on the safer side.

9.

Can One Pee With a Menstrual Cup In?

One can pee with a menstrual cup since the period blood exits through a different opening. Menstrual cups are slipped into the vaginal canal, and the opening through which urine exits is different. If there is an issue with peeing with a menstrual cup, it can be due to the wrong angle of insertion that exerts pressure on the bladder.

10.

For How Many Hours Can One Wear a Menstrual Cup?

It is ideal to empty the menstrual cup every ten to 12 hours. It is better to empty the cup before bedtime to have uninterrupted sleep. One must ensure to empty the cup by the 12th hour and not more than that. In case of heavy flow, one must empty the cup once it gets full.

11.

What to Do if the Menstrual Cup Falls in the Toilet?

One must not try to flush the cup if it falls into the toilet since it can clog the pipes and block the water channel. With the help of disposable gloves, menstrual cups should be removed from the toilet basin. It is up to oneself whether to reuse or dispose off it after retrieving it from the toilet. If one chooses to reuse, the cup should be immersed in rolling, boiling water for 20 minutes and suspended by another utensil, such as a pea strainer.

12.

Can Menstrual Cups Leak if One Lies Down?

Some might experience leaking while sleeping since the muscles relax and the seal of the cup loosens. This can be dealt with by ensuring that the cup is angled appropriately and inserted correctly. This can be checked by running the finger along the outside of the cup near the upper rim. If any dents are felt, there can be chances of leakage. If resistance is felt, it is a good indicator that the cup is open completely and properly sealed.

13.

Is It Possible to Swim With a Menstrual Cup?

Menstrual cups are positioned internally in the vaginal canal and can be worn while swimming. Since period blood is thick, it does not usually leak, but water can get into them. By ensuring a proper fit, this can be prevented. It is even safe if the menstrual cup is emptied before getting into the water. 

14.

Why Is There a Bad Smell Coming From One’s Menstrual Cup?

The following could be the reasons:
- Using the cups for a long time can cause the blood to decompose and give a foul smell.
- If the cup is cleaned with too much soap, leftover soap could be fed by the normal bacteria present in the vagina, which could result in a foul smell.
- Blood towards the end of the period could release a foul smell.
- The cups should be stored in a cotton bag or a container that is not overly airtight, otherwise, there could be a bad smell picked up from the surroundings, and there could even be the growth of some bacteria from the dampness.

15.

How to Remove a Menstrual Cup Without Hurting?

Pulling the cup without pinching the base could hurt since the suction seal is still intact. One must try pinching before pulling the cup down. The base can be reached by squatting and placing the finger next to the cup and gently pushing it against the vaginal wall. The finger should then be hooked over the rim and then slid out gently. This can be messy but will prevent pain or discomfort.

16.

Is It Fine to Pee With Menstrual Cup In?

A woman has three holes, namely the urethra through which urine exits, the vagina through which period blood exits, and the anus through which fecal waste exits. Since there are distinct openings for each, one can pee with a menstrual cup as the menstrual cup is positioned in the vaginal opening.

17.

Will It Hurt While Removing the Menstrual Cups?

Removing a menstrual cup should not be painful if one follows the correct technique. A small amount of lubricant or water can be used to facilitate the cup to slip out comfortably. Pulling the cup without pinching the base could hurt since the suction seal is still intact. One must try pinching before pulling the cup down. The base can be reached by squatting and placing the finger next to the cup and gently pushing it against the vaginal wall. The finger should then be hooked over the rim and then slid out gently.
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Dr. Sunita Kothari
Dr. Sunita Kothari

Obstetrics and Gynecology

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