NEWBIE'S GUIDE TO MENSTRUAL CUPS
Have you ever wanted to be free of the monthly chore and expense of stocking
up on feminine hygiene products? Have you ever wished for a better way than
the pads and tampons most stores have to offer? Say, "Yes!" and read on.
I don't recall exactly where or how it happened, but at the beginning of
March 2007, I ran across the term "menstrual cup" at some website not particularly related to women's concerns. Maybe it was about camping.
Anyway, curious about what it might be and with Google being such a good
friend, I did some research and found that it's a device that many
women rave about for being the perfect solution to their monthly menses.
After more research, I decided to get one for myself and enthused about
it, put this out on
my Information Desk in case you haven't heard and would like to consider
this option for yourself.
In brief, a menstrual cup is a reusable cup that a woman inserts to catch
her menstrual flow that's extremely cost effective and a boon to female travelers
and others who find the
sanitary napkin/tampon experience to be lacking in convenience.
Although there is a learning curve that may be as brief as learning to
use a tampon or as long as three or more cycles to really get the hang of
it, it's well worth the time and effort even if you have to switch to
another size or brand.
The major con against the menstrual cup is the Ickiness Factor. Yes, a woman needs to be comfortable with her
body and with the idea of using a cup, but since it doesn't have to be inserted as far as a tampon and one comes into contact with no
more blood than with tampons, the Ickiness Factor isn't that much unless a
woman is so squeamish that she prefers having to deal with sanitary napkins/tampons.
After all, blood and tissue provide a gentle, nurturing cocoon for a
baby to grow until it's ready to enter the world. How can anything so
good for a precious new baby possibly be bad? All that's needed to
clean your fingers is the same as with using a tampon - soap and water and maybe a quick going-over with a nail
secondary con is if
your grip is impaired due to a condition such as Carpal Tunnel Syndrome
Depending on the degree of impairment,
you may not always be able to use a cup or may not be able to use one at
Pros for the menstrual cup:
* It eliminates having to find, buy, pack or store, and dispose of tampons and sanitary napkins.
* It eliminates major leakage and odor resulting in less mess
and self-consciousness than
with using tampons and napkins. A cup user experiences a neater menses overall. Since the leakage associated with a properly sealed cup is so minor it can be dealt
with a panty liner if the cup is emptied before it fills, stained clothing
and sheets are items of the past.
* The savings over time is money that can be put toward traveling and other
expenditures far more appealing than disposable feminine hygiene products.
Although the initial cost is high compared to a month's worth of disposables, if the expense is amortized over several months, it's free for
the next 5-10 years, maybe longer depending on how well taken care of it
* For all except those having extremely heavy flows, it lengthens the amount of time between having to attend to their periods.
For example, a heavy flow requiring a super plus tampon and pad for
leaks to be
changed every 1-2 hours compares to 3-4 hours using a cup. A
typical light to medium flow with a cup can go up to the 12 hours in
accordance with manufacturers' instructions.
* There's no risk of TSS.
* There's the ability to insert the day of expected menses, before the actual onset, and not get caught at an inconvenient time like when using
* Using one eliminates the discomfort/pain associated with removing a tampon while it's partially dry.
* Using one eliminates the drying, scratching result of tampons and preserves the naturally healthy vaginal environment.
* The cup is environmentally-friendly; reduces landfill waste.
* Using one may decrease/eliminate irritations, infections, and
inflammations typically associated with napkins/tampons.
* Using one may decrease/eliminate cramps.
Basic steps including a few tips:
1. Wash hands with soap and water.
Rinse cup and fold
until the opening is as narrow as a regular or super tampon.
3. Find a suitable position, insert, and release slowly to avoid a
startling SPROING! effect when it opens. It doesn't have
to be inserted all the way at this point, but it does need to be in far enough
for the rim to open inside you. If necessary, turning the cup will help it open.
If you use a Lunette which has a flat stem, it's better to insert or
turn it so that the broad sides of the stem are easy to grasp.
4. Make sure there's a seal by using a fingertip to check for dents in the
base which are a sign of a bad opening and no seal. After it's okay,
push the base then stem while
doing Kegels until the base is inside. Press against a side of the base to break the seal a
couple of times
during this brief process because doing so helps keep the cup lower for
removal later. A bit of another prod with a fingertip on the end of the stem
and a few Kegels later, the stem is drawn up completely inside where it's
supposed to be.
The entire process is short and easy.
5. Forget about it for up to 12 hours later, until it's time for Step 6. You'll learn the proper
time interval for you through experience.
6. Wash hands with soap and water before removing the cup. Sit on the toilet, squat in the shower, or find another suitable
position. Relaxing, gravity, and bearing down as if having a bowel movement will
lower the stem and the bottom of the cup so you can grasp it. Don't
bother trying to pull on the stem when it exits your body to remove the
cup - you'll
only experience suction because you need to break the seal before you
can pull it out. When it's
within reach, grasp the base of the cup - several cups have ridge lines
at the base to aid your grip - and pinch the sides to break the seal.
If you want to facilitate removal, you may insert a finger between the
cup and vaginal wall to press the cup inwards to break the seal earlier.
After the seal is broken, you
may gently pull the cup the rest of the way out. By
keeping it pinched to make it narrow and withdrawing one end of the rim before the
other, removal will be easier because you won't be trying to get the
entire rim out all at once at its widest expansion. I recommend using a square of toilet tissue to grasp the
but you may use your bare fingers, if
you want. The tissue eliminates any slipperiness that may exist
due to natural secretions other than the menstrual flow which remains
inside the cup so the cup won't be inclined to slip from your grasp and
drop into the toilet or fall elsewhere, like on a white bath mat, when
you pull it out like it might when you use bare fingers. If you remove
it while sitting on the toilet, tipping the cup more will empty it
directly into the bowl in a single motion.
women prefer other techniques such as folding the cup back into a C fold
7. Wash, rinse, or wipe the cup, and reinsert. If any holes are clogged,
cleared by filling the cup with water, pressing a palm over the top,
inverting, and squeezing the cup to force the water out through the
Some women perform Steps 1-4 and 6-7 while in the shower for
convenience. Others, using public restrooms, employ different methods
such as taking both a wet and a dry paper towel into the stall with them
to wipe the cup before reinsertion.
8. At the end of menses, sterilize according to the manufacturer's
directions. Usually, a silicone cup is to be sterilized by boiling in water for
2-5 minutes, but some women use a cleaner such as (rubbing) isopropyl alcohol. Frankly, isopropyl alcohol is a
disinfectant, not a sterilizer but whatever you do, don't use hydrogen peroxide because it's not good for silicone.
While some question the efficacy of this step since any contact
afterwards compromises sterility, the purpose is more likely for the
destruction of any infectious bacteria that might have been deposited
onto the cup during menses.
the cup air dry, then
store according to manufacturer's instructions, usually in the
drawstring bag provided.
The Cups at the Top of My List (are made of medical grade silicone):
1. Lunette (silicone) - made in Finland
- VAT is not charged for U.S. residents)
2. Mooncup UK (silicone) - made in the United Kingdom
not available for delivery to U.S. addresses since January 2009 because
Moon Cup US (below) trademarked the name in the U.S. for its copycat
While both products have
excellent reputations, I chose the Lunette over the Mooncup UK because:
1. The difference in ease of insertion and removal isn't significant.
2. The Lunette is smoother, easier to clean.
3. The Lunette has larger holes making them easier to clean and easier to
break the seal for removal.
4. The solid, flexible, flat stem with ridges compared to the hollow, stiffer, mostly smooth, cylindrical stem of the Mooncup UK makes it easier
to grasp and less likely to poke and irritate because it bends
and moves with you which is why some women end up cutting the stem off the
Mooncup UK and others entirely. Also, a
hollow stem is prone to getting dirty inside after the plug's gone,
falling out or from the stem being cut, and is harder to clean.
The Cups at the Bottom of My List and Why:
1. DivaCup (silicone) - made in Canada, it's also available in some U.S.
Although the DivaCup is available in
the U.S. and comes with a one-year full-money-back guarantee, I'm
reluctant to recommend it because it has the highest number of reports about difficulty during the learning phase with insertion
and sealing and with removal because the seal is the most difficult to break.
The reports about difficulty with removing the DivaCup include PAIN because of difficulty breaking the
seal and I'm not into pain. Among the silicone cups, the Mooncup UK has been around longer and those who switched from the DivaCup to
the Mooncup UK are thrilled that they did. While I chose to sidestep the
issue by buying a Lunette from the get-go, if you want, you can try the
DivaCup, and if you like it, keep it. If you don't like it, you can
return it under their guarantee, switch to another size if you want, or
get your money back and buy another brand.
2. The Keeper (rubber/latex) - made in the U.S. (http://thekeeper.com).
Although used by the women of Biosphere 2, I don't recommend The Keeper because it's made of rubber (latex). If one
isn't already allergic to latex, it's possible for an intolerance to develop
as it did for the first time in my entire life at my dentist's office in
Honolulu for a routine cleaning in 2001. I firmly believe that the vagina is
the last place to have an allergic reaction especially while a woman is on a trip and having
3. Moon Cup (silicone) - made in the U.S. by the same company that makes
The Keeper (http://www.mooncupsandkeepers.com).
I don't recommend the Moon Cup (USA) that came out in the fall of 2006
because I suspect the company of trying to cash in on the popularity of the
Mooncup UK; naming their silicone version so similarly to the earlier product is too obvious for me to ignore. I don't like supporting chicanery
especially when I know about and was able to get the original product just as
easily (in 2007 when I was shopping for a menstrual cup).
Another option is the disposable, diaphragm-styled INSTEAD® Softcup® (polyethylene)
There's an increased Ickiness Factor, higher cost over time, reports of leakage and
difficulty inserting and removing. As far as I'm concerned, its being disposable
puts it into the same category as the typical disposable feminine
hygiene products with similar problems for female travelers.
The following are provided for your consideration.
Cup comparisons (text & photos):
discusses more cups than I have here
techniques (text & photos):
Help with Insertion:
Help with Removal:
More information and tips:
There are other forums and discussion groups on this topic such as on Yahoo.
Google is your friend if you want to research this more before trying one out for
issue I want to address before concluding this page is that there are
websites taking an FDA response to a petition out of context.
Misinterpreting the words, "physiologically plausible" to mean
that the FDA noted the association between the association of
endometriosis with the use of menstrual cups to support their desire to
have manufacturer's change the labeling on the packaging of menstrual
cups, they purport that the FDA recognizes a likely increased risk of
endometriosis associated with menstrual cups that manufacturers are
deliberately concealing from buyers and are liable by not providing
appropriate warning labels even while admitting that the cause of the
disease is unknown.
In fact, the FDA's response states (Bold
we agree that endometriosis is an important women's health issue, FDA
does not believe that there are sufficient grounds to 'withdraw
the approval' of these devices, as you request.
agree with the assertion in your petition that it is physiologically
plausible that use (and misuse) of the menstrual cup might
increase the risk of endometriosis by creating an obstruction to the
flow of menstrual effluent (blood and cells) out of the uterus,
re-directing menstrual effluent into the peritoneal cavity via the
fallopian tubes (retrograde menstruation). However, you have not
submitted and we have not identified sufficient evidence to show this is
more than theoretical.
suggests a possible association between a menstrual cup and
endometriosis (and adenomyosis). This is the same report you cite in
your Citizen Petition.
single case report does not constitute an adequate basis for FDA to
issue an order to stop distribution of this product or withdraw
approval. Additional information might warrant a review of menstrual cup
labeling to determine whether menstrual cup wear time should be
re-examined. However, in the absence of results from a well-designed
clinical study, it would be inappropriate to make any statements
about whether menstrual cups (or other menstrual fluid collecting
devices) increase the risk of either endometriosis or adenomyosis."
you can see, the FDA response
points out that the petition is based on only one case report
that suggests a possible connection and that's not enough
to constitute a scientific fact. (See the FDA's entire letter at http://www.mum.org/fdacups2.htm
which also has a link to the petition to which it's responding.)
DivaCup, Instead, The Keeper, Moon Cup (USA) all claim receiving FDA
approval (and for DivaCup, Health Canada as well), somebody's not on the
up-and-up and since "physiologically plausible" was taken out
of context in a spurious attempt to persuade the public that the FDA
supports their position, I'm thinking it's the opponents who are being
deceptive, not the manufacturers, especially since the cause of
endometriosis is not known and has been found in parts of the
body other than the reproductive organs. At any rate, don't wear a cup
for more than 12 hours without removing and reinserting it in accordance
with manufacturer's directions.
Because a menstrual cup is lightweight and takes up such little space that it's okay to pack one "just
in case," I believe the Lunette or Mooncup UK will be a welcome addition to your
home and packing list as the alternative to the disposable feminine hygiene products typically sold in stores. Who wants to pack all that stuff for a trip
or have one's plans disrupted to hunt down suitable products while in a strange town or
foreign country that may not have similar products or the variety that the U.S.