Everything You Need To Know About Menstrual Cups

Menstrual cups have become a popular alternative to tampons and pads. Some are long-lasting and reusable, while others are disposable. But what are they, exactly? And are they the right fit for your period needs?

Ob/Gyn Karmon James, MD, explains how menstrual cups work and shares the pros and cons of using them — plus, how to use them if you do decide to make the switch.

What is a menstrual cup?

A menstrual cup is a flexible cup, made of either silicone or rubber, that you insert into your vagina to collect period blood.

Menstrual cups don’t absorb blood the way tampons or pads do. Instead, you can think of one like catching raindrops in a bucket: Your period blood stays in the cup until you remove it from your body and empty its contents.

You may also hear them referred to as:

• Feminine cups
• Period cups
• Sanitary cups

“These products have been proven to be safe and very effective,” Dr. James says. “And unlike tampons, most of them are designed to be reusable.”

Benefits of using a menstrual cup

One study found that it took most users about three menstrual cycles to get used to using a cup, in terms of insertion, removal and overall comfort. Once they adjusted, though, the majority of users said they preferred cups to other menstrual hygiene options.

So, are menstrual cups right for you? Let’s take a closer look at their benefits.

• Effective: A review of studies showed that leakage when using menstrual cups happens about as often or less than when using tampons.
• More time between changes: Tampons need to be changed every four to eight hours, depending on how heavy your flow is. But you can go up to 12 hours with a menstrual cup before having to empty it.
• Lower costs: Some cups are designed for long-term use, which allows you to save the money that you’d otherwise spend on monthly menstrual products.
• Lower carbon footprint: Because they’re reusable, menstrual cups create less landfill waste. And unlike paper-based alternatives, no trees are sacrificed to make them.
• Fewer visits to the drugstore: Having a cup on hand means no emergency runs to buy tampons or pads when you realize you’re running low in the middle of your flow.

Possible drawbacks

There are two sides to every coin. Dr. James explains some possible downsides of using a menstrual cup.

• Initial adjustment period: If you’re less familiar with your anatomy, have never had sexual intercourse or have never used tampons, you might have trouble learning to insert or remove menstrual cups.
• More mess, at least at first: Many first-time menstrual cup users find it messy to remove and empty. And about 10% of new users report leakage while wearing the cup. Both of these concerns can usually be resolved with a little bit of practice.
• Regular cleaning required: Pads and tampons can be thrown away, but a menstrual cup has to be thoroughly washed after each use and sterilized before you store it between periods. “This can present problems on the go, like if you’re using a public restroom,” Dr. James points out.
• Fit problems: Your unique anatomy could make it difficult for you to wear a menstrual cup. “For instance, if you have a dropped uterus or uterine prolapse, a menstrual cup may not fit in place properly,” Dr. James says.
• Potential for issues: It’s not common, but there have been cases of menstrual cups contributing to vaginal irritation, allergic reactions and urinary tract infections. There’s also some evidence to show that wearing a menstrual cup could increase the risk of dislodging an IUD, if you have one. But more research is needed.

Types

Various brands of menstrual cups are sold online and in stores. And most of them come in small or large versions. Here are a few considerations to help you figure out which type is right for you.

• Flow: How heavy are your periods? Smaller cups are designed for a light to medium flow, while the larger version is best for a medium to heavy flow.
• Past pregnancy: If you’ve given birth vaginally in the past, a larger cup is probably your best bet (even if you’re under age 30).
• Age: If you’ve never given birth vaginally, choose your menstrual cup according to your age. If you’re under 30, the smaller version may work best, while the larger version is often a better fit over age 30.
• Material: If you’re sensitive to latex, stick to a silicone cup.

“It never hurts to do a little research,” Dr. James encourages. “Compare the options that are out there and read the reviews to see what other people are saying.”

If the first menstrual cup you buy doesn’t suit you, the next size — or a different brand — might do the trick.

How to use a menstrual cup

There can be a bit of a learning curve to figuring out how to insert and remove a menstrual cup.

“If you’ve ever used tampons, especially the kind without an applicator, you should have little trouble learning how to insert a menstrual cup,” Dr. James says. “And if you’ve ever used a vaginal ring for birth control, you’ll have even less trouble.”

Still, it may take some trial and error to get it right. She walks us through the steps.

Insertion

Follow these steps to successfully insert a menstrual cup:

1. Wash your hands. Don’t forget to use soap!
2. Lubricate the cup. Apply a thin layer of water or a water-based lubricant to the rim of the cup. This will make it easier to insert.
3. Fold the cup in half. “You want to place the folded cup in one hand and keep the rim of it face-up,” Dr. James explains.
4. Insert the folded cup. While keeping it folded and rim-up, slide the cup into your vagina. “You want to think about inserting the cup like you would a tampon,” she says.
5. Rotate it into place. When the cup is in, you’ll need to rotate it a bit so that it opens up inside your vagina. Once it does, it’ll sit a few inches below your cervix, ready to catch menstrual blood.

You shouldn’t feel pain when you insert a menstrual cup. If you do, stop using it and talk to your healthcare provider.

Wearing

If you’ve inserted your menstrual cup properly, you shouldn’t be able to feel it. So, once it’s in place, feel free to go about your day as normal.

If you experience leakage while wearing a menstrual cup, it could be a sign that it’s been inserted wrong. Or it could be a sign that the cup has been in too long and is full.

“You can use a cup throughout your cycle,” Dr. James says, “but you might need to change it more often on heavy flow days to guard against leaking.”

Removal

Here’s how to take out your menstrual cup:

1. Wash your hands. With soap, of course.
2. Pinch the base. Never just pull on the stem of the cup to remove it. This can cause suction, discomfort and even pain. “Instead, use your thumb and index finger to reach into your vagina and pinch the cup,” Dr. James instructs. “This breaks the seal and makes it easier to remove.”
3. Remove the cup. While pinching the base, pull down gently to slide the cup out of your body.
4. Empty the cup. Once you’ve removed the cup, tip it into the toilet to empty it of blood.
5. Clean the cup. Wash the cup with clean water and a mild, fragrance-free soap before putting it back into place. So long as you rinse it off thoroughly, it doesn’t need to be dried off first — and in fact, the water can help serve as a lubricant for reinsertion.

Cleaning and maintenance

It’s important to wash your menstrual cup each time you remove it. Again, you should always use a fragrance-free soap to clean it before you insert it, as scented soap can cause irritation.

“When your period ends, you’ll want to clean and fully sanitize the cup,” Dr. James advises. “This helps remove any bacteria that could damage the cup or lead to an infection the next time you use it.”

To sanitize your menstrual cup, you can typically clean it as usual, then put it in a pot of boiling water for a few minutes. Some products come with more specific instructions, though, so be sure to read the packaging.

After you’ve sanitized your cup, let it cool off and air dry before you store it for the next month — usually in a pouch or other container that it came with. Between periods, keep it in a cool, dry place like a drawer or linen closet.

Choosing the right menstrual cup for you

Ultimately, the only way to know if a menstrual cup will work for you is to buy one and give it a try. But you don’t have to try to figure it all out on your own.

“If you have concerns about using a menstrual cup, including insertion or removal, always talk to your healthcare provider,” Dr. James urges. “They can even walk you through the process during an office visit.”