The ins and outs of menstrual cups — How do they differ from tampons and pads?

Dear Curious,

A menstrual cup is a type of cup or barrier worn inside the vagina during menstruation to collect menstrual fluid. Unlike tampons and pads, the cup collects menstrual fluid rather than absorbing it. While insertion and removal may take some time to get used to, many women consider menstrual cups to be an innovative and safe alternative to tampons. Menstrual cups are safe for both virgins and non-virgins, and for women of all ages. Here are some of the benefits that menstrual cups provide:

• Reduced risk of toxic shock syndrome or irritation, which may be caused by the bleaching of the absorbent fibers in tampons or the synthetic fibers themselves.
• Can be worn for up to 12 hours on light flow days. This is almost twice as long as a tampon, so it's handy for overnight use or when a woman knows she won't have access to a bathroom.
• Can be worn during vigorous physical activity, such as swimming, aerobics, and dance.
• You might save money — consider how much money you spend each year on tampons and pads compared to the one-time cost of a menstrual cup.
• More environmentally friendly — think about all the trash that tampons and pads create!

Menstrual cups differ from diaphragms in that they are not to be used for contraception, despite their similar shape and positioning to the diaphragm. In addition, menstrual cups do not protect against sexually transmitted infections. Consult a health care provider before using a menstrual cup if you have an IUD inserted, just had a baby, a miscarriage or an abortion, you have a tilted uterus, if you've been advised to avoid tampons after a surgical procedure, or have other medical conditions you feel may interfere with wearing the cup.

There are a few different varieties of menstrual cups on the market. If you choose to try one out, make sure to read the manufacturer's directions and recommendations, as each product differs. Most are washable and reusable, but there are disposable menstrual cups, too. The cups look similar to a cervical cap with small flexible rods connected to the base to aid in their removal (kind of like a tiny plunger). With proper care, some menstrual cups can be used for up to ten years! The cups are made from a few different types of materials such as medical grade silicone (non-latex) or natural gum rubber.

Insertion and removal of menstrual cups takes practice, just as tampons and diaphragms do. The more knowledgeable and comfortable a woman is about and with her body, and the more she practices insertion, the easier it will be. To insert the cup, squeeze and fold the sides of the cup, then push it into the vagina. As it opens up inside, it creates a very gentle seal with the vaginal wall. The cup is held in by the muscles of your vagina, and if put in properly, you shouldn't feel it after it's been in for a few minutes. To remove the cup, pull on the stem, and gently squeeze the base of the cup. This releases the seal. Gently remove it, empty it out, then rinse it out or wipe it (this can be tricky in public restrooms). With practice, privacy, and persistence, a woman can learn to avoid and/or minimize spills.

All types of menstrual cups are safe for virgins to use, although insertion can lead to hymen breakage if the hymen is intact. Remember, the hymen can stretch or tear for reasons other than sexual intercourse or vaginal penetration — sometimes just from bicycle or horseback riding, gymnastics, or dancing. If you are considering using menstrual cups but are worried about hymen breakage, it may be helpful to consider your priorities, cultural values, and what you feel comfortable with. If you use tampons, then you'll probably be able to use menstrual cups, too. Now that you are informed, feel free to give this method a try!