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

Dear Curious,

A menstrual cup is a flexible cup worn inside the vagina during menstruation to collect menstrual fluid, rather than absorb it like tampons or pads. While insertion and removal may take some time to get used to (more on techniques in a bit!), many people consider menstrual cups to be an innovative and safe alternative to tampons. Whether they're more difficult to use than tampons can be a personal opinion and varies based on each user. The menstrual cup differs from a diaphragm as it's a menstrual product intended for use during menstruation, while the diaphragm is a form of contraception. While both are inserted into the vagina, they have primarily different functions. Menstrual cups are considered low risk for people of all ages, regardless of sexual experience. They provide a number of benefits, some of which are unique to the menstrual cup.

Some of the benefits the menstrual cup include:

• Reduced risk of toxic shock: The fibers that are used in tampons have been associated with the rare toxic shock syndrome. Because menstrual cups are made with medical grade (non-latex) silicone or hypoallergenic rubber, the risk of toxic shock is reduced.
• Longer wear time: Menstrual cups can be worn for up to twelve hours, while tampons and pads generally need to be changed every four to six hours. Additionally, extra materials won’t need to be carried as the menstrual cup can be reinserted.
• Environmentally friendly: Pads and tampons end up in landfills. Since most menstrual cups are reusable, this drastically decreases the amount of waste being put into landfills.
• Budget friendly: Because they're reusable, the costs associated with menstrual cups are generally lower than purchasing pads and tampons each month. They can be worn during vigorous physical activity, such as swimming, aerobics, and dance.

While there are a number of benefits, there are some people for whom a menstrual cup may not be the right fit. Consult a health care provider before using a menstrual cup if you have an intrauterine device (IUD) inserted, have had toxic shock syndrome, 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. Additionally, some people may find that it doesn't quite fit their body how they'd like or find that it can be a bit messy. They also require more upkeep than tampons or pads do in order to keep them clean and in good condition each month. 

If you feel like this method might be your cup of tea, it's good to know that 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). Depending on the product, it could last up to ten years.

Insertion and removal of menstrual cups typically takes practice, just as tampons and diaphragms do. The more knowledgeable and comfortable a person is with their body, and the more they practice 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 the vagina, and if put in properly, typically it won’t be felt 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. With practice, privacy, and persistence, spills can be minimized.

All types of menstrual cups are safe for people who haven’t had penetrative sex to use, although insertion can lead to hymen (the thin tissue at the opening of the vagina) stretching. Remember, the hymen can stretch for reasons other than vaginal penetration — sometimes just from bicycle or horseback riding, gymnastics, or dancing. If you are considering using menstrual cups but are worried about hymen stretching, it may be helpful to consider what you feel comfortable with, your priorities, and your cultural values. Now that you're more informed, feel free to give this method a try!