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Menstrual Cup

We ask an expert: Are menstrual cups safe?

TextAlex Peters

With calls for better regulation and safety advice from menstrual cup manufacturers, we ask a gynaecologist what the truth is

Over the past few years, there’s been a rise in the use and production of menstrual cups as women and uterus-owning people are finding them a great alternative to tampons and pads, whether that’s for sustainability reasons, to reduce waste or to save money. There have even been some reports that they help relieve cramps.

Menstrual cups are not for everyone however, those with limited mobility, certain types of pelvic pain or those people for whom insertion brings up trauma may not find this a viable method.

There have also been concerns raised around education and safety. While menstrual cups have seen a rise in popularity, the legislation hasn’t followed and cups are currently not regulated in the UK and there is no safety testing.

This has led the Chartered Society of Physiotherapy to call for better regulation as well as safety education around menstrual cups, particularly concerning the proper use of the cups as several women have reported that incorrect use could be resulting in pelvic organ prolapse. 

Speaking to the BBC, one woman, Jenny said she believed menstrual cups, which she had been using for three months, were responsible for her minor pelvic organ prolapse. A second woman, “Maria” encountered similar problems after using the cup for two months. After being referred to a gynaecologist, she was told that her minor vaginal prolapse “probably happened because of the cup.” “She advised me not to use the cup any more,” Maria told the BBC. “She was not a fan of them at all, especially in women who've already had kids like me.”

Pelvic organ prolapse occurs when the pelvic floor – the muscles and tissue that support the pelvic organs – become weakened and can no longer hold the organs in place, causing organs to drop down. Medical treatment is sometimes needed, however symptoms can usually be improved with pelvic floor exercises and lifestyle changes.

However, Mr Narendra Pisal, a consultant gynaecologist at London Gynaecology has disputed the link between menstrual cups and prolapse. “There is no evidence that menstrual cups cause pelvic floor dysfunction or prolapse. In our clinic’s experience, women have found this to be a great alternative to other sanitary products,” he told us.

“It is ‘greener’ and more environment-friendly but also less likely to cause odour and itching. Obviously, correct application and use are as important as continued emphasis on pelvic floor exercise.”

For those unsure on what exactly correct application and use entails, Mr Pisal says it is important to get the correct size and length of menstrual cup. “The whole cup needs to fit inside lengthwise with nothing sticking out,” he says. It is also important to pay close attention to diameter which is usually decided by whether you have given birth or not. The third thing to consider is capacity which is decided by how heavy the periods are. You may need to try a few different sizes.

“When fitting the cup, two points are important. The first is covering the cervix so that all the blood is collected in the cup. Second factor is getting the cup in without discomfort. The silicon cup is quite flexible and can be compressed to insert inside with ease. Once inside, you can ensure that it fits all around the cervix,” he explains.

“When taking it out, you need to make sure that you release it from the sides so that there is no ‘vacuum’ effect. Also it is best not to ‘push’ it out, but gently help it out. It can then be cleaned as per manufacturer's instructions.”

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