What are Menstrual Cups and why are They Growing in Popularity?
Dr. Kate Dudek • November 20, 2020 • 5 min read
In 2017 it was estimated that, globally, there were 1.9 billion women of menstruating age. Whilst menstruation is entirely normal and actually a sign of good reproductive health, discussing it has traditionally been something of a taboo. For some women, it remains a matter of privacy, something to accept as inevitable, but not draw attention to. For others though, times are changing; they are embracing an era where talking about the ups and downs of periods is the social norm. Alongside this comes a willingness and desire to discuss the different sanitary product options; to open our minds to the availability of pad and tampon alternatives and one of these is the menstrual cup.
What is the menstrual cup?
The menstrual cup is a flexible device that is inserted into the vagina to collect menstrual blood. There are two types, a bell shaped version, that sits lower in the vagina and a flatter version that sits higher up, at the base of the cervix. The menstrual cup holds between 10 and 38ml of blood and will require emptying every 4 to 12 hours depending on how heavy menstrual flow is. It is usually made of medical-grade silicone, rubber, latex or elastomer.
How does it compare to pads and tampons?
One large meta-analysis explored the use, leakage, acceptability, safety and availability of menstrual cups. This analysis compared 43 studies, involving 3319 participants. Key findings were:
- The risk of leakage with menstrual cups was similar or less than the risk or leakage with disposable pads and tampons.
- Menstrual cups do not cause physical harm to the cervix or vagina. Incorrect positioning of the cup may cause discomfort or pain.
- There is no increased risk of infection with menstrual cups compared with other sanitary products. However, there is little evidence to support the idea that the suction seal that is formed, reduces the growth of bacterial species.
- The risk of Toxic Shock Syndrome (TSS) is low.
Why the change in public opinion?
Surprisingly, menstrual cups have been in existence since the 1930s; yet only in the last 5 years or so have they really started growing in popularity. Why is this? Well, there are a number of reasons today’s women give for making the switch, and these include:
- Cost. Menstruating can be an expensive process. Data from the US suggests that the average woman spends between $50 and $150 per year on sanitary items. In contrast, with its ten year lifespan, the menstrual cup represents a significant financial saving. Most simply involve an initial outlay of $20 to $40.
- Durability. The cup holds more than either a pad or a tampon, meaning it needs changing/emptying less often.
- Environmentally-friendly. With the same menstrual cup lasting for up to ten years, it produces none of the additional landfill that disposable products contribute so heavily to.
- Chemical free. Made from hypo-allergenic materials, adverse reactions to the cup are rare. Unlike tampons, there is no risk of fibres being left in the vagina and, to date, there is no association between the menstrual cup and TSS.
- Suitable for use by the majority of menstruating women. Menstrual cups are available in different sizes, meaning they can be used by those with a heavy flow and those with a light flow. They can also be used pre- and post-childbirth. The only women who might struggle to use one are those with an abnormally shaped or positioned uterus.
Are there any drawbacks?
The major issues that women have with the menstrual cup are that it can be messy to empty and it requires a certain amount of looking after. Most manufacturers recommend sterilising the cup between periods, which some women may find an inconvenience.
In addition to this, some women find they need a period of time to familiarise themselves with the menstrual cup and it can take training and practice to really get comfortable with using it.
Menstrual cups: a case example in Ugandan Refugee settlements
The benefits of menstrual cups may well extend far beyond what those of us living in the developed world see. Thousands of women and girls living in refugee camps around the world do not have access to clean water and reasonable sanitation facilities. They are unable to manage their menstrual health with safety or with dignity. Unhygienic conditions mean that infection risk is high and a lack of knowledge on the topic of menstrual health, allows misconceptions and misinformation to spread widely. Health, education and quality of life all suffer as a result.
Globally, UN agencies and women’s protection organisations want to change this. They want to remove the stigma that surrounds menstruation and provide the resources and information women need to manage their own menstrual health. One such project that was set up to help refugees in Uganda by the WoMena Uganda and Public Health Ambassadors of the region was the menstrual cup pilot intervention study.
The project had two aims:
- Provide comprehensive menstrual health education, not only to female members of the settlement, but to males as well. Males were included in the hope that this would lessen the stigma associated with menstruation and that they could provide support to female members of the community.
- Increase acceptability towards the use of menstrual cups, with the idea of improving overall menstrual health for females in the region.
Clearly, in a region such as this, consideration had to be given to the specifics of the menstrual cup being handed out. The free access to clean water that so many of us take for granted is not a given in many refugee settlements. The BFree menstrual cup is an innovative product that does not require water to wash or boil for sterilisation between cycles. As such, it is suitable for use in a humanitarian and low-income context.
As a pilot study there were, naturally, lessons to be learnt. However, the overall outcome was positive. By the end of the pilot study, 91% of surveyed participants were still using their menstrual cups consistently. They reported reduced leaking and improved self-confidence. School aged girls were less embarrassed and their attendance at school increased.
Further promotion of and training in the use of menstrual cups globally, could potentially have a huge impact on the quality of life and menstrual health of many, many women around the world. With advances in modern technology, menstrual cups have become a resource for women from all walks of life and, as such, projects such as the one described above need to be more widely implemented.
Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and menopause.
Get in touch if you have any questions about this article or any aspect of women’s health. We’re here for you.
Sources:
- Eijk, Anna Maria Van, et al. “Menstrual Cup Use, Leakage, Acceptability, Safety, and Availability: a Systematic Review and Meta-Analysis.” The Lancet Public Health, vol. 4, no. 8, 1 Aug. 2019, pp. E376–E393., doi:10.1016/s2468-2667(19)30111-2.
- “Menstrual Cups vs. Tampons: Things You Might Not Know.” Mayo Clinic, Mayo Foundation for Medical Education and Research, newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/.
- “What Can You Tell Me about the Menstrual Cup?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Feb. 2020, www.mayoclinic.org/healthy-lifestyle/womens-health/expert-answers/menstrual-cup/faq-20058249.
- WoMena. MENSTRUAL CUP PILOT INTERVENTION IN ADJUMANI DISTRICT UGANDA. 2020, womena.dk/wp-content/uploads/2020/05/Bfree-Pilot-Intervention-Report-April-2020.pdf.
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A Beginner’s Guide to Menstrual Cups: A Sustainable and Practical Alternative
Menstrual cups have gained popularity in recent years as a sustainable and cost-effective alternative to traditional menstrual products. Made of medical-grade silicone or latex, these reusable cups collect menstrual fluid rather than absorbing it, offering numerous benefits for those who choose to use them. If you’re new to menstrual cups and considering making the switch, this beginner’s guide will provide you with essential information to help you get started. #### What is a menstrual cup? A menstrual cup is a bell-shaped device designed to collect menstrual fluid. It is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects the flow, holding much more liquid than a tampon or pad. The cup is reusable, offering a more sustainable option compared to disposable products. #### Advantages of menstrual cups: **Eco-friendly:** Menstrual cups reduce waste as they can last for several years with proper care. By using a cup, you can significantly decrease the number of disposable pads and tampons that end up in landfills. **Cost-effective:** Although menstrual cups have a higher upfront cost than disposable products, they are a long-term investment. Over time, using a menstrual cup can save you money since you won’t need to regularly purchase [pads or tampons](https://nabtahealth.com/articles/what-type-of-sanitary-product-is-right-for-me/). **Extended wear time:** Unlike pads and tampons, which typically require changing every few hours, menstrual cups can be worn for up to 12 hours, depending on your flow. This makes them convenient for overnight use and allows for uninterrupted activities during the day. **Lower risk of leaks and odor:** When inserted correctly, menstrual cups create a secure seal that reduces the risk of leaks. Additionally, since the fluid is collected rather than absorbed, menstrual cups do not cause the same odor issues that can arise with other products. **Health benefits:** Menstrual cups are made of hypoallergenic materials, making them suitable for people with sensitive skin or allergies. They also do not disrupt the natural pH balance of the [vagina](https://nabtahealth.com/glossary/vagina/), reducing the risk of infections. #### How to use a menstrual cup: **Choosing the right cup:** Menstrual cups come in different sizes and shapes. Consider factors such as your age, flow, [cervix](https://nabtahealth.com/glossary/cervix/) position, and whether you’ve given birth when selecting the appropriate cup. It may take some trial and error to find the perfect fit. **Sterilize the cup:** Before using a menstrual cup for the first time, sterilize it by boiling it in water for a few minutes. Ensure the cup is clean and dry before insertion. **Insertion:** Wash your hands thoroughly. Fold the cup using one of the various folding techniques available. Insert the cup into your [vagina](https://nabtahealth.com/glossary/vagina/), aiming towards the base of the spine. The cup will unfold and create a seal against the vaginal walls. **Removal:** To remove the cup, wash your hands and find a comfortable position. Gently pinch the base of the cup to break the seal, then carefully pull it out. Empty the contents into the toilet, rinse the cup with water, and reinsert if desired. #### Caring for your menstrual cup: **Empty and clean the cup:** Depending on your flow, you may need to empty the cup every 4 to 12 hours. Rinse it with water or wipe it with unscented, mild soap. Sterilize the cup between cycles by boiling it for a few minutes. **Store properly:** Keep your menstrual cup in a breathable bag or container when not in use. Avoid storing it in an airtight or plastic container to prevent odor and bacterial growth. Menstrual cups offer a sustainable, [cost-effective](https://www.lizzom.com/collections/lizzom-products), and convenient alternative to traditional menstrual products. While there may be a learning curve when initially using them, many people find them comfortable and reliable once they get accustomed to the process. By following the tips and techniques outlined in this beginner’s guide, you’ll be well on your way to a more sustainable and hassle-free period experience.
What are Sanitary Pads?
Sanitary pads are recognised worldwide. They are a [menstrual hygiene product](https://nabtahealth.com/what-type-of-sanitary-product-is-right-for-me/), designed for use by women during their monthly periods and also known as sanitary napkins or sanitary towels. #### **From simple beginnings…..** Sanitary pad designs in the 1960s incorporated flexible, thin, leak-proof polyethylene as the back sheet. Over time, sticky, elastic plastics were used, allowing the sanitary pads to be attached to a woman’s underwear directly, rather than hanging off a belt-type device. Later in the 1970s, designers grasped the idea of making plastic “wings” to be used to wrap around panties and place the pad exactly where it is required. #### **……to widespread use in the 21st century** Which brings us, more or less, to the present day, where sanitary pads are still very widely used globally by women during their monthly periods. They can also be used after childbirth when it is normal to have vaginal bleeding for a week or two. In fact, any flow of blood from the [vagina](https://nabtahealth.com/glossary/vagina/) can be easily absorbed and contained within a sanitary pad. Many young women choose to use sanitary pads when they initially start their periods, as it can take time to develop the confidence to use a [tampon](https://nabtahealth.com/what-are-tampons/). Today’s sanitary pads are produced from various materials, based on the brand, country of origin, and even style of pad. #### **How to use sanitary pads** Sanitary pads are worn externally, unlike menstrual cups and tampons that are worn internally. Sanitary pads should be changed regularly, depending on the period flow, i.e. how light or heavy the bleeding is. Provided the right absorbency of the pad is selected, leakage should not occur, meaning menstrual blood does not reach clothing and furnishing Sanitary pads are wrapped individually for easier usage and can be easily carried in your purse. #### **A pad for every flow type** Some of the most common types of pad are: • Regular: it is a middle-range sponginess pad. • Maxi/Super: A spongy bumper pad routinely used by women with heavy periods. • Overnight pads: Longer than regular pads, allowing more protection while lying down.Suitable for use during the night. • Maternity pads; Longer and thicker than maxi/super pads. Designed for women to use after childbirth, can also absorb urine. • Ultra-thin: A thin pad that may be as spongy as a Maxi/Super or Regular pad, but with a reduced amount of bulkiness. It is important to remember that, regardless of type, sanitary pads cannot be flushed down the toilet as they might cause a blockage. #### **The environmental impact of disposable sanitary pads** Establishing exactly how much plastic waste comes from sanitary pads is tough, as it is labeled as medical refuse. The plastic used in sanitary pads is not eco-friendly and can [lead](https://nabtahealth.com/glossary/lead/) to environmental and health hazards as one pad takes hundreds of years to decompose. An increased environmental awareness is one reason why, recently, women have been looking for alternative, more eco-friendly sanitary products. [Reusable pads](https://nabtahealth.com/the-use-of-reusable-sanitary-pads-in-sub-saharan-africa/) and washable [menstrual cups](https://nabtahealth.com/what-are-menstrual-cups-and-why-are-they-growing-in-popularity/) are both becoming more widely used. Both have actually been in existence for a long time, but improved designs make them a viable alternative for the modern woman. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#1960787575785977787b6d78717c78756d71377a7674) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * “How Tampons and Pads Became so Unsustainable.” _National Geographic_, 18 Oct. 2019, [www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/](http://www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/). * “What Is a Sanitary Pad?” _Menstrupedia_, [www.menstrupedia.com/articles/girls/sanitary-pad](http://www.menstrupedia.com/articles/girls/sanitary-pad).
What Type of Sanitary Products is Right for me?
From the time that a female starts her periods when she enters [](https://nabtahealth.com/what-is-puberty/)[puberty](https://nabtahealth.com/glossary/puberty/) until she reaches [](https://nabtahealth.com/about-the-three-stages-of-menopause/)[menopause](https://nabtahealth.com/glossary/menopause/) and stops having periods, menstrual hygiene will become something that she has to carefully consider. Most women menstruate for about 40 years and regular periods are a good indicator that a female is reproductively healthy. Although, unfortunately there are exceptions to this, for example women with [](https://nabtahealth.com/what-is-endometriosis/)[endometriosis](https://nabtahealth.com/glossary/endometriosis/) often have periods that appear normal. As menstruation is such a fundamental part of being a woman of reproductive age, taking the time to explore and sample the available sanitary products can help make periods more manageable. Deciding on which sanitary products to use can be influenced by a range of factors, including: * Cost * Environmental impact * How often the product will need changing throughout the day * Local availability * Heaviness of flow * Personal preference and/or recommendations by friends and family. The range of sanitary products available today means that the majority of women are able to manage their periods safely, comfortably and with dignity; in contrast to days gone by when old rags and sheep wool were commonly used to soak up menstrual blood. **Sanitary pads** ------------------- A common choice for girls who have only just started their periods. [Sanitary pads](https://nabtahealth.com/what-are-sanitary-pads/) are also known as sanitary napkins and sanitary towels. They are narrow pieces of absorbent material that fit directly into the underwear. Easy to use and change, they are available in different absorbencies to suit differing flow rates and times of the day. Some have wings attached to help secure them in place and reduce the risk of stains or leaks. Disposable sanitary pads were first used in the early 1920s, they gave women the opportunity to manage their periods discreetly, as there was no longer the need to wash and dry the bulky homemade versions publicly. Now, with advancements in manufacturing and material availability and a general public who are becoming increasingly environmentally driven, there is renewed demand for reusable sanitary pads, to avoid the high plastic wastage that comes from most disposable variants. [Reusable sanitary pads](https://nabtahealth.com/the-use-of-reusable-sanitary-pads-in-sub-saharan-africa/) are made from new or old materials such as sheets, pillow cases, and towels. They are made from pure cotton, as it is the best material for absorbing and also the most comfortable to wear. **Tampons** ----------- Often preferred over sanitary pads by dancers, athletes and swimmers, [tampons](https://nabtahealth.com/what-are-tampons/) are worn internally. A simple concept, they are devised of a wad of cotton attached to a string. Some come with a plastic applicator for ease of insertion. Once inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), they expand slightly to absorb menstrual blood. They will typically need changing every 4 to 6 hours and, as such, are not ideal for wearing overnight. In the 1980s, an association between tampon use and Toxic Shock Syndrome (TSS) was reported. Whilst the overall risk of developing TSS remained very low, the link between it and tampon use was enough to put some women off using them for prolonged periods of time. Like disposable pads, tampons incur significant plastic waste and many women today strive for alternatives that are more environmentally friendly. **Menstrual cups and disks** ------------------------------ A [menstrual cup](https://nabtahealth.com/what-are-menstrual-cups-and-why-are-they-growing-in-popularity/) is a reusable hygiene product. The cup is made from medical-grade rubber or silicone, it is small and funnel-shaped and is inserted into the [vagina](https://nabtahealth.com/glossary/vagina/), where it forms a seal and collects menstrual blood. There are disposable menstrual cups, but it is the reusable ones that have really been growing in popularity in recent years. The menstrual cup holds up to 38 ml fluid, meaning it requires changing less often than a sanitary pad or tampon; it also has fewer of the negative associations with TSS that tampons have. Whilst it can take a few attempts to master the [art](https://nabtahealth.com/glossary/art/) of insertion, leakage rates are low once the cup is in position. Reusable menstrual cups should be washed and wiped clean before each use and sterilised at the end of your period. Modern menstrual cups are very durable and can last for up to 10 years with proper care. Menstrual disks and cups are similar as both are inserted into the [vagina](https://nabtahealth.com/glossary/vagina/) and both collect blood rather than absorbing it. Disks typically sit higher up, where the [vagina](https://nabtahealth.com/glossary/vagina/) meets the [cervix](https://nabtahealth.com/glossary/cervix/) (the [vagina](https://nabtahealth.com/glossary/vagina/) fornix). Unlike cups, disks are usually not reusable and will need to be discarded after use. They can also be slightly messier to remove than cups. ### **_Advantages of menstrual cups and disks_** * They are affordable. * Potentially safer than tampons * Hold more blood than other sanitary products, meaning you can go longer without changing them or emptying them. * The reusable varieties are more eco-friendly than disposable pads or tampons. ### **_Disadvantages of menstrual cups and disks_** * Emptying them can be messy. * In very rare cases, may cause an allergic reaction. However, most modern varieties are made from hypoallergenic materials. * Vaginal irritation, particularly if not accurately inserted. * Hard to remove or insert. **Period pants** ---------------- Period underwear ([period pants](https://nabtahealth.com/what-are-period-pants/)) are a relatively new addition to the portfolio of sanitary products. These are more like normal underwear, except that they have additional layers of material built in to absorb any period blood. There are different types of pants available for light, medium, and heavy flow days. They can be worn alone, or as a back-up alongside tampons or menstrual cups. Fully reusable, they are another of the more environmentally-friendly options and, because there is no need for any internal insertion, they are a good option for those who are hesitant to use tampons, cups or disks. These special pants can also provide welcome relief for those who experience urinary incontinence. In conclusion, there are now a large selection of products that allow you to go about your normal life whilst on your period each month. Selecting the right product will minimise the risk of leaking, discomfort, embarrassment and inconvenience. Consider a women health test to learn more on your health. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#146d75787875547a757660757c717578607c3a777b79) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Eijk, Anna Maria Van, et al. “Menstrual Cup Use, Leakage, Acceptability, Safety, and Availability: a Systematic Review and Meta-Analysis.” _The Lancet Public Health_, vol. 4, no. 8, 1 Aug. 2019, pp. E376–E393., doi:10.1016/s2468-2667(19)30111-2. * Hajjeh, Rana A., et al. “Toxic Shock Syndrome in the United States: Surveillance Update, 1979–19961.” _Emerging Infectious Diseases_, vol. 5, no. 6, 1999, pp. 807–810., doi:10.3201/eid0506.990611. * “How Tampons and Pads Became so Unsustainable.” _National Geographic_, 18 Oct. 2019, [www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/](http://www.nationalgeographic.com/environment/2019/09/how-tampons-pads-became-unsustainable-story-of-plastic/). * “Menstrual Cups vs. Tampons: Things You Might Not Know.” _Mayo Clinic_, Mayo Foundation for Medical Education and Research, [newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/](https://newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/). * “Tired of Tampons? Here Are Pros and Cons of Menstrual Cups.” _Health Essentials from Cleveland Clinic_, Health Essentials from Cleveland Clinic, 15 Nov. 2019, [health.clevelandclinic.org/tired-of-tampons-here-are-pros-and-cons-of-menstrual-cups/](https://health.clevelandclinic.org/tired-of-tampons-here-are-pros-and-cons-of-menstrual-cups/).