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Menstrual cups 101: A comprehensive guide

Menstrual cups 101: A comprehensive guide

Is it your *cup* of tea?

Text: Redzhanna Jazmin


In this guide, we cover the plethora of menstrual cup types that exist, the misconceptions associated with them, the risks of using them and why they're worth a shot!

On average, a woman will experience 30 or so years of menstruation in her lifetime, from menarche (her first period) to menopause. Each period calls for three to five pads or tampons a day (depending on your flow) for five days of her period at around 60 sen a piece.

Doing the math (and lowballing it), that’s around RM4,000 in her lifetime on a necessity.

In addition to that, tampons, panty liners and pads, along with their applicators and packaging contribute to around 200,000 tonnes of waste per year. Pink tax and politics aside, we can’t exactly avoid using menstrual products despite the environmental and financial costs (unless you opt for birth control to stop your period entirely, which is a whole ‘nother ball game).

That said, there are ways to revamp your period routine to make it easier on our earth and your wallet!

With the movement towards sustainability and environmentally-friendly solutions gaining more traction, menstrual cups have surged in popularity in the last few years, presented as the most environmentally friendly alternative for menstrual products.

Although shelling out anywhere from RM50 to RM100 (often more, if you’re ordering from international brands) all at once seems like a lot to pay for a menstrual product, however consider the facts:

  1. They can last up to 10 years
  2. They considerably reduce waste sent to landfills as they are reusable
  3. They are guaranteed to save you some moolah in the long run

That said, it’s foreign territory for many, so here’s a nifty little guide to outline whats available, how to use it, the misconceptions, the risks and why it’s worth a try.

MENSTRUAL CUPS

What is it?

These are probably the type you are well acquainted with, and they certainly are popular for a reason. There are tons of brands on the market, with options for size, shape and material for maximum comfort.

Obviously, some brands are more reliable than others as there’s a lot of cheap imitations made of suspect materials, but the most popular (and well-established) brands are the DivaCup, the Mooncup and the Freedom Cup, to name a few.

How does it work?

As you can see, they are shaped like, well, a cup. The general idea is that you fold them down to size, and once inserted, they’ll ‘pop’ back into shape and create a suction seal—this is what keeps it in the vagina and stops your period blood from going everywhere as it is collected.

Once it’s in properly, you shouldn’t be able to feel it at all, and you’ll have up to 12 hours of leak-free protection before you have to change it again.

But...how?

Obviously it’s easier said than done. The cup looks massive compared to a tampon, and can be daunting for a first time user.

First thing’s first—wash your hands with antibacterial soap and warm water (this is not optional). Then, fold the cup to make it more compact (and things easier for you). If you’re stuck, here are a few different ways to fold your menstrual cup:

Once you’ve got your folds down pat, it’s time to insert the cup. As different brands have different instructions, insert the cup according to the brand’s recommendations (though, it’s not too difficult to understand—just push it up your vagina).

Once you release your grip, you should feel the cup ‘pop out’ back to its normal shape in your vagina, which creates the suction. If you don’t, or if the cup is stubbornly folded, either try squeezing the sides to encourage it to pop or simply remove, try a different fold and insert again.

How do I take it out?

To take it out, simply break the suction by pressing on the sides and pull the cup out. Easy as pecan pie! Oh, and please—don’t pull them out by the stem without breaking the suction (more on that later)

Troubleshooting your cup:

  • Stem too long and uncomfortable? Trim it down.
  • Can’t get it in? Firstly, that’s what she said; secondly, try a few different ways to fold your cup down, and add a bit of silicone-safe lube for good measure.
  • Blood. Everywhere. Try emptying your cup more often. The longer you wait between changes, the messier it’s going to get.
  • Cup not popping? Your cup is probably too soft—get a firmer one like the one from OrganiCup.
  • Irritated hoo-ha? Try a different cup size.
  • When should I get rid of it? Here are three things to look out for when it’s time to retire your cup: the presence of a sticky, powdery film over the cup, odour and extreme colouration.

MENSTRUAL DISCS

Although it’s got a similar philosophy to the menstrual cup, the menstrual disc is better described as the more intimidating big sister.

It’s much bigger in size to the traditional menstrual cup, and is typically much softer (read: malleable). They go in the same way (duh) but sit in a completely different part of the vagina. See, instead of low down in the vaginal canal near the vulva, the menstrual disc sits in the vaginal fornix, where the vaginal canal meets the cervix (the entrance to the uterus).

This positioning gives the disc many advantages over the cup, such as that it doesn’t require any suction to stay in place (just a careful tuck behind the pubic bone) and it allows for mess-free period sex (if you’re interested). If this isn’t making any sense, here’s a video to illustrate things a little better.

As with the cup, it will keep you leak-free for 12 hours (yay!). To remove it, simply untuck it from behind the pubic bone and pull it out of the vaginal canal while keeping it level (this may take a couple tries) and dump it in the loo (or the shower). Plus, depending how you look at it, another advantage is that having a poo will empty it for you!

MENSTRUAL CUPS VS DISCS

There is no one train of thought with this. Some find the cup to be easier to use and handle than the disc while others think the contrary.

It’s all about finding what works for you and your anatomy. If you’re struggling to decide, there’s a great YouTube channel that talks about everything to do with menstrual cups (and discs): Put A Cup In It.

MISCONCEPTIONS

1) There’s no way it could hold the entire contents of my period

You’d be surprised! During the average period, a woman loses less than 80ml of blood. An average menstrual cup can hold around 30ml of fluid at its maximum capacity, so you’d pretty much be set for each day.

2) Don't they hurt when you put them in and while they're in you?

They certainly can, but that’s more down to bad technique and a lack of lubricant. Other than mild discomfort from time to time at most, they are painless.

3) They are extremely messy

Not necessarily; like we said, empty your cup often and if you’re not super confident on keeping things mess-free, do it in the shower.

4) They’re gross and unhygienic

Only if you are. If you are diligent about cleaning your cup, sterilising it by boiling it in hot water before and after every cycle and using mild soaps to clean them between uses, they’re actually super clean.

5) I can’t use an IUD with a cup in—it'll dislodge it

Yes you can! In fact, this 2012 study found that the risk of dislodging your IUD was the same with or without a menstrual cup in. With regards to discs, which sit closer to your cervix, they are generally considered safe to wear with an IUD when used as directed, but you may want to consult with your physician before using them.

6) You’re not a virgin if you use them

Virginity is a social construct and if you’ve not had sex yet, rest assured that the menstrual cup isn’t going to take your v-card.

7) They’re not biodegradable and will contribute to landfill anyway

If you’ve got a silicone menstrual cup, it will actually naturally degrade over time depending on the conditions of the landfill as the material starts off as sand anyway! Just make sure that before disposing, you wash the cup thoroughly, cut it into small pieces and dispose in the trash. Alternatively, if you have a recycling facility that can handle silicone, take it there!

RISKS

No menstrual product comes without its risks, but menstrual cups are generally considered safe among the medical community, with any potential risks considered rare when the cup is used as recommended.

Infections

Although yeast infections and bacterial vaginosis are super rare with the menstrual cup, they can happen if you’re not super hygienic about things. In fact, they’re more likely to result from the bacteria on your hands transferred onto your cup.

Basically, the general rule is that as long as you keep your hands clean (Wash. Your. Hands.) and you’re cleaning the cup regularly, you won’t be having any problems.

Toxic Shock Syndrome (TSS)

This is the condition that everyone’s mothers, aunts and grandmas warned against when we started using tampons. TSS, a rare but serious medical condition, occurs when the bacteria Staphylococcus aureus enters the bloodstream and produces toxins. It’s often life threatening and highly associated with the use of superabsorbent tampons.

However, there has only been one confirmed case of TSS related to menstrual cup usage, and it happened because the user had scraped the inside of her vagina when inserting the cup initially that allowed the bacteria to enter her bloodstream and spread.

The best course of action in these cases is to use lubricant when inserting the cup, properly sterilise your cup before use and to wash your hands before and after using it.

Pelvic organ prolapse

Remember when we said you shouldn’t take the cup out without first breaking the suction? Yeah, the reason behind that is so that you avoid any or all of your pelvic organs (namely, the uterus, bowels or bladder) slipping out of place. Pelvic organ prolapse, although not life-threatening, can cause a great deal of discomfort and pain.

In fact, that’s not the only thing that can lead to prolapse—advice to bear down when removing menstrual cups is directly counterintuitive to avoiding prolapse (note: this doesn’t apply to the menstrual disc as it is suction-free).

Mooncup Ltd, one of the leading manufacturers has particularly spoken out against the misinformation spreading within the growing market. “The Mooncup menstrual cup is designed to be worn as low in the vagina as comfortably possible with a clear space between the top of the cup and the cervix. It is important that the cup is not positioned in contact with or over the cervix, and that the seal is fully released before removing the cup. The Mooncup menstrual cup comes with comprehensive instructions for use.”

In particular, women who have had pregnancies should be wary of the risk of pelvic organ prolapse that comes with menstrual cups, as their weakened pelvic floor leaves them most susceptible to the complication.

THE VERDICT

Regardless of the risks, a recent study published in the Lancet Journal of Public Health concluded that menstrual cups are a safe option for menstrual management.

So, as long as you're careful and diligent, the cup is a great way to go!

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