When I first heard about using a menstrual cup 10+ years ago, my initial thought was, ‘what a big ole mess.’ The cup is worn internally during menstruation and collects your flow rather than absorbing it like a tampon. I had images of unfortunate removal that could result in embarrassing spills and laborious clean-up. I wrote off the concept and didn’t look back.
But I’ve had a major change of tune. After researching the cups thoroughly and giving the concept a lot of thought, I decided to take the plunge. Through much trial and error and a lot of research, here’s what I’ve learned (and what I wish I’d known early on).
Menstrual Cups: What to Know
First off, the typical menstrual cup is about two inches long (not including the stem at the bottom), bell-shaped, and made from BPA-free medical-grade silicone. They’re usually clear and are flexible. As mentioned, they’re worn inside the vagina to catch menstrual blood and can be worn up to 12 hours, depending on your flow.
When full, they’re removed, emptied, cleaned, and re-inserted. Menstrual cups are safe when used as directed and no health risks related to their use have been found. This is hugely significant. From my extensive research on menstrual cup user forums, I only found one health issue related to the cup: a single case of cervicitis that resulted from a user not properly cleaning her cup (but this would fall under the ‘not used as directed’ category). Bottom line? They are safer than tampons, and there is no risk of toxic shock syndrome.
Menstrual Cup Advantages
- Healthier and safer than tampons. In addition to the toxic shock syndrome risk, tampons can alter the pH and beneficial bacteria in the vagina because they absorb all vaginal secretions in addition to blood. Also, tampons undergo a bleaching process that produces dioxins, a suspected carcinogen. I don’t know about you, but I don’t want carcinogens up in my vag. Not to mention they’re made from cotton doused in pesticides. It is of course possible to buy organic tampons, but the cotton still affects vaginal pH. The menstrual cup’s silicone does not affect pH.
- Blood flows downward during menstruation, and the menstrual cup naturally collects this flow and supports this rhythm. Tampons collect and hold the blood near the cervix for hours at a time, affecting the downward flow.
- Many women report fewer cramps and lighter periods with the cups. This has been true for me.
- The cups reduce the waste associated with tampons and pads. They’re reusable and last for years! (though I’ve read they should be replaced yearly). Tampons and their packaging produce SO much waste. Have a zero waste period! Hot tip: I combine the cup with menstrual panties, so no need for panty liners.
- The cups save money spent on tampons and pads. If you’re reading this in 2022, there is currently a national tampon shortage (!), but not for us cup users.
- No odor.
- No more plumbing problems from pads and tampons clogging your pipes! Ugh.
- Once you get the hang of it, it doesn’t leak like tampons tend to.
- No hauling around tampons in your bag or suitcase. I love this feature, especially for travel. It’s small and discreet and easy to pack, and if you’re wearing it, you don’t need to bring anything!
I actually look forward to my period now (how weird is that?) because I am so psyched about my cup. It makes menstruation a breeze, and let’s face it, your period isn’t the most pleasant time of the month. I personally have noticed less bloating and cramping and far more comfort than tampons.
The single biggest advantage to me is overnight use. I don’t think it’s healthy to wear tampons overnight for reasons stated above: blood collection remaining coagulated in cotton next to your cervix is a breeding ground for bacteria. So I wore pads overnight, which is super uncomfortable because it’s not a, um, very dry experience. Shifting also causes pads to leak. Blech. When I first wore my cup successfully overnight and woke up dry and comfortable, it was like a dream come true.
Menstrual Cup Disadvantages
- The biggest downside is the learning curve. Every article I read said it takes at least 3 cycles to really get it right. I scoffed, thinking I could easily get it down in one cycle. Not true. It really does take several months to get the hang of it, and your period only comes once a month, so that’s the only time you can practice. Be patient. You will get the hang of it!
- Adding to the learning curve is the fact that there are so many cups from which to choose, and we are all shaped differently. Certain cups work better for women with higher or lower cervixes, so you’ll need to get all up in there to figure out which cup will be the best fit for you. Or, you can buy a bunch of them and try different types til you find your Prince Charming.
- Cost. The cups run around $30-$40, which is no big deal. But if you have to try out several different models like I did to find the best fit, it can be a bit costly initially. BUT it’s still a savings over tampons once you find your model.
- Removal can get messy. Not at all what I was picturing (which was splattering my bathroom walls with blood), but there will be some blood on your hands until you figure out what you’re doing. I promise you though, after the learning curve, it’s a breeze, really!
- You really need to get comfortable getting your fingers all up in your vaginal canal. This doesn’t bother me one bit, but it can be challenging to figure out the best method to insert and remove it, and you’ll learn a lot about your anatomy.
To get the best fit, here are a few considerations: have you had kids? How heavy is your flow? How high up is your cervix? Certain cups are shaped to accommodate such considerations. Finding the right fit is essential: If you have a low hanging cervix, for example, that’s going to take up some space in your cup and cause spill-over. See this chart for help with fit. Most people choose Diva or Lunette. Make sure you choose the right model, either 1 or 2, for flow and/or pre or post childbirth. There are typically 2 sized models specified.
Removal and insertion are going to be your biggest challenges up front. Mine leaked constantly at first, but that was because I hadn’t yet mastered the placement or proper suction.
Here are some tips to help you: (i.e. what I wish I’d known just starting out)
- Don’t try “practicing” when you don’t have your period. Makes it was harder to get in and out, and you don’t know if it’s working anyhow.
- When you insert it, don’t shove it straight upwards like a tampon. It needs to be pointed at an angle toward your tailbone to align with your cervix, like so: (I find that picturing anatomy helps)
- The directions will say you can wear it for 12 hours. During the first couple days, I can get about 4-5 hours max out of it, and my flow is pretty normal. The remaining 2-3 days I wear it for 12 hours without even thinking about it. It will depend on your flow, so plan to check it every 4-8 hours for the first few months til you begin to learn what works for you. NOTE: it will be about 3/4 the way filled when it reaches capacity; I assume because your cervix dips in the top and prevents it from filling all the way.
- Once you figure out your capacity, you’ll know how long you can wear it before it leaks. When it’s full you will get spillover, so wear a liner or the period panties for the first few cycles til you gauge how long you can wear it.
- You have to get the right “suction” or it will leak. This involves inserting and rotating it so it pops open, which isn’t super simple at first, but as long as the cup opens, just give it a small tug to click the suction in place and you should be good it go.
- If you see a few spots of blood after you insert it, it doesn’t mean it’s leaking. That just happens (maybe blood leftover in the canal is what I’ve read). I used a liner for the first several months while I was getting the hang of it. But I used to have to do that with tampons too, so no big deal. EDIT: I’ve now switched to period panties for a totally zero waste period!! Check em out here. I LOVE not having to use anything disposable during my period.
- Use extra protection overnight (pad or period panties) until you get a feel for which capacity you need.
- People are always scared about having to empty it in public, but you can time it so this shouldn’t be a problem. I find overall you don’t need to change it nearly as much as a tampon, even if you have a heavier flow.
- Speaking of flow, some of the cups are sized according to whether or not you’ve given birth. I found that it’s more of a flow issue. If you have a heavier flow, get one that’s a bigger capacity, baby or not.
- Removal: I am honestly not sure why these things have stems. If you have the suction right and you tug on the stem, that thing isn’t going anywhere. You basically have to bare down like you’re pooping until you can feel the bottom of the cup, then squeeze it gently to release the suction, then sort of shimmy it out. Then dump it in the toilet. Yeah, you’re gonna get some blood on your fingers, but it’s still way more pleasant that tampons. Then make sure you wipe super well because you have to kind of hobble to the sink to wash it out before you reinsert it.
- Don’t freak out if you can’t “find” it. It really doesn’t have anywhere to go. It’s in there, promise. If you can’t easily feel it when you’re bearing down, it’s not full. The fuller it gets, the lower it will move down, and you can easily remove it. Just wait a few hours and try again. Really, if you leave it in longer than 12 hours, it’s no big deal.
- Getting it in: the directions will have different options, but I think the “C” fold method works best (see below). I usually squat down, relax, C fold it, insert, then rotate it a bit and it kind of finds its own place. Then I give the stem a very gentle tug to make sure it’s suctioned. It’ll move where it needs to be. Insertion is the big learning curve you’ve been warned about, because it truly does take a few cycles to learn how where and if it’s perfectly positioned for no leaking.
Which Menstrual Cup is Right for You?
So this is the million dollar question. It took me several months of both experimenting and learning AND trying out different models before I settled on one I like. It really depends on your body. This was the biggest downside for me, because I had to try 4 different cups before I found the perfect solution, and that whole shebang cost me around $100. One hint: if it leaks no matter what, try a different model or size.
Still, I’ve been using the same cup for over 5 years now, and the average cost of a period is $168 per year. (source) So i’ve saved $840 so far (well, $740 after my initial investment).
If you have a longer vaginal canal and/or your cervix sits higher (meaning it’s hard to reach with a finger), you’ll do better with a longer cup like Diva or Lily. If your cervix sits low, Skoon is a good choice because it’s pretty short. (Again, this chart is super helpful in terms of determining flow and capacity.)
I first tried the Diva cup, which worked ok but tended to leak (I’ve read similar accounts from others). Then I tried the Skoon cup, which is the softest and most comfortable and has the longest stem for easiest removal. That one didn’t work for me at ALL, and I think probably works best for gals with a low cervix. It was too short and wide for me, so it leaked right away. I then tried the Lunette model 2. It’s the firmest cup and may not be best for beginners, but it worked the best for me– no leaks! It’s sometimes a challenge to insert because it’s so stiff. I think the stiffer cups are best at preventing leaks.
Bottom Line: DON’T GIVE UP. I was so excited to get my first cup and try it out and got really discouraged when it leaked quite a bit. Then I had a hard time finding it to remove it. Turns out that one was the wrong size and model. Experiment with different sizes and models if you don’t get it right off the bat. I’m telling you, it is SO worth it.
Mary Vance is a Certified Nutrition Consultant and author specializing in digestive health. She combines a science-based approach with natural therapies to rebalance the body. In addition to her 1:1 coaching, she offers courses to help you heal your gut and improve your health. Mary lives in San Francisco and Lake Tahoe in Northern California. Read more about her coaching practice here and her background here.