Menstrual cups: what are they and how do you use them?

Menstrual cups can be a safe, reliable and sustainable choice for your periods. So read on to get the answers to all your menstrual cup questions – including what they are, how they work, and how you use and clean them.

What is a menstrual cup?

While tampons are made of absorbent cotton to soak up your

blood, reusable menstrual cups are made of flexible rubber or silicone. Like a tampon, you push them into your vagina, but they collect your menstrual blood rather than absorbing it.

Here are the key things you need to know:

• they’re available in different sizes and shapes, but most are funnel-shaped – like a tulip – with a narrow stem at the bottom
• you fold them and insert them into your vagina, where they open up like an upside-down umbrella to catch your blood
• research shows they’re safe and effective, and may lead to fewer leaks
• they’re reusable and have a lower environmental impact than other period products (though you can also buy disposable cups, which can be useful when you’re travelling)
• you wash them each time you empty them, then sterilise them at the end of your period

How to use a menstrual cup

If you’re comfortable using tampons, you’ll probably be more at ease with menstrual cups. But it can still take a bit of time and trial and error to get used to inserting, positioning and removing a cup correctly.

A menstrual cup doesn’t come with an applicator, so you need to use your fingers. As it’s made from flexible material, it shouldn’t hurt or feel uncomfortable to insert.

While you get used to using a cup, you may also want to wear a back-up pad at first, in case of leaks.

How to insert a menstrual cup

You should take note of the instructions that come with your particular cup, but you can generally follow these steps.

1. Wash your hands thoroughly with soap and water. You may also find it useful to lubricate the rim of the cup with water to make it easier to insert.
2. You need to fold your cup to insert it. There are several ways to do this, but the ‘C fold’ or ‘U fold’ is popular. First, flatten the cup, squeezing the edges of the opening together, then fold it in half to make a ‘C’ shape.
3. With the stem pointing downwards, gently insert the folded cup into your vagina – it will open up once it’s inside.
4. The cup should sit quite low, with the stem only about 1.3cm (half an inch) from your vaginal opening (but it shouldn’t stick out).
5. Once in place, the cup should form an airtight seal to prevent leaks. Depending on the brand, you may be advised to rotate it to make sure that it’s sealed and secure.
6. If you’ve inserted it correctly, you shouldn’t feel any discomfort.

How to remove a menstrual cup

How often you need to remove your menstrual cup to empty it will depend partly on your flow, which varies from person to person – as well as varying from day to day during your period. You’ll need to empty it more frequently on heavier flow days, for example.

Some manufacturers say a cup can be worn for up to 12 hours. But many recommend emptying it at least every 4 to 8 hours, in line with the official safety recommendations for tampons.

When you first start using a cup, you’ll probably want to remove it more often, to check how full it is. Over time, you’ll get to know how long you can leave it before you need to empty it. But never go for more than 12 hours without removing and cleaning your cup.

Again, you should check the instructions about how to remove your particular cup, but in general you can follow these steps.

1. Wash your hands thoroughly with soap and water.
2. Relax, then feel your way up the stem with your fingers until you find the base of the cup.
3. Pinch the base of the cup to release the seal, then gently pull the cup out of your vagina.
4. Pour the collected blood into a toilet.
5. Wash the cup using warm water – you can also use a mild, unscented, water-based soap if you want to.
6. Reinsert the cup into your vagina.

Cleaning your menstrual cup

It’s essential to keep your menstrual cup clean to avoid bacteria, which can lead to infections. You should:

• sterilise it (see below) before using it for the first time and at the end of your period
• clean it between uses during your period
• never share it with anyone, even after washing it
• use alternative period protection or a spare cup if you’re out and about and you can’t clean your cup
• store it in the pouch or container it comes in – avoid airtight containers, which can encourage bacteria

How to clean a menstrual cup

Check the instructions that come with your cup, as the best way to care for it can vary depending on the material.

You don’t need to sterilise your cup while you’re using it during your period, but you should wash it between uses before reinserting it – either just with water or with a mild, unscented, water-based soap.

Before you pack away your cup until your next period, sterilise it by following these steps.

1. Put your cup into a pan of boiling water, making sure it’s submerged but not touching the bottom.
2. Boil for 2 to 10 minutes, depending on the instructions that come with your cup.
3. Drain it and leave it to air-dry.
4. Pack it away in its pouch or container.

Is a menstrual cup right for me?

Pros of menstrual cups

Research shows that menstrual cups are a safe and effective option for period protection. Here are some other reasons to try them:

• good value – a reusable cup can last for up to 10 years if it’s used correctly
• no supply issues – you’ll have your period protection ready, with no need to buy more products every month
• exercise-friendly – you can wear a cup during swimming and other exercise
• big capacity – some cups hold 3 times more blood than an average tampon. So you may not need to empty a cup as frequently as you change a tampon, and there may be less chance of leaks
• can be worn
  overnight
  – some cups can be worn for up to 12 hours, so you can use them while you sleep
• eco-friendly – with less waste in manufacturing and use, reusable cups have a lower environmental impact than other period products

Cons of menstrual cups

There can also be downsides to using a menstrual cup – though if you’re aware of them, they’re less likely to cause problems:

• one size doesn’t fit all – cups vary in shape and size, so you may have to try a few types to find the ideal fit for you
• possibility of discomfort – to minimise the risk of irritating your vagina, wet or lubricate your cup before inserting it, and clean it thoroughly between uses
• can be tricky to use – inserting and removing your cup can take time to get the hang of, and you may get spills or leaks to start with
• cleaning difficulties – you may feel awkward cleaning your cup in a public toilet, or there may not be cleaning facilities available (having a spare cup can be helpful)
• infection risk – a good cleaning and sterilising routine is essential to avoid infections (never use a disposable cup more than once)
• possibility of allergic reaction – most cups are latex-free, but rubber or silicone cups can cause allergic reactions in some people

When to see a doctor

Menstrual cups are generally safe to use, but they’re not suitable for everyone. See your doctor for advice if:

• you’ve have ever had
  toxic shock syndrome
  (TSS)
• you have a vaginal infection
• you’re allergic to rubber or latex
• you’ve recently had surgery, given birth or had a miscarriage
• you start to get pain when inserting your menstrual cup – this could be caused by
  vaginismus
  , a
  sexually transmitted infection
  (STI) or inflammation of your cervix or vagina

You should also see a doctor if you think you have

. Although these symptoms can be caused by something else – such as the flu – it’s important to get them checked. You should go to the emergency department or call an ambulance if:

• your symptoms are severe or getting worse quickly
• you feel dizzy or faint
• you have problems breathing
• you feel confused

Find more useful information on periods with our

.

Menstrual cups – your questions answered

Are menstrual cups safe?

Menstrual cups are generally safe and complications are rare. However, as with tampons, using a menstrual cup may carry a very small risk of

. This is a rare but life-threatening condition, which can happen if bacteria get into your body and release toxins.

You can reduce your risk by following good hygiene when using and cleaning your menstrual cup. But as TSS needs immediate medical attention, it’s important to be aware of the symptoms, which include:

• flu
  -like symptoms – such as severe tiredness, body aches, sore throat and cough
• feeling sick (
  nausea
  ), being sick (
  vomiting
  ) or
  diarrhoea
• a high temperature (
  fever
  )
• a sunburn-like rash
• red lips, tongue or whites of eyes
• feeling very unwell, dizzy or faint

A scientific review of studies into general menstrual cup safety found that:

• the risk of other infections, such as
  bacterial vaginosis
  (BV), is no higher than for tampon or pad users
• allergic reactions are uncommon
• a handful of users report pain, but without harm to the vagina or cervix. Researchers suggest the pain might relate to incorrect cup positioning or variations in vagina shape

How much blood can a menstrual cup hold?

Most cups can hold more blood than a ‘super’ tampon – but the capacity depends on the brand and size of cup you choose.

They usually come in 2 sizes. In general, a small/medium cup can hold 10 to 30ml, while a large cup can hold 30 to 50ml of blood. You may need to try a few options, so you can get to know what works for you.

Due to their large capacity, menstrual cups may be a good option for

.

Do menstrual cups leak?

Once it’s inserted into your vagina, your menstrual cup will create an airtight seal. This means it shouldn’t leak, as long as you empty it regularly. How often you need to empty it will depend on your flow.

Can menstrual cups get stuck?

No. If it’s inserted correctly, your menstrual cup will be secure, yet easy to remove by following the steps outlined above.

What size menstrual cup should I use?

Menstrual cups generally come in 2 sizes (or sometimes 3), which can be referred to as small and medium, 1 and 2, or A and B.

Different brands offer different sizes, so you may need to try a few before you find your ideal fit. Some brands even offer free exchanges if you want to try a different size.

Your menstrual flow (light or heavy) can help you decide what size of cup you need. Other things to consider include your age, whether you’ve had a baby, and the height of the top of your vagina (cervix).

Some manufacturers recommend a smaller cup if you’re under 30 and you haven’t given birth vaginally, and a larger cup if you’re over 30 or you’ve had a vaginal birth.

Other brands recommend checking if you have a high or low cervix – which is at the top of your vagina. To do this, you can put your longest finger into your vagina. If your finger touches your cervix when only about half of it is in your vagina, you have a low cervix – and a smaller cup may be better for you. If your finger goes almost all the way in before reaching your cervix, you have a high cervix – and you should try a larger cup.

How often do I need to buy a new cup?

Reusable menstrual cups can last between 5 and 10 years if you look after them properly. It’s time to get a new cup if you notice signs of wear and tear, such as deep stains or an odour, flaking, tears or cracks, or if you start to get leaks.

Can I wear a menstrual cup overnight?

As mentioned above, some manufacturers say their cups can be worn for up to 12 hours. So if this is the case, you should be able to safely use your cup overnight.

However, you should always follow the instructions for when to empty and rinse your particular cup – some brands recommend emptying them every 4 to 8 hours. Obviously, this also depends on your flow – if your cup gets full sooner, you’ll need to empty it to avoid leaks.

Do I need to remove my menstrual cup when I go to the toilet?

No. The cup sits in your vagina to catch your period blood. You pee out of a seperate hole, called your urethra. A third hole – your anus – is used for pooing. So going to the toilet shouldn’t affect your menstrual cup.

If you’re using a public toilet, you may need to wash your cup in a communal sink. Some people prefer to carry a bottle of water or wipes, so they can clean their cup in the toilet cubicle.

Can I go swimming or do other exercise while wearing a menstrual cup?

Once you’ve inserted your menstrual cup correctly, it will be totally out of sight (including the stem) and will provide full waterproof coverage. This makes it ideal for exercise, especially swimming.

Can I have sex with a menstrual cup?

Reusable menstrual cups sit low down in your vagina, so can’t be worn during penetrative sex with a penis, fingers or sex toys – so remember to remove your cup before having sex.

Menstrual cups are not a form of birth control (

).

Can I use a menstrual cup with an IUD?

If you’re using an

(IUD) or ‘coil’ as contraception, it should be fine to use a menstrual cup at the same time.

You may have heard that wearing a cup can dislodge an IUD, but there’s no evidence that cup use leads to an increased risk of this. If you’re concerned, ask your doctor for advice.

How soon after giving birth or having a miscarriage can I use a menstrual cup?

Your periods can return within 4 to 8 weeks of giving birth, but you may still have tearing, swelling or discomfort in and around your vagina at this stage. So it’s best to avoid using an internal product such as a cup – it could cause further discomfort, or increase your risk of infection.

It’s a good idea to wait until you’re fully healed, or until you see your doctor at your 6-week postnatal check-up. Your pelvic floor muscles will also be weaker after the birth, so it can be a good idea to wait until they’re stronger before you restart using your menstrual cup.

If you have a miscarriage, you should only use pads – using a menstrual cup or tampons can increase your risk of infection.

Looking for more period protection options? Get the lowdown on other

.