Are menstrual cups safe?

Will a menstrual cup make my prolapse worse?

I want to switch over to a menstrual cup, what do I need to know and where do I start?

Will menstrual cups make a prolapse worse? 

In general, when used (and removed) correctly, a menstrual cup is safe and will not worsen a prolapse.  A study in 2019 showed that menstrual cups are a safe option for menstruation. I’m the nerd that loves to look through research and I gotta tell you, I have not yet found a study that showed bearing down or pulling on a cup or the suction itself it harmful to a prolapse. If the time comes that this changes, I will let you know.

There have been a few cases where people notice a prolapse when wearing a cup. It’s also important to know that our cervix naturally goes lower and feels harder during menses. Add in the hormonal changes of menstruation and our pelvic floors are a little less mobile during that time. It makes sense that people notice a prolapse when wearing a cup because they are naturally paying more attention to down there when utilizing a cup.

If you know you have a prolapse, there are some cups that are naturally wider and can act as a pessary. A pessary is a removable device that goes in the vagina and acts to almost help lift and support the area to reduce a prolapse. These cups include the Ziggy cup, soft disc (formerly soft cup), flex cup. If you are concerned please see a pelvic floor provider to work on pelvic floor strengthening, relaxing, and lengthening while also using the menstrual cup!

If you have a connective tissue disorder like Ehlers-Danlos then the suction of a menstrual cup may be too much for you. In this instance, a menstral disc may be a suitable alternative after talking to your provider. 

Getting the Right Fit of Menstrual Cup

No two bodies are the same so it’s important to get a menstrual cup that works for you. The Hello Cup, Hoo Haa Cup, Diva Cup, Ziggy Cup, Flex, Soft Disc, Skoon, the list goes on. All of these products are great for the right person. Finding a cup that works for you depends on a lot of things- fitness level, number of children you have had, how heavy your cycle is, position of your cervix during menstruation, and even your pelvic floor muscle strength, coordination and ability to lengthen.

My number one recommendation is to take the quiz on Put a Cup In It. This site is amazing and helps you figure out what is best for you. During the quiz they will ask about the position of your cervix and it’s important to check the height of your cervix during your period to get the best fit. It’s important to get a cup that works with your body rather than against it and then find a cup that fits your needs.

Sometimes the stem of the menstrual cup can irritate the vaginal opening. If this happens to you, you can also consider trimming the stem as long as you are still able to safely remove the cup. Fun fact, some people even love to flip their cups inside out because the stem/tip caused irritation of the canal.

How do I insert or remove a menstrual cup?

When you are first starting out, inserting a menstrual cup can seem rather invasive. The fact of the matter is, cups are not tampons or pads and they usually take some getting use to and a bit of practice and patience. The best way to get a good fit is to make sure it is snug around the cervix. You can do this by checking the angle of your cervix prior to insertion. You can also check out this lovely video on how to insert a menstrual cup along with different folding techniques because it really is all about practice.

If you typically have a hypertonic pelvic floor, you may need to practice relaxing and lengthening the pelvic floor. A great way to do this is by sitting on a big exercise ball. As you inhale, your pelvic floor will naturally descend a bit into the ball. If you don’t feel that slight drop, you can practice on the exercise ball, sitting on a yoga ball or even sitting on a rolled up towel. Try inhaling and feeling that pelvic floor gently drop into the towel or ball. 

When removing a cup that has a suction, it’s important to always break the suction before removing the cup. When you remove the cup, make sure you are not just pulling down on the tip to remove it (trust me on this one, nobody wants to yank their cervix as that doesn’t feel good). Instead, place your finger in and up around the rim and push inward to gently release the suction. You can also squeeze at the base of the cup to break the seal or wiggle the cup to break the seal prior to removing.

What if I can’t keep a cup in place?

In order to keep a cup (or tampon) in place we need to be able to rely on the muscle structure and tone of our pelvic floors. If you have a levator avulsion (separation of pelvic floor muscle from the bone) then you may have more difficulty keeping a cup or tampon in place because there is naturally more space down there. Our pelvic floors are never “off” but if we don’t have the normal muscle strength and resting tone it can be hard for the muscles to keep the cup in place. If you find your cup or tampon are constantly slipping out, you should reach out to a pelvic floor rehab provider.

What if I leak pee when I wear a cup?

Incontinence is annoying and even more so during our menstrual cycle. You can get more information on this blog about incontinence and your period but the key take away is that sometimes a menstrual cup can unmask a small prolapse that already existed. In this case, a pelvic floor provider is a great option to getting you on the road to continence. 

What if I have cramping when wearing a cup?

I love a good cup but sometimes a cup isn’t for everyone at this moment. If you have a ton of cramping it could be from a number of things like a heavy flow or muscle tension on the pelvic floor. Unlike a tampon, the cup doesn’t let blood leak through and can cause cramping. This is actually one reason I like the cup because you can measure the amount of blood flow you have at a given time. If your period is super heavy and needs changed every 3-4 hours, it’s a good idea to talk to your midwife or OB about it. If you notice cramping without a lot of blood, reach out to a pelvic floor rehab provider to see if you have any muscle tightness or hypertonicity. You may also benefit from a softer/less firm cup so it will take some experimenting to see what works best for you!

Yeah, that’s not happening so what are my other options?

There are ALWAYS alternatives. If a menstrual cup just isn’t for you, you can check out period underwear such as THINX or Knix or Ruby Love. There are reusable pads like Glad Rags that can be a great alternative for the ec-minded person. You can also try organic pads and tampons like L. Brand, Lola, Cora, Honest, and Get Rael.

If you are wanting to try menstrual cups or discs I hope you find something that works for you!