What does science say about the menstrual cup?

In recent years the use of the menstrual cup as an alternative to tampons and compresses has become very popular, and more and more women are opting for this method.

The menstrual cup is nothing more than a flexible container made of hypoallergenic material, which is inserted into the vagina to collect the fluids of the period, and that can be used for several years, if used with proper hygiene. If you google, ‘menstrual cup’ you will get many hits on articles talking about the advantages and disadvantages of the menstrual cup, so we wanted to take a step further and look for scientific studies about the topic.

An extensive review published in The Lancetm (July 2019), concludes that the menstrual cup is a safe alternative to traditional hygiene products, although more studies are needed in this field, as well as more complete calculations comparing the real environmental costs of the different options. On the other hand, the paper warns that users of the IUD (intrauterine contraceptive device) may be more likely to expel the IUD when using the menstrual cup, so more research is needed on the combined use of both devices.

It is not as novel as we thought.

Given the recent hype about the menstrual cup, you’ll be surprised to hear that the cup has been used for more than 80 years and in fact, we find relatively old medical work that has already explored the advantages of its use. For example, a study published in the Journal Obstetrics & Gynecology, in 1962, presents the menstrual cup as a good alternative to avoid vaginal infections by Trichomonas vaginalis and other discomforts caused by tampons. Three years earlier, the same publication also included a paper with instructions for the correct use of the menstrual cup. 


Numerous studies have also compared the incidence of the famous toxic shock syndrome in women when using a tampon or a menstrual cup. Up until today, researchers have been able to make little progress in finding the toxin responsible for this disease in menstrual cups, but in the case of tampons they have found a lot of evidence suggesting that toxic shock syndrome is caused by the materials with which tampons have been made. That being said, in a paper published in the journal of Applied and Environmental Microbiology, researchers observed increased growth of Staphylococcus aureus in menstrual cups but they went onto indicate that good product hygiene does minimize risks. When it comes to tampons and toxic shock syndrome, a great deal of progress has been made in recent years:  given that it is not known which fibres are most at risk, the composition of current tampons guarantees greater protection against the disease.

Ideal for studying endometriosis

Let’s go beyond the medical recommendations on the use of menstrual cups, it also presents a good opportunity to study the composition of the fluids that we expel during the period. By simply collecting the fluid, it remains unaltered, since it is not mixed with other substances as it would be with tampons and absorbent compresses. A paper published in the journal Fertility and Sterility in 1997, indicates that the samples collected with the menstrual cup are viable even five days later and goes on the claim that “they contain endometrial tissue that can be used for in vitro analysis of endometrium and endometriosis”.


Alternatives in resource-poor countries 

Compresses and tampons are a luxury products and in many parts of the world women who cannot afford them still protect themselves with cloths or pieces of fabric when they have their period. This is an uncomfortable solution that leads to many hygiene and health problems so, the menstrual cup could ultimately be a good solution for them: it can be reused and is easier to clean than pieces of stained cloths. 

One main disadvantage of the menstrual cup is that it is a fairly unknown method and requires you to get to know how to use it. Another one is that in many cultures there are still certain taboos with issues related to menstruation. It seems risky to ‘jump’ into distributing menstrual cups among the population without first knowing what the degree of acceptance will be.

A paper published in 2012 in the Journal of Economic European Association describes a study carried out on this subject with girls from four schools in Nepal which discovered a very interesting pattern: two months after having distributed the menstrual cups, many girls with friends who had already begun to use them regularly were also encouraged to do so, which suggests that is it better to try to introduce them gradually to create this ‘contagious effect’.


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