Pads and tampons aren't the only ways to manage your flow during shark week. Menstrual cups are another great option. But unless you've personally tried one, or know somebody who has, you probably see these rubbery wonders as shrouded in mystery. Today we lift the veil. Illustration by Jim Cooke.
What Is a Menstrual Cup?
Photo of cup in hand by menstruationstasse.net.
It's a reusable alternative to tampons and pads. A menstrual cup sits inside the vagina to collect the period blood that flows out. A few times a day, you pull it out (Careful! Don't spill!) and pour the contents into the toilet. It's washable, so you can use it cycle after cycle. One menstrual cup can replace years' worth of disposable products.
If you've never seen a menstrual cup, imagine a silicone shot glass: that's about the right size and feel. Except they're usually curved at the bottom and have a little stem for a handle, so the shape is more like a cut-off wine glass.
Are Cups Safer Than Tampons?
You're not running major risks with either one. We have a better sense of the risks of tampons than of cups, just because tampons are so popular and cups -- though gaining in popularity -- are still kind of underground. DivaCup, one of the biggest makers, has reportedly sold a million cups. That's not a lot considering how many menstruating women there are in the world.
Most people who use the cups don't have any problems, so as far as we can tell, they're safe. However, there's a myth that cup users "can't" develop toxic shock syndrome, or TSS, the disease that all the tampon packages are required to tell you about. This is false.
TSS is a serious and very rare infection that can lead to organ failure and death. Around 1980, it was associated with a brand of super duper absorbent tampons in the US. Those were pulled from the market, and other manufacturers changed their formulations. The US FDA required warnings about changing your tampon often. Cases plummeted, and TSS is now extremely rare again.
Last year, a study published in the Canadian Journal of Infectious Diseases and Medical Microbiology documented the first case of TSS associated with a menstrual cup. Obstetrician/gynaecologist Dr Jen Gunter writes, "We should now make no assumptions that cups are safer than tampons." But both are still very safe.
There's one other safety question: are cups a good way to avoid the chemicals in tampons? Critics point to dioxins, chemicals resulting from a bleaching process that used to be used in the making of tampons. But the FDA's latest patient alert on the subject points out that makers are required to test for dioxins, and the tests haven't been turning up any dioxins at detectable levels.
People who love their menstrual cups seem to feel the need to rail against "toxins" in pads and tampons, but there's no realistic reason to fear the disposables. Those toxins are either obsolete like dioxins, imaginary like the urban legend about asbestos, or otherwise vague puffery like what you hear about in juice cleanses. Bottom line, neither cups nor tampons have any serious health risks that we know of.
Are Cups Better for the Environment?
Clearly, you generate less trash when you use a cup than when you're going through a few dozen pads or tampons in a month. On the surface, that's a win for the cup.
But let's stop for a reality check: those products make up 0.5 per cent of the garbage you produce over your lifetime. There's enough guilt and shame surrounding periods without pretending your tampon habit is destroying the environment. Switching to a cup is a great way to reduce your garbage footprint, but you can make more of an impact by finding ways to reduce the other 99.5 per cent.
Are Menstrual Cups Cheap?
Cups run $30-$60 each, depending on the brand. That's a lot up front, but you'll save over time if it means you're not buying pads or tampons. (Quick calculation: if a multi pack of tampons is $7, and you buy a box every month, that's $84/year. Obviously, prices and needs vary.)
Realistically, you might spend more. If the first cup doesn't work out, you'll be checking out comparison tools like this one to find a better model. Some women like to have a spare cup on hand, so that will double your costs. And while the cups don't usually leak, nothing is foolproof -- so you may still end up wearing a thin pad like a pantiliner as well.
You'll also have to replace it, eventually. DivaCup suggests buying a new one annually. Mooncup says that their product lasts "for years and years". The material will eventually break down, and your body may change over time, too. So the lifetime cost of using cups is more than the initial $40, but it's still far less than using disposable products in the same timeframe.
Are Cups More Convenient?
This one is a toss-up, because convenience has many facets.
You (probably) don't have to change cups as often. Cup devotees like to say they're great for lazy people, since they can hold a ton of blood before you're in any danger of leaking. Manufacturers aren't required to put a warning on them saying how often to change them (the US FDA wants you to change your tampon at least every eight hours), so cup makers often recommend a more generous 12 hours or so. Whether that's a good idea or not, we really don't know.
You (probably) don't need to carry extra supplies with you all the time. If you suddenly realise you need to empty the cup, you just do it. If you like to wear backup pads, you'll need those, of course. And you might want to carry wipes or a water bottle to clean the cup.
Emptying the cup can be annoying. If you're in a restroom with stalls, it's inconvenient to dump out the cup, pull up your pants, wash the cup in the sink and then go back into the stall to reinsert. If you're stuck somewhere with just a porta-potty, it's the same situation minus the sink. In these cases, most manufacturers say you can dump the blood, wipe the cup with toilet paper, and pop it back in. You're supposed to make sure to clean it for real as soon as you get a chance, but if you're camping, that might not be possible. That's where the wipes or water bottle come in: they're ways to clean the cup when you don't have access to a sink.
You also have to keep track of the cup when you're not wearing it. If you're used to always having tampons and pads in your purse, in your bathroom closet, in your car, in your gym bag and everywhere else, it can be a little nerve-wracking to know that you only have one menstrual cup and you better know where it is. (Of course, you can still keep those pads and tampons around just in case.)
Some people even boil their cup between uses, although that's probably not essential. If you want to sterilise it but don't want to use your cooking pot, a microwave steriliser bag made for baby bottles would probably do the trick. Check the instructions that came with your cup for specifics -- for example, the Keeper's material will break down sooner if you boil it often.
I'm Not Ashamed of My Period. Does That Mean I Should Use a Cup?
You don't have to -- but there's an argument about cups as a feminist statement that's worth looking at. Jane Hu explains it here in Slate: it's kind of insulting to women to pretend that periods (and period blood, and putting your fingers inside your vagina for routine maintenance) are disgusting. The makers of traditional pads and tampons keep perpetuating this myth with all their euphemisms and their talk of being discreet.
But that's nothing to do with the cup itself. Sure, you stay in touch with the colour and amount of your flow, but at the end of the day you're just choosing something to soak up the blood that you're already very aware is coming out of you. You may find it kind of nice to buy from a company that celebrates your period being natural and beautiful, rather than one that advertises on TV in terms so vague it's not always clear what they're talking about. But that's marketing. It's fine to use your brain to vote with your dollars, but know that your vagina doesn't care.
How Exactly Would I Use One?
I admit it looks kind of intimidating, if you're used to slender little tampons. Just remember that your vagina was designed to accommodate a baby, so a soft little shot glass is no big deal. Once you get it inserted, a cup doesn't feel much different from a tampon. You'll forget it's there.
Before we get into the specifics, a disclaimer: if you have a prolapsed uterus or just a weird shaped vagina, it's possible that a cup (or even tampons) might not fit comfortably. No shame in that; keep on keepin' on with pads if that's what works for you. You may also hear warnings about not using a cup if you also have an IUD, but it's usually fine to combine them. Check with your gynaecologist if you want to be sure.
That said, if you're having difficulty or discomfort with the cup, it's likely a fixable problem. There's a definite learning curve when you start using a cup. Here are the major skills to master:
- How to insert the cup. With clean hands, fold the cup to make it narrower and push it into place. Here are some tips on inserting, and check out the video above for some folding techniques. You can also use a water based lubricant if you need help to ease it in.
- How to make sure it's securely in place. The cup should unfold once you let go of it (there may be an audible "pop!") and then you can give it a twist or a gentle pull to make sure it's not going anywhere.
- How to remove it. Again with clean hands, pinch the base of the cup to release the suction, and carefully slide it out, folding it slightly as you go. The video below explains the technique.
A major perk of cups is that you'll never have trouble finding advice on how to use them. People love, love, love, love, love talking about their menstrual cups. There's even a thriving community that started discussing them on LiveJournal in 2002, and became so enthralled that they could not leave. The companies that make the cups are also typically happy to help.
How Do I Pick the Right Size?
Extensive handy-dandy chart by Amanda at The Eco Friendly Family.
Most brands offer two sizes, recommending the larger for women who are older or who have had a baby. But everybody is shaped a little differently, so these guidelines won't always lead you to the right size.
There's no guaranteed way to know which one to pick, no dimension you can measure to be sure. But if you've tried a cup and it feels too long or too wide or too narrow, you can use this comparison tool by Amanda at Eco Friendly Family, who also made the chart you see above. If you visit her page, you'll also see a chart of measurements of each brand, and a tool that lets you slide pictures next to each other. That way you have both numbers and a visual comparison for, say, whether the FemmyCycle Low Cervix is smaller than the MeLuna Shorty.
As the chart shows, each brand has multiple sizes, but if you want to change shapes you'll have to change brands. One thing the chart does not show is the difference in materials. Some are softer, which makes them easier to insert but they're also more likely to slip out of place. In some brands, the different sizes are made with different materials. If you want to customise all the aspects of your cup, MeLuna is your best bet: you can get almost any combination of material, size (diameter), height and handle type.
And about that handle: it's just to help you grab onto the cup if it's really high up in your vagina. As long as you can reach the cup, the handle isn't necessary. So if you have a cup that fits great except for the long stem, you don't need to find a new cup -- you can just grab a pair of scissors and snip the stem right off.
Cups may be different than what you're used to, but they're a great option if you'd like to use something reusable and don't mind the learning curve and extra maintenance. Now that you know what cups are and how they work, you can decide whether it's worth giving them a try the next time the Reds are playing downtown.