Menstrual Cups – the Holy Grail for Periods, or the Worst Thing Your Could Do To Your Vagina?
When I saw the posts from American environmental bloggers and influencers about the life – changing effects of their menstrual cup, I had to jump on the band wagon. Could there be a no - waste, cheaper solution to our bloody (pardon the pun) women’s troubles that happen every 26 days? Yep, it’s every 26 days for me! As a pelvic floor physiotherapist and greenie, I cupped my hands together in glee (pardon another pun!) as I purchased the Diva Cup from Chemist Warehouse for $45.00 AUD.
Cups had also been touted as a miracle for painful periods and endometriosis – so was it hype, or the holy grail?
Anatomy of a Period – the real costs of menstruating:
The average woman has more than 400 periods over her lifetime – and a whopping $19 000 on average is spent over our lifetime on period products! Think of all the food and holidays you could have with that?! Period “care” – chocolate, medication, heat packs, fresh undies and UberEATS do not even factor into the Suzuki Swift size dent that periods will create in your bank account. The wastage and environmental impact have always been a huge concern for me - tampons and pads take longer than your own body to biodegrade once we're gone!
Here what you need to know about menstrual cups:
A menstrual cup is made of silicone, not plastic. Silicone is constantly marketed these days as the safer alternative to plastics for our food storage, baby bottles, medical devices and even mechanical motor parts. We need to segue into a chemistry lesson to understand how your silicone menstrual cup is NOT made directly from beach sand (as I also previously thought). Silica – also known as silicon dioxide – is most commonly found in beach sand and fused quartz. In cosmetics, it’s known for its reflective properties – that highlighter you put on your cheekbones, girls – that’s silica! Silica heated at high temperatures with carbon becomes silicon. When this silicon is reacted with hydrocarbons, it produces silicone (also known as siloxane) - a polymer, which can be moulded into hard, plastic – like materials or malleable, rubber – like products, i.e. menstrual cups.
A menstrual cup is a bell – shaped container that can be inserted into the vagina to collect menstrual fluid during a woman’s period. The stem, or pointed – end of the cup points away from the cervix, while round, open part encircles the cervix.
Most menstrual cup brands have two sizes – a shorter, narrow bell for those of us who haven’t been pregnant (the Diva Cup specifically states the smaller is for women who “have been pregnant or had a Caesarean section"), and the wider, longer cup for those who have. Interesting point that – if the vagina hasn’t stretched and the pelvic floor hadn’t dilated in labour, as per an elective C – section, the company still advises women to use the larger cup. Given I’m 5ft tall, and haven’t had babies, the length of my vagina is – well – shorter than the average length of 10cm.
Getting the Cup In
If you followed the instructions, like me, and believed that you could waddle with your pants down from the toilet to the sink to wash the cup without drips and messiness – you’re in for a shock. Let’s talk about the in before the out first. Folding the rim of cup to the advised ‘C’ or ‘Z’ shape required more dexterity and origami skills than I was prepared for on day 1 of a period. At my best I’m confused, teary and *talking* *with* *simple* *words* usually gets me through. My husband knows to throw a chocolate block at my feet and scamper away.
I digress – back to the skilful insertion.
- Trim and file your fingernails – you will be reaching in, and the vaginal walls are thin
- If you have used tampons before, you may have a preferred position for insertion – deep squatting, one leg up on the seat, or just bending all the way over to see where it’s going. I’d recommend a combination of all three for the cup.
- As with tampons, the cup will be easier to insert with more menstrual flow acting as lubrication
- Part the labia with one hand, and keep the cup rim squashed between your index finger and thumb (I’d recommend this with your dominant hand)
- Aim the folded rim of the cup to the back half of the vagina. Why the back half? The rim can scrape the urethra (tube connecting the bladder and the hole for urine) if you pushed too far forwards at the entrance of the vagina.
- Push the cup as far as it will go. Reach in, sweep your finger around the rim to make sure it has opened back to a circle. This is to ensure the cup as sealed against the vaginal walls.
- If the cup is too low, the stem may be uncomfortable. You can trim the stem, but make sure it is not sharp, and there is still some length for removal of the cup.
- Wear a panty liner as extra protection until you get the hang of fitting the cup
Getting the Cup Out
Right - here’s the tricky, potentially messy, and crucial part to prevent long term risk to your pelvic organs. I can’t be more serious about this. The uterus is suspended in your pelvis with connective tissue (think of them as ropes) called the uterosacral ligaments. These ligaments literally hold the uterus up by attaching to the inner scarum (the upper part of your tailbone). The first few times I removed the cup, it *bloody hurt!*
No joke, I thought it was stuck. I squatted ass to grass. Pushed down while I pulled the stem. Nothing worked. It then struck me - I did such a good job creating the seal, that the cup had suctioned with the menstrual fluid to the cervix and vaginal walls.
Have you ever used a toilet plunger over a blocked drain? Plunging a drain uses the forces of suction and compression. Pulling up on a plunger pulls water in the drain upward, in order to remove the clog. When you push down on the plunger, water is forced downward, moving the clog in the other direction. For those playing at home, the plunger (menstrual cup) will pull down on your uterus by way of the negative pressure created inside of the suction if you pull it down while it's still suctioned. What is the risk of this? A uterine prolapse – see my blog piece on pelvic organ prolapses.
BREAK. THE. SUCTION!
- You’ll have to get all up in there and *break* that bloody suction. Don’t ever pull down on a cup that still has suction.
- Reach your finger up to the rim and sweep it around. You may even need to pinch the sides of the cup to make the rim oval shaped before you gently pull it out.
- Make sure the cup is upright as you remove it past the labia – the fluid can flick everywhere and look like a crime scene
- Tip the menstrual fluid out into the toilet
- Waddle to the sink and wash the cup with water. Ensure your hands are clean before you re – insert the cup.
The Diva Cup instructions advise that you sterilize the cup in boiling water before and after your cycle, then drying and storing it away in its cute bag. That’s the easy part. The cleaning while in the trenches (bathroom) of a period can be harder. Waddling with your pants down, washing the cup at sink, hoping it doesn’t slip out of your wet hands, and then re – inserting it wasn’t my favourite part.
Pros, Cons & Caveats
At $45.00 AUD, I was impressed with the variety and sizes – there are even cups made for teenagers. The cup can be used at night and the current research has not indicated a link with toxic shock syndrome (TSS) as with tampon usage. Once fitted correctly, I could not feel it inside and happily had a few restful nights of no leakage, despite wearing a pad for extra protection. You will cover the cost of a cup over four months’ worth of menstrual products, and won’t have little packages discreetly wrapped in toilet paper once a week every month.
The simplistic instructions were very disappointing – not only did it promise a unicorn, mess – free period (so not the case!) but didn’t go into enough anatomic detail for women to know how important it is to *not* pull down on anything suctioned inside the vagina. It will take a few periods to get used to being more involved with your period than before. Maybe hold off on the white jeans during your period. Wear a liner during the day, and a pad at night for the next few periods while getting used to the cup.
Unsure whether a cup is right for you? Speak to your Pelvic Health Physiotherapist to learn more!