Menstrual cup

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A bell-shaped brand of menstrual cup (left) which is about 2 inches (5.7 cm) long, not including the stem. A disposable softcup (right) looks similar to a contraceptive diaphragm and is about 3 inches (7 cm) in diameter.

A menstrual cup is a flexible cup or barrier worn inside the vagina during menstruation to collect menstrual fluid. Unlike tampons and pads, the cup collects menstrual fluid rather than absorbing it. Menstrual cups are usually made from medical grade silicone.

Manufacturers have different recommendations for when to replace the cups, but in general they can be reused for years. Disposable menstrual cups are also available - these work in the same way as a regular menstrual cup except they are disposed of after every use or (for some brands) after every cycle.

History[edit]

An early version of a bell-shaped menstrual cup was patented in 1932, by the midwifery group of McGlasson and Perkins.[1] Later menstrual cups were patented in 1935, 1937, and 1950.[2][3][4] The Tassaway brand of menstrual cups was introduced in the 1960s, but it was not a commercial success.[5] Early menstrual cups were made of rubber.[6] Today, both silicone and rubber models are available. Most are reusable, though there is at least one brand of disposable menstrual cups currently manufactured.[7]

In 1987, another latex rubber menstrual cup, The Keeper, was manufactured in the United States. This proved to be the first commercially viable menstrual cup and it is still in manufacture today. The first silicone menstrual cup was the UK-manufactured Mooncup. Most menstrual cups are now manufactured from medical silicone because of its durability and hypoallergenic properties. The German brand MeLuna is the only company to manufacture their cup out of TPE (thermoplastic elastomer). Menstrual cups are becoming more popular worldwide, with many different brands on the market, and there are different sizes and shapes available.[7]

Types[edit]

MeLuna Menstrual cups come in a wide variety of colors, stem styles, capacities and 'firmness' levels

The menstrual cups currently available can be divided into two basic types:

The first type is a bell-shaped cup made of rubber (latex), silicone or thermoplastic elastomer (TPE). It is reusable and designed to last for up to 10 years. Some brands recommend replacement each year, as it is a hygiene product. Other brands recommend replacement after 5–10 years, stating that women have been comfortable using them up to 10 years. These bell-shaped silicone or rubber cups must be removed before penetrative vaginal sex.[8]

The second type is made of polyethylene and resembles the shape of a contraceptive diaphragm. There are two types of polyethylene softcups: a disposable version designed for disposal after one use, and a reusable version, designed for re-use for one menstrual cycle. These polyethylene cups may be worn during intercourse, though they are not contraceptive devices.[8]

Sizing and Selection[edit]

Fleurcup small size (left) and large size (right). The stem may be trimmed.

Most brands have a smaller and a larger size. The smaller size is normally recommended for women under 30 who have not given birth vaginally. The larger size is normally recommended for women over 30 or who have given birth vaginally. The menstrual cups with the smallest size diameter are recommended for teenagers, as well as women who are more physically fit, as those with stronger pelvic floor muscles may find a larger cup uncomfortable. Length also needs to be considered: if a woman's cervix sits particularly low, she may want to use a shorter length cup. Capacity is important to women who have a heavier flow; however, all of the menstrual cups currently available have higher capacity than a regular tampon.[9]

A final consideration in selecting a menstrual cup is firmness/flexibility. Certain brands are firmer than others, the firmness of certain brands varies according to size. A firmer cup pops open more easily after insertion and may hold a more consistent seal against the vaginal wall (preventing leaks), but many women find softer cups more comfortable.[10]

Color[edit]

Lunette "Selene" blue menstrual cup

Most menstrual cups come in colorless, translucent silicone. Several brands offer colored cups in addition to (or instead of) the colorless ones. Colored cups use a dye that is certified to be safe for food. Translucent cups lose their initial appearance faster than colored - they tend to get yellowish stains with use. The shade of a colored cup may change over time, though stains are often not as obvious on colored cups. Stains on any color of cup can often be removed or at least lightened by soaking the cup in diluted hydrogen peroxide and/or leaving it out in the sun for a few hours.

Use[edit]

A menstrual cup correctly inserted low in the vagina

The menstrual cup is first folded, and then inserted into the vagina. It will normally unfold automatically and create a light seal against the vaginal walls. In some cases, the user may need to twist the cup or flex her vaginal muscles to ensure the cup is fully open. In most women, a menstrual cup will sit lower in the vagina than a tampon. If correctly inserted, the cup shouldn't leak or cause any discomfort, as with a tampon. Those who are familiar with inserting a non-applicator tampon should learn faster how to insert a cup, though there is still a learning curve. There are a number of different folding techniques that can be used for insertion.[11] If lubrication is necessary for insertion, it should be water-based, as some lubricant ingredients can be damaging to the silicone. After up to 12 hours of use (less if the cup starts to overflow), the cup is removed by reaching up to the stem of the cup in order to find the base. Simply pulling on the stem is not recommended to remove the cup, as pulling it down will create suction. The base of the cup is pinched to release the seal, and the cup is removed. After emptying, the cup should be rinsed or wiped and reinserted. It can be washed with a mild soap, and sterilized in boiling water for a few minutes at the end of the cycle. Alternatively, sterilizing solutions (usually developed for baby bottles and breast pump equipment) may be used to soak the cup.[12]

Safety[edit]

Boiling a menstrual cup

Menstrual cups are safe when used as directed and no health risks related to their use have been found.[6][13] However, no medical research was conducted to ensure that menstrual cups were safe prior to introduction on the market.[14]

One case report in the journal Gynecologic and Obstetric Investigation noted the development of endometriosis and adenomyosis in one menstrual cup user.[15] Additionally, after one survey with a small sample size indicated a possible link, Associated Pharmacologists & Toxicologists and Endometriosis Research Centre issued a combined statement that urged further research.[14] However, the U.S. Food and Drug Administration declined to remove menstrual cups from the market, saying that there was insufficient evidence of risk.[16]

A 2011 randomized controlled trial in Canada measured urovaginal infection in a comparison of menstrual cup and tampon use, and found no significant difference in physician-diagnosed urovaginal symptoms between the 2 groups.[17] The Journal of Women's Health has published a clinical study demonstrating the acceptability and safety of the Instead Softcup in both clinical and pre-clinical testing.[18] Generally, menstrual cups do not significantly affect the population of vaginal flora, including the bacteria responsible for bacterial vaginosis (including yeast infections) or urinary tract infections.[18] There have been no reported cases of toxic shock syndrome (TSS) occurring with the use of menstrual cups.[17]

Acceptability studies[edit]

A large Fleurcup menstrual cup with capacity roughly 3 times greater than the absorbency of a Super tampon

A 2011 randomized trial in Canada investigated whether menstrual cups are a viable alternative to tampons and found that approximately 91% of women in the menstrual cup group said they would continue to use the cup and recommend it to others.[17] In a 1995 clinical study involving 51 women, 23 of the participants (45%) found menstrual cups to be an acceptable way of managing menstrual flow.[19] In clinical testing, after three cycles of softcup use, 37% of subjects rated the softcup as better than, 29% as worse than, and 34% as equal to pads or tampons. The 37% who preferred the softcup attributed their preference to "comfort, dryness, and less odor."[18]

Advantages[edit]

Disadvantages[edit]

See also[edit]

References[edit]

  1. ^ Goddard, L.J. US Patent #1,891,761 (issued December 1932).
  2. ^ Hagedora, Arthur F. US Patent #1,996,242 (issued April 1935).
  3. ^ Chalmers, Leona. US Patent #2,089,113 (issued August 1937).
  4. ^ Chalmers, Ileona W. US Patent #2,534,900 (issued December 1950).
  5. ^ Wysocki, Susan. "New Options in Menstrual Protection". Advance for Nurse Practicioners (November 1997).
  6. ^ a b Pruthi, Sandhya. "Menstrual cup: What is it?" Mayoclinic.com (January 30, 2008).
  7. ^ a b c "Alternative Menstrual Products". Center for Young Women's Health. Boston Children's Hospital. 28 March 2013. Retrieved 30 March 2013. 
  8. ^ a b LeVay, Simon & Sharon M. Valente. Human Sexuality. Sinauer Associates (2002), p. 104. ISBN 0-87893-454-5.
  9. ^ "Assorted Size Charts". Menstrual Cup Support. 18 August 2008. Retrieved 8 November 2009. 
  10. ^ Melissa L. "Menstrual Cup Info: Measurement Chart". Word Press Blog. Retrieved 21 May 2014. 
  11. ^ Melissa L. "Folding And Insertion". 
  12. ^ "How should I clean my Mooncup?". Mooncup UK. Retrieved 9 April 2014. 
  13. ^ Stewart, Elizabeth B. The V Book: A Doctor's Guide to Complete Vulvovaginal Health. Bantam (2002), p. 96. ISBN 0-553-38114-8.
  14. ^ a b "The ERC Online Questionnaire of Women Who Used Menstrual Cups: Summary Statement of Results and A Call For Additional Research". Associated Pharmacologists & Toxicologists (APT). 
  15. ^ Spechler S, Nieman LK, Premkumar A, Stratton P (2003). "The Keeper, a menstrual collection device, as a potential cause of endometriosis and adenomyosis". Gynecologic and Obstetric Investigation 56 (1): 35–7. doi:10.1159/000072329. PMID 12867766. 
  16. ^ Lione, Armand. "Citizen Petition on Menstrual Cups & Endometriosis". Retrieved 19 December 2010. 
  17. ^ a b c Howard C, Rose CL, Trouton K, Stamm H, Marentette D, Kirkpatrick N, Karalic S, Fernandez R, Paget J (June 2011). "FLOW (finding lasting options for women): Multicentre randomized controlled trial comparing tampons with menstrual cups". Canadian Family Physician 57 (6): e208–15. 
  18. ^ a b c North BB, Oldham MJ (February 2011). "Preclinical, Clinical, and Over-the-Counter Postmarketing Experience with a New Vaginal Cup: Menstrual Collection". Journal of Women's Health 20 (2): 303–311. doi:10.1089/jwh.2009.1929. 
  19. ^ Cheng M, Kung R, Hannah M, Wilansky D, Shime J (September 1995). "Menses cup evaluation study". Fertility and Sterility 64 (3): 661–3. PMID 7641929. 
  20. ^ "The Environmental Impact of Everyday Things". The Chic Ecologist. Retrieved 2014-08-22. 
  21. ^ van Schagen, Sarah. "A review of eco-minded feminine products". Retrieved 2014-08-22. 
  22. ^ Taylor, Bethany, M.D. "Using Tampons: Facts and Myths". SteadyHealth.com. Retrieved 2013-05-14. 
  23. ^ Thompson, Rachel. "Toxins & Tampons". Canadian Women’s Health Network:. Retrieved 2014-08-23. 
  24. ^ Howard, Courtney E., MD CCFP (EM), et al. "FLOW: Finding Lasting Options for Women". The Mayo Clinic:. Retrieved 2014-08-23. 
  25. ^ Gallenberg, Mary M., MD. "What can you tell me about the menstrual cup?". The Mayo Clinic:. Retrieved 2014-08-23. 
  26. ^ "Problems". Lunette:. Retrieved 2014-08-22. 
  27. ^ "Size of Menstrual Cup". Lunette:. Retrieved 2014-08-22. 
  28. ^ a b Smith, Sue (March 14, 2011). "How a Menstrual Cup Saves you $1000". Brokelyn. Retrieved 9 April 2014. 
  29. ^ "How I Learned to Stop Hating My Period, And Love The Menstrual Cup". Blisstree. November 29, 2012. 
  30. ^ Melissa L. "Menstrual Cup Info: Illegal Copies". Word Press. Retrieved 21 May 2014. 
  31. ^ Hearn, Amanda. "Menstrual Cups: One Size Does Not Fit All". The Eco Friendly Family:. Retrieved 2014-08-23. 
  32. ^ "What Is Pelvic Organ Prolapse?". Band Back Together. 
  33. ^ "Menstrual Cup use and IUDs". Feminine Wear. Retrieved 22 December 2013. 
  34. ^ "Questions". Moon Cups and Keepers:. Retrieved 2014-08-23. 
  35. ^ Sager, Jean. "Menstrual Cups: One Size Does Not Fit All". The Stir:. Retrieved 2014-08-23. 

External links[edit]