Everything you wanted to know about a menstrual cup

Everything you wanted to know about a menstrual cup
Image: @ziqianqian

To be a woman means regular menstruation over the course of roughly 40-45 best years of our life. This rather unpleasant physiological peculiarity is something that we now experience with the most comfort we have ever had. A visit from Aunt Flo is no longer a reason to isolate in some remote shack, worrying that we might be transforming into the devil’s concubine. Today, there is no need to shamefully hide a pack of sanitary pads from your boyfriend, or even use the Aunt Flo euphemism for that matter.

Yet, it is sanitary inventions that have done exponentially more for women’s health and wellbeing, than the lifting of the taboo on discussions surrounding menstruation. Pads and tampons, painkillers, oral contraceptives as a way of delaying menstruation. Each and one of these methods has truly revolutionised the world. Nevertheless, further attempts to come up with even more innovative ideas have not stopped.

Menstrual cups are currently aiming to lead the revolution in intimate care. An invention with many accomplishments, but not one without its flaws. Can it succeed in overtaking conventional sanitary items and become a product of mass consumption? Time will show. There is no harm in learning more about it in the meantime.

Intimate care
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The old new cup

Surprisingly, menstrual cups have been attempting to win women over for more than a century. The first prototype of the so called “vaginal vessel” for discharge collection was patented in 1867. In 1932, midwifery group of McGlasson and Perkins developed a dome-shaped menstrual cup, which remains relevant today. The first production model appeared already in 1937. However, the idea did not have much commercial success or pick up. It is possible that, during this interwar period, women were far more preoccupied with keeping up the daily routine, rather than these once-in-a-blue-moon occasions.

Further attempts to take menstrual cups to mass market were taken in the US and the UK in the 60s and the end of the 80s, albeit unsuccessfully. It was only in the 2000s that this sanitary item gained some sort of semblance of mass production and a positive reputation. A likely cause was the medical silicone, which was finally used to produce the cups. All previous models were made from rubber or latex, which can cause allergic reaction and are not very flexible.

Their close proximity to such delicate areas as a vagina and cervical uterus often led to painful sensations, irritation and discomfort during replacement. No wonder then that a cup with such qualities could not seriously compete with tampons and pads. Additional interest was prompted by expert advice regarding their safety, comfort, cost and sustainability, when compared to other sanitary items. As to which of these promises are true, is the most interesting point of scrutiny.

The old new menstrual cup
Image: @ziqianqian

Is it safe?

To start with, let us agree that by a menstrual cup we imply a quality certified product with a name and website in one of the key international languages and a price mark over five dollars. This basic set of conditions means that the cup has been industrially manufactured using either medical silicone or thermoplastic elastomer. Both materials are entirely hypoallergenic, resistant to mechanical and chemical manipulation, as well as long-lasting. Although transparent cups might seem purer in composition, the pink or black coloured ones are an outcome of vigorously tested food colourings. Individual sensitivity to these components is possible, but this is extremely rare.

In other words, if the cup is used strictly as intended, following basic hygiene and instructions, no harm to health is to be expected. It does not dry out the mucous membrane unlike tampons, does not lead to irritation and sweating unlike the forever humid pads, and does not trigger changes in vagina’s microflora. Until 2015, it was considered that unlike the highly absorbent tampons, menstrual cups cannot be the cause of a fatal condition known as toxic shock syndrome. However there has unfortunately been one such occasion. This has resulted in manufacturers’ insistence on rinsing the cups at least once during a 12-hour window.

However, research carried out by scientists from Lyon, France, has since demonstrated that dangerous growth of staphylococcus aureus bacteria is still possible, even when using the cups correctly. The researchers state that potentially dangerous amounts of bacteria can remain, when not using soap while washing the menstrual cups. Therefore, the question of menstrual cup usage safety is entirely dependent on the user’s hygiene level. Meanwhile the shape and material are of no cause for concern among gynaecologists.

By researching the technical side of things in advance, the first cup experience can be made positive.

One of the questions asked when it comes to safety is whether there is any possibility of the object getting lost inside the body. Would it not create a greenhouse effect, where one shouldn’t be?

The simple answer is that it is impossible to push a sanitary product further than nature intended. Cup removal is easy, as even in the case of the special stem or ring detaching, the vessels have a grooved texture. Many contemporary cups are also produced without any stem at all, and women tend to cut the stem for ease of use anyway. As to the greenhouse effect, most cups have small holes for ventilation, which does not impact how securely fitted a cup is but does provide air circulation.

In Summary

A menstrual cup is a safe sanitary produce, given that the following rules are adhered to: using certified products, sterilising your cup in between the cycles in boiling water or a microwave and diligently washing the cup and your hands with soap during each replacement.

Menstrual cup — is it comfortable?
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Is it comfortable?

Menstrual cup adverts make many grand promises: that there is no need to have menstruation weigh on your mind other than twice in 24 hours and that all you need to replace it is a toilet/shower and some water. With a cup you can have sex and do sports without worrying about leaks. Sounds like the dream and many women would agree. For all there is, in 2011, 91% of women, who tested menstrual cups in a research carried out by Canadian scientists, claimed that they consider it a fair alternative to a tampon, would continue using it in the future and are likely to recommend it.

For comparison, in a similar study taken in 1995, only 45% of participants agreed with those statements. This example is a good illustration of how an attitude to a product can change with progress. Elastic silicone and cute design have helped recruit a substantial following. However, the ease of use remains contested. The web is full of bloggers’ outpours as to their peculiar and dramatic experience of menstrual cup installation. Young women have been either uncomfortable, hurt, disgusted, or simply too put off by the complexity of it.

These narratives are sadly not sponsored by sanitary pad salespeople, but are just a typical reaction of women, experiencing a cup for the first time. In this respect, menstrual cups are very similar to contact lenses. Everyone who wears them, would remember their first experience. Spending an hour in the bathroom, nearly damaging the retina, dropping the transparent piece of plastic 50 times on the sink, and then the experience of utter despair at the sensation of eyefuls of sand, when eventually fitting them in.

Same goes for a menstrual cup. The first attempts to fold it correctly, insert and open a cup can take up a lot of time to no avail. But those that would find the motivation to keep trying and survive at least one menstrual cycle with the new sanitary product, will likely become converts of this method.

By researching the technical side of things in advance, the first cup experience can be made positive.

The main thing being the correct cup choice. Many manufacturers offer them in sizes S and M. The small ones are intended for teenagers, women who have not given birth and the lucky few with moderate menstruation. Larger cups are suitable for women with abundant discharge, a highly positioned cervical uterus, weak pelvic floor muscles and a multiple birth record. Needless to say, these recommendations are approximate and the best way to find your own cup is by trial and error.

In Summary

A menstrual cup is a very convenient sanitary product. However, a cup’s installation and cleaning process requires a specific set of conditions. You will certainly need a shower or a toilet with access to a running tap, as well as a soap and an antiseptic for your hands and cup. It is important to thoroughly rinse the latter under running water before insertion. A cup also cannot be put out of sight at the end of the cycle. It needs to be sterilised and put away in a container until next month. The final counterargument is that cup replacement can be difficult and traumatic for those with long nails.

Menstrual cup — is it clean?
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Is it clean?

If you were to favour one thing about a menstrual cup, it would most likely be the lack of hassle when it comes to seeking out ways to disguise used sanitary products in the bin. Everything that you would want to be out of sight is washed away by water. In other words, if you have access to a shower or sink twice a day, menstruation leaves no trace on your clothes or bedding. The only thing left to get messy is your own hands. This can be an unbearable threshold of squeamishness to cross, and rightly so!

Experienced independent reviewers praise the cup when it comes to its “night shift”. No matter how maxi a pad the manufacturers might invent, leaks happen. With a correctly fitted cup this is impossible, be it at night, day or during your upside down asanas.

In summary

If tampons and pads are selected to suit your individual needs and changed in good time, the chances of staining your underwear are next to zero. But a cup’s performance is still higher, given that the volume of even the S-size vessel is bigger than the volume of discharge over the course of the entire cycle. A cup cannot get too full or change its position inside the vagina, even during intense physical activity. This rules out any unexpected surprises. There is however one condition: installing the cup correctly, i.e. deep enough.

Menstrual cup — is it cheap?
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Is it cheap?

The price of a quality menstrual cup can start at around 5 dollars or 10 pounds per item. Anything cheaper is likely to not be made using medical silicone and can therefore turn out to be unsafe. There is no upper price limit.

Every manufacturer is free to bump up the price by offering a cup in a rare colour, an imaginative design or with additional accessories such as sachets and containers for storage and sterilisation, special cleaning brushes and other bits and bobs.

However, the accounting side of a relatively more expensive cup, say for the price of 30 pounds, is still not in favour of tampons or pads. An average annual supply of sanitary items costs around 120 British pounds, which means that a menstrual cup pays itself off in less than a year.

In summary

It is objectively the least expensive way to maintain comfort during menstruation.

Menstrual cup — is it sustainable?
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Is it sustainable?

An average woman living in the 21st century has around 30% more menstruations than a woman living in the 19th century. This is due to our right to give birth whenever we truly intend to, a more stable cycle given our comfortable living environment, and an increase in reproductive age, as well as other progressive developments. The dark underbelly of all this is the much higher volume of one-time use sanitary products in our waste footprint.

In total, a year of regular menstruation for one woman results in 200 used tampons and pads. A very noticeable waste trail, which cannot be ecologically recycled. A menstrual cup may be made using a synthetic material but can serve its purpose for around 10 years, taking its owner as close to the zero-waste concept as possible.

Someone truly fastidious might criticise the product for the need to regularly wash it, hence wasting precious drinking water. However, most would agree that this argument is rather weak. Another argument against it is the power of marketing. Hardly any woman uses the one and only cup for several years, when new more attractive models keep appearing on the market. However, for true advocates for our planet’s future the point stands: one menstrual cup for 10 years. That is it.

A truly ecological approach begs another question: how natural is a cup for a woman’s body?

This is unfortunately unclear: expunging excess bodily fluids such as snot, urine or menstrual discharge is what the body does. There is no scientific data to say that holding in clusters of blood or epithelium is either harmful or safe. However, users of menstrual cups note that the sensation of a cup bubbling somewhere within is not the most pleasant experience.

In Summary

The question of menstrual cups’ sustainability often depends on the level of dedication to environmental issues. True advocates would rightly criticise a piece of plastic for polluting our planet and begging the question of utilisation. But for those that seek a reasonable balance between sustainability and comfort, a menstrual cup is undoubtedly a better choice than tampons or pads. The outstanding question is how natural is it to collect blood inside rather than excrete it outside the body right away, as nature intended.

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