All the Questions You Definitely Have About How to Use a Menstrual Cup
I've been a devoted menstrual cup user for three years. When I started, there were only one or two brands to choose from and not a ton of information about making the switch from tampons. Through a lot of trial and error (and, TBH, a few messes), I found methods that worked for me. Now, I'm in love with using a menstrual cup. I know: Being in love with a period product is weird, but here we are.
In the last few years, the period industry has seen a (long-awaited) boom with new brands entering the marketplace—and the menstrual cup category, specifically. (Even Tampax makes menstrual cups now!)
That said, making the switch isn't necessarily easy. On a mission to provide the menstrual cup guide that I never had and so desperately wanted, I took to Instagram to crowdsource people's questions, concerns, and fears about using a menstrual cup. I was flooded with responses ranging from the simple ("how do I insert it?") to the more complex ("can I use it even though I have endometriosis?"). The most-asked question? "How do you change it at work?"
It's time to throw TMI to the wind and give a menstrual cup a try. Consider this your complete guide to menstrual cups, with insight from both experts and cup users to cover everything you could possibly want to know about using (and loving) your menstrual cup.
What is a menstrual cup, anyway?
A menstrual cup is a small silicone or latex vessel that's inserted inside the vagina when you're on your period. The cup works by collecting (rather than absorbing) the blood and, unlike pads or tampons, the device can be sanitized and reused for many cycles before needing to be replaced.
Because it's not absorbent, there's little risk for toxic shock syndrome (TSS), says Jennifer Wu, M.D., ob-gyn at Lenox Hill Hospital in New York City. Even though it is highly unlikely that you would get TSS, she recommends removing and emptying your menstrual cup every 8 hours to be on the safe side. (Most menstrual cup companies say it can be worn for 12 hours.)
Also important: Be sure to wash your hands before placing the cup and sanitize the cup between uses.
What are the benefits of switching to a menstrual cup?
While the vagina is self-cleaning, period products can be a culprit for vaginal discomfort. When you insert a tampon, the cotton absorbs the vagina's protective fluid along with the blood, which, in turn, causes dryness and disrupts normal pH levels. Bad pH levels can contribute to odor, irritation, and infection. (Read more about that here: 6 Reasons Your Vagina Smells) A menstrual cup is non-aborbent so is less likely to cause the irritation or dryness. (Read more on Why Your Vaginal Bacteria is Important to Your Health.)
The cup can be worn for more consecutive hours than tampons, which should be used at the lowest absorbency possible for your period and changed every four to eight hours. They're also are less of a hindrance on your daily activities than pads. (Swimming? Yoga? No problem!)
But the most obvious benefit of a menstrual cup is the ability to reuse it. "Non-disposable menstrual products are becoming increasingly important," says Dr. Wu. "The amount of waste related to sanitary napkins and tampons is a huge environmental issue." Diverting period waste from landfills can have a huge environmental impact over the course of your lifetime; period underwear company Thinx estimates that the average woman uses 12 thousand tampons, pads, and panty liners over the course of her lifetime (!!).
Okay, but are menstrual cups expensive?
Aside from the environmental benefits, there are financial perks too. If the average woman uses about 12 thousand tampons and a box of 36 Tampax Pearl's currently costs $7, that's about $2,300 in your lifetime. A menstrual cup costs $30-40 and can last anywhere from one to 10 years depending on the company and material used. The money saved by switching to the cup is made up after just a few cycles of use. (Related: Do You Really Need to Buy Organic Tampons?)
How do you pick a menstrual cup?
Unfortunately finding the cup that works best for you takes some trial and error; however, with so many brands and varieties on the market, you're bound to find your perfect fit. "A few considerations to keep in mind when choosing a menstrual cup would be your age (usually, younger women will need a smaller cup size), previous birth experience, menstrual flow, and activity level," says Tangela Anderson-Tull, M.D., ob-gyn at Mercy Medical Center in Baltimore, MD.
Most menstrual cup brands have two sizes (like Tampax, Cora, and Lunette) but some have three or more (like Diva Cup and Saalt). Saalt also makes a soft cup, a less firm version of their classic cup, in two sizes for people who experience bladder sensitivity, cramping, or discomfort with traditional cups. The softer silicone makes it more difficult to insert because it doesn't pop open as seamlessly but the design is gentler for people who are sensitivity to firmer cups.
A general rule of thumb: Cups for teens would be the smallest (and are often labeled with size 0), women under the age 30 or who haven't given birth would be the next size up (often called small or size 1), and women over the age of 30 or who have given birth would be the third size up (regular or size 2). But if you have a heavier flow or a higher cervix (aka the cup will need to be larger to reach farther), then you may like the larger size even if you don't fit those general criteria.
Each cup is different in terms of width and shape (just like every vagina is different!), so try one for a few cycles, and if it's not comfortable or working for you, try a different brand. It seems expensive up front, but the money you'll save on tampons will be worth your investment in the long run. (To make the process even easier, the website Put a Cup In It has created a nine-question quiz to guide you in selecting a cup based on things like activity level, flow, and cervix positioning.)
How do you insert a menstrual cup? How do you know if you did it correctly?
When it's placed correctly, a menstrual cup stays in place by creating a seal between the cup and the vaginal wall. There are tons of helpful videos on Youtube showing insertion methods (usually with diagrams or using a water bottle to represent a vagina). The first time you attempt to insert the cup, make sure you're not rushing out the door. Maybe do it before bed with a glass of wine or chocolate in reach (for a cup-placing reward, of course).
- Deep breath. The first step is a bit of origami. There are two main folds to try—the "C" fold and the "Punch Down" fold—but there many other variations if one of these does not work. For the "C" fold (also called the "U" fold), press the sides of the cup together, and then fold in half again to form a tight C shape. For the "Punch Down" fold, place a finger on the rim of the cup and push until the rim hits the inside center of the base to form a triangle. Fold in half by moving your fingers to the outside and pinching the sides together. The goal is to make the rim smaller in order to insert. (Pro tip: It's more comfortable to insert if the cup is wet, either with water or a silicone-safe lube.)
- Using your preferred method, fold the cup, then grip the sides with your thumb and forefinger with the stem facing your palm. I've found it easier to contain the mess if you remain sitting for insertion, removal, and emptying, but some find better luck with standing or squatting.
- In a comfortable position, with your vaginal muscles relaxed, gently separate the labia with your free hand and slide the folded cup up and back into your vagina. Rather than an upward motion like a tampon, you'll want to aim horizontally towards your tailbone. The cup sits lower than a tampon but can be inserted farther inside if that's more comfortable for your body.
- Once the cup is in position, let go of the sides and allow them to open. Gently rotate the cup by pinching the base (not just holding the stem), to ensure it forms a seal. At the beginning, you may need to run a finger around the edge of the cup to check for folded edges (meaning it hasn't formed a seal) but as you get more comfortable with the process, you'll be able to feel the difference.
- You'll know the cup is in place when the entire bulb is inside and you can just touch the stem with a fingertip. (If too much is poking out, you can even cut the stem shorter.) You should barely be able to feel the cup and there shouldn't be pressure on your bladder (if so, it may be inserted too high). Similar to a tampon, you'll be aware the product is inside you but it shouldn't be painful or noticeable.
You'll feel like a rockstar when you succeed and eventually it becomes just as natural as changing a tampon.
How do you remove it?
When the cup is full (unfortunately, there's not a noticeable way to "tell" until you learn your personal period better) or you're ready to empty it, pinch the base of the cup with your thumb and index finger until you feel or hear the seal pop. Don't just pull the stem (!!!); it's still "sealed" to your vagina, so you're yanking on the suction inside your body. Continue holding the base as you gently wiggle the cup down.
Keeping the cup upright as you remove will avoid spillage. Once you've pulled it out, empty the contents into the sink or toilet. While the cup can't actually get lost in the body, sometimes it shifts too far up to get with your fingers. Don't panic, just bear down like you're having a bowel movement until the cup slides to where you are able to reach. (Pro tip: You can also squat while you're showering to remove and reinsert with ease.)
Does it leak? What if you have a heavy flow?
When inserted correctly (the cup forms a seal with the vaginal walls and there are no folded edges), it won't leak unless it overflows. Trust me: I've tested the limits in many road races, yoga inversions, and long days at the office. A small menstrual cup holds two to three tampons worth of blood, and a regular holds three to four tampons worth. Depending on your flow, you may need to change more frequently than every 12 hours. (In case you've heard the myth, no, it's not bad to do yoga inversions on your period.)
For myself, on days 1 and 2 of my period, I have to switch mid-day, but starting day 3 until the end of my period, I can go a full 12 hours without needing to worry. At the beginning, you may find comfort in using a pad or panty liner as backup. Since you can keep it in for nearly three tampons worth, I've found that I leaked way less when I switched to the cup. You can still use a cup if you have a light flow but may need to wet the cup to aid with insertion. Be sure to remove and empty it regularly, even if your cup is not full.
One of the biggest eye-opening moments will be the realization of exactly how much you bleed each day and each cycle of your period. Hint: it's a lot less than tampons will make you believe. Some people may be able to go all day and never change it, while others may have to dump and reinsert in the office bathroom (more on that below). Either way, as you wear a menstrual cup, you'll begin to better understand your cycle better to make those decisions.
How do you change it at work or in public?
The biggest hurdle (after learning how to insert it), is the first time you need to empty the cup at work (or elsewhere in public).
- Remember how stressful learning to use tampons was? You conquered that hurdle too (and, most likely, at a much younger and more vulnerable age, I might add).
- Remove the cup and dump the contents into the toilet. No need to pull up your pants, sneak to the sink and discreetly wash the cup; save that step for the privacy of your own bathroom.
- Rather than the tampon-secret-slip-into-the-pocket, bring DeoDoc Intimate Deowipes (Buy It, $15, deodoc.com) or Summer's Eve Cleansing Cloths (Buy It, $8 for 16, amazon.com). I've found that using this pH-balanced, vaginal wipe to clean the outside of the cup is key to the public restroom experience.
- Reinsert the cup as normal, then use the rest of the wipe to clean your fingers. Trust me, the wipe is sooo much better than attempting to use the tissue-paper-thin toilet paper to do the job. Exit the stall, wash your hands, and continue on with your day.
Once you're super comfortable with removing and inserting the cup, which could take a few times or a few cycles, it really is that simple.
Can you wear menstrual cups while exercising?
Yes! The workout arena is where a menstrual cup really shines. There are no strings to hide when you're swimming, no tampon to change during an endurance race, and very little chance of leaks during headstand. I've run, cycled, planked, and squatted for the last three years with no exercise-induced period woes. If you're still concerned, I recommend investing in a few pairs of Thinx Undies. The washable, reusable absorbent period panties give you an extra layer of protection, especially during intense workouts or on heavy period days. (Added bonus: Ditching Tampons Might Make You More Likely to Go to the Gym)
How do you clean it?
After each removal, you dump the cup, rinse it with water, and clean it with a mild, unscented soap or a period-specific cleanser, like Saalt Citrus Menstrual Cup Wash (Buy It, $13; target.com) At the end of each period, clean with the same mild soap, then boil the cup for five to seven minutes to resanitize. If your cup becomes discolored, you can wipe down with 70-percent isopropyl alcohol. To prevent discoloration, rinse with cold water each time you empty the cup.
I have an IUD—can I use a menstrual cup?
If you pay the not-insignificant amount of money to have an IUD (intra-uterine device, a long-term method of birth control) inserted, you want it to stay put. A tampon is one thing, but a menstrual cup with the suctioning to your vaginal walls? Yeah, that sounds suspicious.
Well, have no fear: A US National Library of Medicine National Institutes of Health study on the IUD and period methods (pads, tampons, and menstrual cups) found that, no matter which period method used, there was no difference in early expulsion rates of IUDs. That means menstrual cup users weren't any more likely than tampon or pad users to eff with their IUD to the point of it coming out. "Patients with IUD's need to be careful to not pull on the strings when they remove it, but they should still be able to use a menstrual cup," says Dr. Wu.
Can you use a menstrual if you suffer from endometriosis pain?
Endometriosis is a condition in which the lining of the uterus grows where it isn't supposed to, like the cervix, bowel, bladder, fallopian tubes, and ovaries. (Here's a full guide to endometriosis.) It can cause pelvic pain, cramping, and heavy, extremely uncomfortable periods.
While the period experience can be incredibly difficult with endometriosis and may make using tampons painful, the silicone of the cup may actually be a more comfortable option. "Women with endometriosis pain can use a menstrual cup without any special considerations," says Dr. Anderson-Tull. If you experience sensitivity, you may want to consider a softer cup, or if you have a heavier flow, you may need to empty it more often. (Related: Docs Say the New FDA-Approved Pill to Treat Endometriosis Could Be a Game-Changer.)