Menstrual CupsEverything You Need to Know About Menstrual Cups

by Audrey Kopp, CNM

Sometimes magic, sometimes misery. Here's the story:

Here’s the main message for those of you using or considering using a menstrual cup: they’re magic for some and misery for others but worth a try for anyone who gets a period! 

Let’s talk about some of the basics:

Where does it go? Much like a diaphragm for birth control, the menstrual cup goes to the top of the vagina sits around the cervix. The cervix is the tunnel-like structure that blood passes through to transition from the uterus into the vagina. 

How does it get there? And more importantly, how do I get it out?! I’ll touch on the basic idea here but make sure you follow the specific instructions provided with the cup you decide to try! Placement and removal is very similar to a tampon.

menstrual cup-folded.jpgAfter washing your hands, fold the rim of the cup into a “U” shape. PRO TIP: Especially with your first few insertions use warm water, coconut oil or non scented lubricant to ease placement. Either, sitting, standing or squatting, separate your labia with one hand and insert the folded cup rim first into the vagina, pushing it toward the base of your spine, not straight upward! The cup will open once in the vagina and will push against the side walls of the vagina. You may even feel it “pop” open. Once inside, the cup shouldn’t feel uncomfortable (yay!). You also shouldn’t have the small tip of the cup sticking out of the vagina or rubbing between your labia (ouch!). When you’re getting used to placement make sure you check to ensure a good seal. This can be done by placing one finger inside the vagina along the wall of the cup, it should feel smooth and touch all sides of the vaginal walls. If it’s leaking but in place correctly, try moving one size up!

Sometimes, even for experienced users, you’ll need to employ the “if at first you don’t succeed, try, try again” type attitude to get a comfortable fit! 

To remove the cup, you need to break the suction that it creates with your vagina. Most cups will have a short tail that you will gently pull. All the cup starts to pass through your labia, carefully grab it and pour the blood into the toilet. Carefully not to pull it out quickly without control, it’s a small cup of blood which can get a little messy! PRO TIP: remove and replace it in the shower!! Warm water, no mess and plenty of soap available. 

How long can it stay in place? Depending on how heavy your period is, some women can comfortably wear a menstrual cup for 12 hours without having any leaking. On heavier days, some women may need to empty it every 3-4 hours. Unlike tampons, we don’t worry about toxic shock syndrome (TSS) because the cup is made of silicone, not cotton. However it’s worth stating that the overall risk of TSS when tampons are used appropriately is very very low.  

Is it messy? Initially…it can be but once you become a menstrual cup master, nope! Think back to when you first started getting your period, the struggles of putting in/taking out a tampon can be pretty real. The menstrual cup learning curve can be similar. Once you’ve gotten enough practice and figured out a brand/technique that works for you; it’s a snap!

Won’t the blood smell bad if I leave it in all day? This is one of the great benefits of a menstrual cup, the blood does not hit oxygen in the air. Oxygen is what will give the classic “period” smell to a blood on a pad or tampon. Since the cups are silicon, another benefit is that you can put the cup in if you think you might get your period and don’t have to worry about a dry, scratchy tampon or bulky pad!

Does it get washed? Whenever you take a cup out and plan to put it back in, you should wash it first with cold water, then warm water with unscented, gentle soap or cup specific wash. Most of the different brands have cup specific washes that can be good for people with sensitive skin or who struggle with yeast infections! If you’ve finished your period, make sure to fully clean your cup before putting it away. Some people will choose to boil or steam sanitize theirs, this is a good habit, but not required. If you choose to just use soap and water, make sure you scrub the top and all the air holes to ensure a good seal next time!

What if I’m out in public? How do I clean it? PRO TIP! Carry some non-alcohol, fragrance free cleaning wipes in your purse or bag. Fragrance free baby wipes work great!

Can you use it if you're a virgin? Or if you’ve had vaginal deliveries? Yes to both! There are varied size options based on age, sexual experience, birth history or body type! Virginity is not changed by use of a menstrual cup. The hymen is a thin piece of tissue that can be present across some of the opening to the vagina and can be changed by normal daily activities! Some women have little to no tissue and some women have tissue covering much of the vaginal opening. It can stretch, change or heal without having anything enter the vagina. Using a menstrual cup will not change this. Sizing can be a trial process, don’t be afraid to try more than one if it doesn’t feel right. 

I have an IUD, can I use one? YES! The strings of your IUD become soft and tend to wrap themselves around or even inside your cervix. The menstrual cup will be lower than these and will not put pressure directly on your cervix. If you’re wanting to use a menstrual cup and are worried about your string length, your women’s health provider can look at the length and trim them if needed. 

HELP! It’s stuck!! It’s lost!! It’s not, I promise it won’t go anywhere. You’ve just got some good suction working against you. First step is to relax! Your pelvic floor muscles are really powerful and can make it much harder to find or remove your cup if they’re tight. If this happens, push firmly on the side of the cup and break the seal. Then gently pull down, just make sure to be gentle so you don’t damage the walls of the vagina. 

What’s your favorite brand? Personally, I’ve used a few and have found that cone shaped cups are my favorite. Specifically, I’ve loved the FLEX® because of the suction release pull tab, which lets you pull it out just like a tampon. You'll find the one that's right for you.

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The Cup: An environmentally friendly and economically competitive solution in developing nations.

According to – 

"In 2015 UNICEF and the World Health Organization estimated that at least five hundred million women lack sufficient resources to manage their periods. With insufficient menstrual solutions, many girls miss a week of school each month or they drop out for good. Too often these girls even engage in transactional sex to make money for pads and tampons.

The Menstrual Cup is a menstrual product made out of medical grade silicon that can be reused for up to 10 years, this means the lifetime cost of a cup user is a fraction of that of a traditional tampon or pad user. All this makes the Menstrual Cup the environmentally friendly and economically competitive solution to disposables.
The Cup Foundation aims to make the cup the product which will empower girls around the world; giving them a chance to stay in school and strive to live with dignity."

You can read more about what they're doing:



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About the author: Audrey Kopp, APRN, DNP, CNM

Audrey has her doctoral degree in nurse midwifery. In addition to her academic achievements, she has been actively working as a Labor and Delivery Charge Nurse in the Hennepin Healthcare system. Her entire work life and education has focused on pregnancy, moms, labor, delivery, and birth. 

About her practice as a nurse midwife, Audrey says:
I believe in providing individualized care to every woman I see. Part of providing individualized care is working hard to create a familiar relationship with my patients where they can feel safe to verbalize the good, the bad and the ugly. Every woman I care for is strong and powerful in their own way. My care centers around maximizing strengths, creating a trusting bond and supporting women through each stage of their life as their needs and desires evolve. 

If you are interested in booking an appointment with Audrey for your prenatal, delivery or wellwoman care, call Minnesota Women's Care at 651-600-3035 or click Book Now.