So by now, if you're a person with a vagina that bleeds, you've probably heard about the newest fashion trend in menstrual products: the menstrual cup. And even if you haven't yet, no worries, because you're about to get the rundown.
This topic was actually a request from a very good friend of mine, and I figured, hey, menstrual health is part of sexual health, and how we control, change, and accommodate that oh so auntish of flows is a really important discussion to have, because for a lot of people with a uterus, menstruation is a real pain in the, erm, uterus?
For many people, menstruation brings with it a whole slew of unwanted and unwelcome side effects, including bloating, cramping, moodiness, breast tenderness, migraines, food cravings and food aversions, nausea, fatigue, and just general fuck-it-all-ness, on top of the bleeding itself, which can be a real frustrating thing to contend with, especially if your cycles are irregular, heavy, or just plain make you feel like "ugh." For may people for whom this is their menstrual reality, a cup can really help to alleviate a lot of the general hatefulness that bleeding for days on end can bring with it.
I first discovered cups about 10 years ago when my best friend introduced me to the Diva Cup. She talked about this silicone cup that goes inside you and catches all the blood, and you empty it once or twice a day, and then when you're done, you boil it and get it ready for the same process next cycle. Of course, I had so many questions.
How does it fit inside you?
Does it hurt?
How does it keep from leaking?
Don't you get blood all over your hands?
Is it safe?
And these are often the same questions I get whenever people message me asking for feedback and suggestions (because I post about cups pretty regularly on my Facebook page, just as a general thing, but also about my own experience with my cup). So, let's talk a little bit in generalities and go through these questions one at a time together, shall we?
As stated above, a menstrual cup is a cup made of medical grade silicone (usually, I think there are others made of other body safe materials); they come in reusable or disposable versions, depending on your needs and preferences. Many people are switching over from pads and tampons to cups for various reasons: more economical, better for the environment, more comfortable, better coverage, more convenient, and both the reusable and the disposable versions have their benefits and their drawbacks, again, depending on each person's needs and preferences. Rather than soaking up blood into cotton and other synthetic fibers the way a tampon does, or collecting and soaking up blood as it exits the body the way a pad does, the cup fits around the cervix, and collects the blood like a little vampire shotglass being held beneath a fountain drink dispenser of uterine lining. Once or twice a day (maybe more depending on the heaviness of the flow), you simply bear down (think pushing out like you would if you were having a bowel movement), to help push the cup down, grab the base, stem, or ball handle (each cup is designed a little differently), pinch and pull the cup out, and empty the contents into the toilet (or shower, which is where I like to empty mine). You rinse it with warm water and soap (or an adult toy cleaner also works well) for the reusable version, and then reinsert, or throw it away if you're using a disposable version.
Now, as to getting it inside (and even getting it out): there is a learning curve, and I always recommend people practice before they expect their next period so that they get an idea for how to best position it, what feels most comfortable, etc. A good water based lubricant inside the vagina can help to make things glide a little better, especially if you're doing a "dry run" with your cup to get a feel for how to use it. My favorite site and resource for this is Put a Cup in It, which has links to demo videos that are super helpful. This is also a great resource for brand comparisons, and even has a quiz to help you determine the best cup for you. Put a Cup in It's videos will show you how to fold the cup so that you can insert it, and also show you how to remove it. I promise, once you've done it a couple of times, it becomes second nature, and you will learn to stop pinching yourself, or popping the cup open before it's fully inserted (all of these things I did when I first started learning to use my cup).
Once it's in, positioning it in a way that is comfortable and also doesn't leak can take some time to learn as well. When I switched cups from the Diva Cup to the Lena Cup, I had to learn a whole new positioning that felt right and also worked with the design of the cup. There was some leaking at first, but once I figured out the best way to work with the cup, the leaks stopped. So it may be helpful to wear a pantyliner or pad at first, or even some period panties, until you can be sure you've got it positioned around your cervix correctly. Once you've got it in right, you shouldn't feel it at all, just like a tampon (or, if you have issues with tampons causing irritation due to the fact that they're a dry wad of cotton that sucks all the moisture out of your vagina, then cups should feel immensely more comfortable than that). Reasons that you may feel it include: improper positioning, which can be remedied by pushing the cup up a little higher, or even wiggling it back and forth until it feels comfortable; having the wrong cup size -- too big, and it may put pressure on your urethra or rectum, or too small, and it may slip down; the stem sticks out and irritates the vaginal opening or labia, which can thankfully be fixed by just snipping it off. I've done this with both my Diva and my Lena; or the cup hasn't fully opened, which you can fix by either wiggling it til it pops open, or removing it and reinserting it. Again, a little trial and error will help you figure out the best way to work with your particular cup.
And, just as insertion and positioning take time to master, so can removing it. Disclaimer: a menstrual cup is not a product for you if the idea of getting your own menstrual blood on your hands squicks you out. It's going to happen, a lot at first most likely, and a lot less as you get the hang of things. I can say from experience, menstrual blood will not burn your skin or cause you to melt or have any other negative consequence just from touching your skin. It's a little warm, it's wet, and washes off easily with soap and water. I get and respect that not everyone can get down with that, so if that's you, and you're not able to work up to that, then perhaps cups are not for you, and that's okay. For everyone else, just be prepared. Spillage when removing the cup is just a natural part of the learning curve (hence why I like to remove mine in the shower). For the most part though, removal is usually easier than insertion, as you're working with gravity to work the cup down, using your fingers to break the suction seal (that's part of how it stays inside you), and then just pulling it out gently and carefully so that you can empty it into the toilet. Then just start it all over again.
As to its safeness, when cups first came out, they were touted as the safest alternative to tampons because there was zero risk of toxic shock syndrome (TSS) associated with them, as tampons created a breeding ground for bacteria by keeping things dark and moist and warm inside their cotton fibers. However, recent studies have suggested that there is still a small risk of TSS with cups, because as they collect the blood, you're still leaving it in a dark and moist and warm environment for bacteria to grow -- it's just not being held directly against your body since it's all contained in the cup. To that, I disclaimer this: practice good menstrual hygiene. Empty your cup at least once every 24 hours, and wash your hands before and after. They're meant to be worn long term instead of needing to be emptied every 2-3 hours like a pad or tampon, but long term doesn't mean 4 days straight. Empty your cup and rinse it with warm water and a mild, pH-balanced soap or adult toy cleaner at least once every 24 hours, and you should be completely fine. Every body is different though, so listen to yours if it needs to be emptied and sanitized more often. Beyond that minimal risk, unless you have sensitivities or allergies to the materials that make up the cup itself, there should be no other risks to your health or wellbeing. In fact, many people have found improved vaginal health because the cup doesn't dry out the vaginal environment the way tampons tend to, which leads to a decrease in infections, and overall comfort.
So you say, "Okay, Andrea, I'm sold. I'm ready to give this menstrual cup thing a try. How do I know which one to get?" Again, I point you to the Put a Cup in It website, whose quiz is a great way to narrow down the best brand and size to choose. Like I mentioned before, when I first learned about cups, it was a decade ago, and there wasn't very much information about them, let alone choices. I went with the one I had heard of first, and the one that was available in a store, which, at the time, was a Diva Cup. You'll find that there are many brands, with many styles, designs, and colors, and different sizes for where you're at in your life, including whether or not you've had a baby, and how old you are. There are reasons for the different sizes based on age and childbearing. For one, birthing a human through your vagina tends to stretch things out a bit (not to the extent that it never goes back, but the vagina can lose a bit of elasticity from the event), and the natural hormonal changes your body goes through during those 9 months changes the environment of the vagina as well, so you may even find there's a different whether you birth that baby from your vagina, or have it delivered via C-section. Aging also causes hormonal changes. It's just the natural way of things.
That's where I found myself when I switched cups. In the years since getting my Diva Cup I had become sexually active, started birth control, stopped birth control, and entered my 30s. These tend to change a vagina. So my super amazing, comfortable size 1 Diva Cup no longer fit me perfectly. It slipped and leaked and was uncomfortable. Since new cups had come out in those 10 years, I decided to make a change and see if there was a brand that might fit me better, and ended up with the large size Lena Cup. The main differences between the two are that the Lena is bell shaped, whereas the Diva is shaped more like a cone. The edge of the cup is a bit firmer so it stayed in place better, which was good for me since I find myself on a pole twice a week. Oh, and also, the Lena is pink. 'Nuff said.
But yeah, there are so many to choose from and it can feel overwhelming. My biggest suggestion: get to know your body. Stick your fingers up inside your vagina to figure out how long it is, and where your cervix is. Do this throughout your cycle (that's actually fun, because if you're not on hormonal birth control, you'll notice that the height changes throughout your cycle as your fertility changes) so you have an idea of the ranges within which the height fluctuates. Then head on over to Put a Cup in It, jump on their quiz, and check out their recommendations. Don't feel bad if the first one you get doesn't seem like a perfect fit. Again, it's trial and error. A friend of mine once tried a cup that was not long enough for her and had a horror of a time trying to get it out. Each body is different and each cup is different, and it may take trying one or two before you find the best fit for you. But once you do, I promise you'll love it. At this point, it's honestly the best thing I love about my period.
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