Menstrual cup

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A bell-shaped menstrual cup, about 2 inches (5 cm) long not including the tab

A disposable menstrual cup that looks similar to a contraceptive diaphragm, about 3 inches (7.5 cm) in diameter

A menstrual cup is a type of cup or barrier worn inside the vagina during menstruation to collect menstrual fluid. Unlike more common methods, such as tampons and pads, the cup neither absorbs the flow nor catches it outside the body.

There are two types of menstrual cup currently available for sale over the internet and through retail stores worldwide. The first is a soft, flexible, disposable cup called the "Instead Softcup," which is manufactured by Instead Inc. and can be found in many major retail outlets. It is made of latex-free polyethylene and resembles the contraceptive diaphragm (although it is not a contraceptive device). The second type is a bell-shaped cup made of rubber (latex) or silicone. It is reusable and designed to last for up to 10 years. Current brands include "Mooncup" (manufactured in the United Kingdom), "DivaCup" (Canada), "Keeper" (USA), "LadyCup" (Czech Republic), "Lunette" (Finland), "Moon Cup" (USA), "Miacup" (South Africa), and "Femmecup" (Far East).

The majority of women in Western countries do not use menstrual cups, but rather disposable tampons or disposable sanitary napkins (also known as pads) to handle their menstrual flow. A number of different companies have attempted to promote the use of menstrual cups during the 20th century; many of these products were withdrawn when they failed to gain enough market share. This may change with the potential growth of the alternative sanitary product market. Other popular alternatives to conventional products include: non-bleached (and often non-GM cotton) or organic tampons; washable cloth sanitary napkins; and natural sponges.

Contents 1 Usage 2 Safety 3 History 4 Comparisons with tampons and sanitary napkins 4.1 General 4.2 Bell-shaped cups 4.3 Disposable cups 5 Size Chart for Reusable Cups 6 See also 7 References 8 External links 8.1 Official company websites

[edit] Usage

Insertion

Users of bell-shaped cups can usually choose from two sizes to fit their body shape. The disposable cup is prepared by flattening the rim against itself and is more flexible than reusable cups. The cup is inserted into the vagina and pushed into place near the cervix and behind the pubic bone, where the internal structure of the body keeps it in place. The bell-shaped cup is inserted until the body of the cup and stem are completely inside, then held by the lower point or stem and turned; this opens the cup and creates a seal between the rim and the inner vaginal walls. The reusable cup will situate itself and need not be placed as high as the cervix nor tucked into a specific spot, as long as it is completely open.

Removal

Removal should occur as needed, but the cup should never be left in longer than the manufacturer recommends (usually 12 hours^{[citation needed]}). Menstrual cups require relatively less attention and maintenance by the user than more traditional menstrual hygiene methods. The reusable cups are designed to hold roughly 30 ml (1 oz) of fluid, which is a third of the entire volume of blood lost in an average menstrual period. Bearing down with the muscles will help bring the cup within reach. The design can be pulled out by a fingertip hooked into the rim. The lower part of the bell-shaped cup usually features "grips" or slightly raised ridges as well as a stem to assist removal. A disposable cup should be discarded and replaced, but the reusable cups need only be emptied, cleaned (preferably with hot water and gentle soap or with a paper towel when this is not possible), and reinserted.

At the end of menstruation, the reusable cup should be well-cleaned and carefully stored. Since silicone versions can tolerate high temperatures, very hot water is a popular option: a few minutes of stovetop boiling or even a run through the dishwasher provide sufficient sterilization. However, hand-washing in mild soap and hot water is the only absolute necessity.^{[citation needed]} After drying, the cup must be placed in storage that allows for air flow; all reusable cups come with a small drawstring fabric bag for this purpose.^{[citation needed]} When menstruation begins again, the cup should be inspected for any damage, then washed in warm water just before being used. Some discoloration can set in over time, though this does not affect the cup's performance. Proper care will prolong the life of the cup, allowing several years of use.

click on the images to enlarge - diagram with labels

Opened bell shaped cup	Diaphragm-style cup	Non-expanded tampon
The bell-shaped cup is worn low in the vagina. It may work its way higher during the day, which is perfectly natural, but it is not designed to be placed over the cervix. Every bell-shaped cup has a tab at the bottom to make it easier to remove.	The diaphragm-shaped cup is inserted and worn in the same way as a contraceptive diaphragm. It sits over the cervix, and is kept in position by pressure from the pubic bone. To remove, hook a finger over the rim and pull it down past the pubic bone.	A tampon should be inserted up next to the cervix; this is the most comfortable position as it leaves plenty of room for the tampon to expand both widthwise and lengthwise as it absorbs the flow. A tampon has a string stitched through it which hangs clear of the body for ease of removal.

[edit] Safety

They are regulated by the Food and Drug Administration (FDA) in the United States^[1], and have been used for decades. No reported cases of toxic shock syndrome have been attributed to the use of menstrual cups^{[citation needed]}, though some doctors believe that one reported case of endometriosis may have been partially attributable to use of the Keeper. There have been instances where women have experienced yeast infections due to lack of cleanliness of their cup. In such cases an appropriate health care provider should be consulted.

[edit] History

The first bell-shaped menstrual cup was patented in 1932, and sold under the name Daintette. The Chalmer's Cup (patented 1937), Foldene (undetermined date) and Tasette (post World War II) were all early versions of this bell shaped cup. In 1970 a disposable version of the Tassette (called Tassaway) was brought out.

None of the early cups stayed in production for long^{[citation needed]}. With advertising restrictions, social taboos on discussing menstruation^{[citation needed]}, the reluctance of women to use an internal device and the fact these products required washing and reuse (in a time when disposable products were becoming available), all had a role in the products not becoming successful^{[citation needed]}.

Commercial tampons that started production at this time tackled the problem of touching the body for insertion by inventing the applicator, which greatly improved their market position. They also brought out a new marketing strategy that allowed women to take a box of tampons off the counter themselves (placing the money in a tin beside the display), rather than asking the pharmacist for them.

In 1987, another rubber menstrual cup, The Keeper, was manufactured in the USA. This proved to be the first commercially viable menstrual cup, as it is still in manufacture today. The first silicone menstrual cup, the Mooncup (UK manufactured), opened the way for future cups^{[dubious – discuss]}. Most menstrual cups are now manufactured from silicone because of its hypoallergenic properties.

[edit] Comparisons with tampons and sanitary napkins

Many advantages/disadvantages are a result of personal preference. However, some of the more commonly mentioned ones are listed below.

[edit] General

Advantages

• Can be worn up to twelve hours before emptying. Manufacturers recommend that tampons and pads be worn for no more than eight hours.
• Contain no harmful substances (e.g. dioxin and bleach), unlike many commercial tampons and sanitary napkins.^{[citation needed]}
• Compared to sanitary napkins
  • Can be worn during sports such as swimming. Tampons can also be worn swimming, though they may wick water, become saturated, and then drip dilute bloody water. Menstrual cups are therefore more reliable menstrual protection for public swimming activities^{[citation needed]}.
  • Will not cause cystitis by transferring E. coli from the anus to the urethra or vagina, as long as proper hygiene is practiced.^{[citation needed]}
  • Will not cause the warm, damp conditions around the vulva that favor bacterial growth.
  • Will not absorb the natural fluids present in the vagina, which can cause dryness.
• Compared to tampons
  • Does not dry/scratch the vaginal walls or leave fibers behind.^{[dubious – discuss]}
  • Does not interfere with the vagina's natural sloughing off of dead cells.^{[dubious – discuss]}
  • Does not disrupt the vagina's natural acidity as bleached menstrual products do^{[dubious – discuss]}.
  • Has never been linked to Toxic Shock Syndrome (TSS)^{[citation needed]}.
  • Can be inserted at any time of the month. This allows the user to practice inserting the cup or to insert the cup when they are expecting their period, instead of having to wait for it to begin.
  • After urination, leaves no wet string behind.
• Longer-lasting
  • Useful for travel, where access to tampons or sanitary napkins could be limited.
  • Cost less than tampons or sanitary napkins, if expenses are added up over the long-term.
    • Some manufacturers, such as The Keeper and Instead, offer a money back guarantee.
• Manufacturing may be less harmful to the environment, as it does not use bleach, wood pulp, or other potentially environmentally damaging substances.^{[citation needed]}
• Require very little storage room, making them ideal for packing in luggage or for those who have very limited living space.Template:Biased
• Menstrua tends to have less odor compared to tampons and pads.^{[neutrality disputed]}
• Allow the user to track the amount of menstrua by visually inspecting the contents of the cup.
• Can be used for a wider range of anatomical structures (ex. with tilted uterus).
• Are ideal for paramenopausal women or women on certain hormonal contraceptives who can have irregular spotting (light bleeding) during much of the month and for whom using tampons for such long durations is not possible because of dryness, irritation and health risks such as TSS.
• Requires touching of the genital area: gives women further opportunity and encouragement to touch their genitals and become familiar with vaginal processes.^{[neutrality disputed]}

Disadvantages

• Discarded silicone, rubber and plastic cups require far more time to biodegrade than cotton tampons or pads.
• Requires touching of the genital area.
• Removal and/or insertion may take some practice, and can be messy if an incorrect technique is used.
• Requires access to soap and running water or hand wipes/cleaning spray, for cleaning hands before and after removal and insertion.
• Improper cleaning and sterilization can result in a bacterial infection.
• Use with an IUD must be approved by a health professional.
• Both types of cups may break the hymen, making them unsuitable for those belonging to religious groups where high value is placed on having an intact hymen upon marriage.

[edit] Bell-shaped cups

Advantages

• Minimal waste
  • The only thing to dispose of is the menstrual fluid.^{[neutrality disputed]}
  • Ideal for situations such as hiking, camping, swimming, and all kinds of sports when disposal of menstrual products would otherwise be a burden.^{[neutrality disputed]}
• Reusable design does not contribute to landfills or other waste collections.^{[dubious – discuss]}
• Very little packaging required, as compared to tampons or sanitary napkins.
• With proper care it will last for up to 10 years
• Does not cause TSS (toxic chock syndrome associated with sanitary tampons)
• Can be used with both heavy and light flow and when while expecting menstruation.

Disadvantages

• Weak vaginal muscles may allow the cup to slip too low. (but can be strengthened by using the cup)
• Although rare, changes in cup position and subsequent leakage may be caused by an orgasm, a full bladder or rectum, and by defecating.
• Incorrect insertion may also cause leakage. Correct insertion technique typically requires practice.
• Require a greater initial investment than either tampons or sanitary napkins. The cost is a one-time cost and is a fraction of what disposables will cost.
• Require some care and upkeep, disinfecting the cup takes about 3 minutes and emptying the cup takes as long time as it takes to change a sanitary pad or tampon.
• After childbirth (even by C-section) you should purchase a larger cup.
• Cannot be used during sex. The cup is placed low in the vagina and will be in the way, but oral sex is possible.

[edit] Disposable cups

Advantages

• Can be worn during sexual intercourse, though menstrual cups are not a contraceptive device.
• Create less non-biodegradable waste than either tampons or sanitary napkins, as fewer cups are used per cycle than tampons or pads. (Although not designed for repeated use, they are typically sturdy enough to be washed and reused for an entire cycle.)
• Designed for health-conscious women and women for whom hygiene and safety are of the utmost importance.
• Comparable in price to tampons, considering longer wear-time.

Disadvantages

• One-time use creates waste, which is an environmental concern, especially as the materials used are non-biodegradable.
• Need to be disposed of in an appropriate waste receptacle.
• Due to the necessary depth and location of insertion, the learning process for correct use is often discouraging.
• Many users find them messier to empty than reusable menstrual cups due to the shape.

[edit] Size Chart for Reusable Cups

Brand	Capacity	Width	Length (w/o stem)
Mooncup (UK)	Size B: 15ml Size A: 20ml	Size B: 43mm Size A: 46mm	Size B: 30mm Size A: 30mm
Diva Cup	Size 1: 20ml Size 2: 25ml	Size 1: 42mm Size 2: 45mm	Size 1: 57mm Size 2: 57mm
Keeper	Size B: 13ml Size A: 13ml	Size B: 42mm Size A: 45mm	Size B: 54mm Size A: 54mm
Ladycup	Size S: 15ml Size L: 26ml	Size S: 40mm Size L: 46mm	Size S: 46mm Size L: 53mm
Lunette	Size 1: 25ml Size 2: 30ml	Size 1: 41mm Size 2: 46mm	Size 1: 27mm Size 2: 32mm
Femmecup	30ml	40mm	50mm
Miacup	Size 1: 25ml Size 2: 30ml	Size 1: 43mm Size 2: 46mm	Size 1: 53mm Size 2: 53mm

[edit] See also

• menstrual cycle, endometrium
• Kegel exercises
• tampons, sanitary napkins (UK: towels), sponge
• hygiene, toxic shock syndrome, candidiasis, cystitis, E. coli
• pollution, environmental movement, ecology movement

[edit] References

1. ^ FDA > CDRH > Database Super Search

[edit] External links

• The History of Menstrual Cups from the Museum of Menstruation and Women's Health - including many photographs of menstrual cups available today, and those from earlier in the 20th century, and comments from those who have worn them
• Menstrual Cup Support
• Tampaction - the Tampaction campaign of the Student Environmental Action Coalition
• Go Ask Alice! - The Ins and Outs of Menstrual Cups
• Menstruation Products: A Compare-And-Contrast - explaining how to use tampons, pads, and menstrual cups
• www.ecomenses.com - Menstrual cup photos, history and information

[edit] Official company websites

• Mooncup
• DivaCup
• Keeper
• Lunette
• LadyCup
• Femmecup
• Instead
• Miacup