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Are Menstrual Cups Bad For Pelvic Floor?

June 01, 2024

Are Menstrual Cups Bad For Pelvic Floor?

Menstrual cups have gained popularity as an eco-friendly and cost-effective alternative to traditional menstrual products like pads and tampons. However, concerns about their impact on pelvic floor health, particularly the risk of pelvic organ prolapse, have sparked debate and confusion. This article aims to explore whether menstrual cups are detrimental to the pelvic floor by examining pelvic floor anatomy, the mechanics of menstrual cups, current research findings, and expert recommendations.

Key Takeaways

  • There is no direct evidence linking menstrual cup use to pelvic organ prolapse.
  • Proper insertion and removal techniques are crucial to avoid potential pelvic floor issues.
  • Menstrual cups can be a safe alternative to pads and tampons when used correctly.
  • Consulting with pelvic floor specialists can provide personalized guidance and reassurance.
  • Education and awareness about pelvic floor health can help mitigate concerns regarding menstrual cup usage.

Understanding Pelvic Floor Anatomy

The pelvic floor is a complex structure that plays a crucial role in maintaining overall pelvic health. It consists of a group of muscles that span the bottom of the pelvis and support the pelvic organs, including the bladder, uterus, and rectum. These muscles are essential for maintaining continence, supporting the pelvic organs, and stabilizing the body during physical activity.

A healthy pelvic floor allows for easy control of urine flow, comfortable bowel movements, and the ability to lift without injury. However, a weakened pelvic floor can lead to conditions such as prolapse, where the pelvic organs descend due to insufficient support. Understanding the anatomy and function of the pelvic floor is vital for recognizing the impact of various menstrual products on pelvic health.

Menstrual products, including menstrual cups, can have a significant impact on pelvic health. It is important to consider how these products interact with the pelvic floor muscles and whether they contribute to or alleviate common pelvic floor disorders. By understanding the structure and function of the pelvic floor, individuals can make informed decisions about their menstrual health and choose products that best support their needs.

Mechanics of Menstrual Cups

Design and Material Composition

A menstrual cup is a small, flexible cup that you insert into your vagina. Instead of absorbing your period flow, like a tampon or pad, the cup catches and collects your flow. Menstrual cups most often have a V-shape and a stem. They come in different sizes and materials, mostly sold in small and large sizes. The materials used are typically medical-grade silicone, rubber, or elastomer, ensuring safety and durability.

Insertion and Removal Techniques

Proper insertion and removal techniques are crucial for the effective use of a menstrual cup. To insert, fold the cup and gently push it into the vagina, ensuring it unfolds completely to form a seal against the vaginal walls. Removal involves pinching the base to release the seal and gently pulling it out. It is recommended to empty the cup every 8 to 12 hours.

Potential Risks and Benefits

The use of menstrual cups offers several benefits, including cost-effectiveness, environmental sustainability, and longer wear time compared to other menstrual products. However, potential risks include discomfort during insertion and removal, and in rare cases, an increased risk of urinary tract infections. Proper hygiene practices and following the manufacturer's instructions can mitigate these risks.

Evaluating the Evidence: Menstrual Cups and Prolapse

Current Research Findings

A recent rumor suggests that menstrual cups cause vaginal prolapse, a condition in which the pelvic floor muscles weaken and internal organs protrude into the vaginal space. However, the reality is that there is no evidence to support this claim. Prolapse is not uncommon, and the use of menstrual cups is on the rise, meaning more prolapse sufferers will be cup users. This does not equal a correlation. Until there is actual evidence that supports the 'guesses' put forward regarding cups leading to prolapse, the stance is that light bearing down is no more likely to cause a prolapse than your daily bowel movement.

Expert Opinions and Clinical Guidelines

In the BBC's article, the claim was made that the motion of bearing down on your cup for removal could weaken the pelvic floor and result in prolapse. However, it's important to mention that currently, there are no peer-reviewed studies that show a direct correlation between menstrual cup use and prolapse. Dr. Crouch has also weighed in on this topic, emphasizing the lack of scientific evidence supporting these claims.

Case Studies and Anecdotal Evidence

To start, a comparative study by Howard in 2011 looked at menstrual cup wearers vs. tampon wearers. The main results of this small study were that there were no differences in pelvic health concerns when comparing the two groups. One thing to note is that prolapse in general is fairly common in women, especially postpartum women. As more women are wearing cups, more data will become available to further evaluate these claims.


Proper Use of Menstrual Cups to Protect Pelvic Health

Step-by-Step Guide to Safe Use

To ensure the safe use of menstrual cups, it is essential to follow a step-by-step guide. Breaking the seal before removal is crucial to avoid any issues with organ position. Here is a simple guide:

  1. Wash your hands thoroughly before handling the cup.
  2. Fold the menstrual cup in a C-fold or punch-down fold for easier insertion.
  3. Insert the cup into the vagina, ensuring it is fully open and sealed.
  4. To remove, pinch the base of the cup to break the seal and gently pull it out.
  5. Empty the contents, wash the cup with mild soap and water, and reinsert if needed.

Common Mistakes to Avoid

Avoiding common mistakes can help protect pelvic health. One common error is not breaking the seal before removal, which can cause discomfort or even minor injuries. Additionally, using a cup that is not the right size can lead to leakage or discomfort. It is advisable to consult with a healthcare provider to determine the appropriate size and type of menstrual cup for individual needs.

Tips for Individuals with Pelvic Floor Issues

For individuals with pelvic floor issues, special considerations are necessary. Menstrual cups should not pose any risk of worsening a prolapse if used correctly. However, always break the seal when removing it to avoid any issues with organ position. Consulting a pelvic floor physical therapist can provide personalized guidance and ensure the menstrual cup is comfortable both physically and emotionally.

Comparative Analysis: Menstrual Cups vs. Other Menstrual Products

Environmental and Economic Considerations

Menstrual cups are often lauded for their environmental benefits. Unlike disposable products such as tampons and pads, menstrual cups can be reused for several years, significantly reducing waste. Economically, while the initial cost of a menstrual cup may be higher, the long-term savings are substantial. Concerns and drawbacks of menstrual cups include health risks, environmental impact, economic barriers, and user experience variability.

Health Implications

When comparing menstrual cups to other products, it's essential to consider the health implications. Menstrual cups are made from medical-grade silicone, rubber, or elastomer, which are generally safe for use. However, improper use can lead to health issues such as infections or Toxic Shock Syndrome (TSS). On the other hand, tampons and pads also carry risks, including TSS and exposure to chemicals used in their production. A comparative study by Howard in 2011 found no significant differences in pelvic health concerns between menstrual cup wearers and tampon users.

User Satisfaction and Comfort

User satisfaction varies widely among different menstrual products. Menstrual cups offer the advantage of longer wear time—up to 12 hours—compared to tampons and pads, which require more frequent changes. However, some users find menstrual cups challenging to insert and remove, which can affect overall satisfaction. Period for women can be a time of discomfort, and the choice of menstrual product can significantly impact one's experience. According to a systematic review and meta-analysis published in Lancet Public Health, menstrual cups have a high acceptability rate among users, although individual experiences may vary.


Expert Recommendations and Resources

Consulting Pelvic Floor Specialists

For individuals concerned about the impact of menstrual cups on their pelvic floor health, consulting with a pelvic floor specialist is highly recommended. These professionals can provide personalized advice and treatment plans tailored to individual needs. Expert consultation ensures that any underlying issues are properly addressed and that menstrual cups are used safely and effectively.

Educational Resources and Support Groups

There are numerous educational resources and support groups available for those seeking more information on pelvic floor health and menstrual cup usage. Websites like Expecting Pelvic Health offer free courses and webinars, such as the Free Pelvic Floor Educational Series. Additionally, online forums and local support groups can provide community support and shared experiences.

Future Directions in Menstrual Health Research

Ongoing research in menstrual health continues to shed light on the safety and efficacy of menstrual cups. Future studies are expected to focus on long-term effects and potential benefits. Staying informed about the latest research findings can help individuals make educated decisions about their menstrual health. 


In conclusion, the current body of evidence does not support the notion that menstrual cups are detrimental to the pelvic floor or that they cause pelvic organ prolapse. While concerns have been raised, particularly regarding the suction effect during removal, proper usage techniques, such as breaking the seal before removal, can mitigate these risks. Menstrual cups offer a sustainable and cost-effective alternative to traditional menstrual products and can be safely used by most individuals, including those with pelvic floor issues, provided they are used correctly. As always, individuals with specific health concerns should consult with a healthcare professional or a pelvic floor physical therapist for personalized advice.

Frequently Asked Questions

Can menstrual cups cause prolapse?

To date, there have been no peer-reviewed studies that show a direct relationship between menstrual cup use and damage to the pelvic floor. Generally, as long as you use and remove it correctly, a menstrual cup is safe and shouldn’t damage the pelvic floor, even if you have a prolapse. Proper insertion and removal are key.

Are menstrual cups safe to use with pelvic floor issues?

Yes, menstrual cups can be safe to use with pelvic floor issues. However, it is essential to break the seal when removing the cup to avoid any issues with organ position. If you have concerns, consult a pelvic floor physical therapist for guidance.

What are the pros and cons of using menstrual cups?

Pros of using menstrual cups include environmental benefits, cost savings, and longer wear time compared to pads and tampons. Cons may include a learning curve for insertion and removal, potential discomfort, and the need for proper cleaning and maintenance.

How should I properly insert and remove a menstrual cup?

To insert a menstrual cup, fold it and gently insert it into the vagina, allowing it to open and create a seal. To remove it, pinch the base to break the seal and gently pull it out. Always ensure your hands are clean during the process.

Can menstrual cups worsen pelvic organ prolapse?

Menstrual cups should not pose any risk of worsening pelvic organ prolapse if used correctly. Always break the seal before removal to avoid any potential issues with organ position.

What should I do if I experience pain while using a menstrual cup?

If you experience pain while using a menstrual cup, it may be due to tight pelvic floor muscles or improper insertion. Consider consulting a pelvic floor specialist for personalized advice and to ensure you are using the cup correctly.

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