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Menstrual cups a safe, economic and environmentally-friendly choice, study finds

Research 11 Nov 2019
Menstrual cup and tampon

For most women, tampons and pads are the usual choices for managing period flow. However, menstrual cups remain "a not well-known alternative", say British researchers, who have found menstrual cups to be "a safe option for menstruation management" internationally after reviewing numerous studies.

In 2017, an estimated 1.9 billion women – more than a quarter of the world's population – were of menstruating age, spending an average of 65 days of the year having periods.

For most women, tampons and pads are the usual choices for managing period flow. However, menstrual cups remain "a not well-known alternative", say British researchers, who have found menstrual cups to be "a safe option for menstruation management" internationally after reviewing numerous studies.

Although the researchers said "good quality studies" were still needed, they recommended that information on menstrual cups be provided in puberty education materials.

The researchers' views are supported by Jean Hailes for Women's Health specialist women's health GP, Dr Amanda Newman.

"There is definitely space for educating teenagers, young adults and policymakers, that menstrual cups are available," Dr Newman said.

The British researchers reviewed 43 different studies, which involved more than 3300 participants, with their report published in medical journal The Lancet under the title Menstrual cup use, leakage, acceptability, safety, and availability: a systemic review and meta-analysis.

Like tampons, menstrual cups are inserted into the vagina. But rather than absorbing blood as tampons do, the cups catch the blood. Depending on the type of cup, 10-38ml of blood can be collected, and should be emptied every 4-12 hours.

Menstrual cups are made of medical-grade silicone, latex, rubber or elastomer. Most are bell-shaped and designed to sit low in the vagina, while others are flatter and designed to sit higher up, over the cervix.

Although menstrual cups and tampons appeared on the market around the same time – in the 1930s – it is thought that the more aggressive marketing of tampons made them more popular.

Sustainability

While tampons and pads are designed for single use, menstrual cups can last up to 10 years, which makes them an increasingly attractive environmental and economical choice.

In Australia, menstrual cups range in price from $35-$50, while a box of 16 single-use tampons costs $4-$9 – which means that a menstrual cup that could be used for years would cost the same as 3-6 months' supply of tampons.

"From a sustainability point of view, use of the menstrual cup should be strongly endorsed," Dr Newman said. "Because it is reusable, it's cost effective and presumably better for the environment.

"Hopefully their use will be encouraged by health professionals such as GPs and pharmacists."

In the British review, only four of the studies made direct comparisons of leakage amounts between menstrual cups and other products. Leakage between products was similar in three studies, and significantly less for menstrual cups in one study.

Many studies showed that adoption of the menstrual cup required several menstrual cycles for users to become comfortable using them – particularly for younger girls and those who have never had penetrative sex – but that support and encouragement from others improved uptake of them. In 13 studies, 73% of participants wanted to keep using the menstrual cup at the end of the study.

The report said allergies to the menstrual cups were not common, but women should be aware of the possibility. Also, it said that the combination of use of an intrauterine device (IUD) and a menstrual cup may need further study.

No adverse effects

The researchers found use of the menstrual cup showed no adverse effects on the vaginal flora, and that there was no increased infection risk associated with menstrual cup use among European, North American and African women and girls compared with other menstrual products.

"At present there is no particular concern about the safety of using menstrual cups compared to other forms of sanitary protection," Dr Newman said.

Dr Newman said another benefit of the menstrual cup was that it allowed women "to become more familiar with their own genital area."

"This is a huge issue. Many women don't know what a vulva is, they just use the word vagina, so it's a way of encouraging familiarity with one's own body," she said. "It also allows a woman to more accurately assess how much blood is lost each period.

"I think it's a wonderful idea, I hope use of the menstrual cup becomes more widespread in the next few years."

Read more information on periods.