for Better Menstrual Options

New Zealand's

One stop shop for alternative menstrual products

Kia Ora! Welcome to EnvironMenstruals.

Common questions about cups

OMG It's huge! How am I meant to get that in there?

Don't panic, you don't put it in unfolded. Menstrual cups are very soft and squishy, as they need to be folded for insertion and squashed for removal.There are a number of different folds you can use, each has pros and cons, so have a play and work out which you prefer.

Folding the cup makes it much smaller to insert, so it doesn't have to be much bigger than a tampon or a finger.


Can I wear a menstrual cup swimming/horse-back riding/skydiving etc?

You can wear it in a plane; you can wear it in a train.
You can wear it in a pool; you can wear it using tools.
You can wear it on a horse; you can wear it "on the sauce."
You can wear it on a bike; you can wear it all you like.
You can wear it here or there; yo ucan wear it anywhere.


How do I use a menstrual cup?

First of all, wash your hands. Then take your cup and fold it. Use whatever fold you think you can hold, fit, and open easily. You then insert your cup in much the same way as you would a tampon, directing it back toward your butt (as this is how your vagina is naturally angled). When the rim is just past your pubic bone (where the vagina suddenly gets a lot squishier), let go of the fold and let the cup open. You may need to help it open buy turning it or pushing and pulling it a bit. Once it's open, twist it around a few times (2 full rotations usually does it) to make sure the rim is fully unfolded. You may want to reach a finger up past the cup body and feel for dents in the side - these indicate that it's not open, so you need to rotate it a bit more or it will leak.

Cups are designed to sit lower in the vagina than a tampon, so don't push it all the way in. Instead position it as low as you feel comfortable with, then squeeze your pelvic floor muscles to move it upward (these are the muscles youuse if you're trying not to pee). This way it will naturally move up to where it wants to sit, under or around your cervix, rather than beside it.

When it comes time to remove your cup, again make sure your hands are clean. Feel around for the cup stem (if you left it intact), give it a gentle tug to pull the cup down lower. Don't use the stem to just tug the cup out, that will hurt like ^%&*!! Just pull it down until you can reach the cup body. If you can't reach the stem, try bearing down, like you're trying to do a poo - the cup will move downward. Now, grab hold of the bowl of the cup and squeeze it gently to break the seal. You may find it useful to refold the cup a little at this point. Now, holding the cup body, gently remove it one side at a time(it's nicer than all at once).

Rinse and repeat.

All cups come with an instructions (Fleurcup has them as a download) to help you with insertion, removal and cleaning. Make sure you read this.

 There are excellent tutorialvideos on youtube if you need help.

 There is a learning curve involved, just like with any new device, so don't get discouraged if you can't get it in, form a seal or remove it easily the first time you use it. You may get it first time, or it may take you a little longer,but don't worry, that's normal. You should really give yourself about 3 months with any new cup before giving up on it altogether as the wrong cup, as it can take some getting used to. I recommend doing a 'dry run' with your cup before your period, ortrying to insert and remove it a few times at home before venturing out into the world of public toilets, as removing it may be messy at first (dropping thecup on the floor in a mall toilet is not ideal for your composure), and it may take a little longer than you'd expect. You'll get faster and tidier with practice.


Will I be able to feel the cup when I'm wearing it?

If you've chosen the right size and shape you shouldn't be able to feel it unless you try to. Only the first couple of centimetres of the vagina are sensitive to stretching. Once past the muscles infront of the pubic bone the vagina opens out and has far fewer stretch receptors (nerves that tell you that there's outward pressure happening – yourbladder has lots of them). The widest part of the cup sits here, so you shouldn't really feel it any more than you would a tampon. Some shapes have larger bases than others, so if you do find you can feel it, you may need a narrower bodied cup. The stems on most cups can also be trimmed if you can feel them, just make sure you can still reach the cup and that you don't damage the bowl of the cup.

The first few times you use it there may be some discomfort as you get used to inserting and removing it, but this shouldn't continue once you're used to using it. Some water based lubricant can help while you learn.


Will anyone be able to tell I'm wearing it?

Only if they get right up close and very personal with that area. In fact, if the stem is right inside you (and it usually will be) there is no visible evidence that you're wearing it at all. You could do naked gymnastics* and noone could tell you were wearing a cup. The only reason anyone would know you are a cup user is because you smirk whenever a woman complains about tampons or pads, you never have a spare tampon (or always do, since you never use up your old stash), or because they're so great you'll be walking around telling everyone "I have a cup and it's awesome and you should get one too."

*EnvironMenstruals does not encourage naked gymnastics (much). You might hurt yourself, and that could be hard to explain.


Will it leak?

If it's the right cup for you and positioned properly, no, it shouldn't. There is no one cup fits all, so making sure you have the right size and shape for your body, and that it's sitting correctly and sealing well are important. If you have one that's too small it may not seal properly with your vagina walls, and if it's too large, it may not open properly, allowing fluid to escape past it.

 When it's full you may feel it begin to leak, just like a tampon would. If you find it is leaking before it's full, check that the holes are clear. If your period is especially 'clotty' this can sometimes block the holes and cause leaking, so when you empty the cup, make sure you squeeze water or air through the holes.


Isn't it unhealthy to keep the blood inside?

No. Menstrual blood itself is clean, so the blood itself is not a problem. Like with tampons, capturing the blood before it leaves the vagina does feed the microbes (years and bacteria) that live in the vagina. To be safe, and to reduce the amount of bacteria or yeast growing in the blood and on the cup, the cup should never be worn for longer than 8 hours at a time without thoroughly cleaning it. 


Can I get TSS from a menstrual cup?

Toxic Shock Syndrome (TSS) is a reaction to the presence of a certain bacterial toxin, so can occur from any kind of exposure to that toxin. Usually it gets into the blood stream through damaged tissue, such as from a scratch, cut, or insect bite.

While very few cases of TSS have ever been confirmed as connected to cup use, there is always a small risk so making sure you empty and sterilise your cup regularly (at least every 8-12 hours is regularly) to make it even harder for the little buggers to grow. This will also reduce staining, odour and the risk of yeast infections (because yeast and bacteria like the many of the same things).

Until very recently (the week before writing this) the understanding of how the medical grade materials of menstrual cups worked was that it created an environment on which the bacteria could not grow. This has been shown to untrue. The bacteria do grow, and grow in such a way that they are difficult to remove with rinsing alone (forming a 'biofilm'). Therefore, it is my recommendation (as a qualfied and experienced microbiologist) that you sterilise or thoroughly scrub your cup at least once every 8-12 hours, including boiling it for 60 seconds at least once per day. 

The risk is not high, but it exists, and with proper care (which means not just rinsing the cup in hot water as this does nothing to biofilms) it can be reduced significantly. I am very concerned about the number of manufacturers who are downplaying this, so you may find that my recommendations are more conservative than the instructions that come with your cup. What you choose to do is up to you, but I prefer to be cautious when it comes to issues of health.


Is the material safe?

All cups are made from medical grade materials. Specific allergies may be an issue however, that could limit the choice of cup you make. Most cups are silicone, so allergies are rare. The silicone used is the same as the kind theyuse for making heart valves and other medical devices, so it's very safe to use even right inside the body. The keeper is made from natural, organic rubber(vegan), so is not appropriate for anyone with (or who's partner has) a latex allergy. Silicone or TPE cups can be worn instead. The Meluna cups are all TPE, so can be worn by women with latex or silicone allergies.


What about endometriosis? I heard that cups can cause this.

There was a suggestion that this might happen, but there have been no reported cases of endometriosis caused by wearing a menstrual cup. This theory was based on the idea that endometriosis is caused by 'retrograde menstruation' (backflow) from the vagina into the body from the filliopian tubes. In order for a cup to cause endometriosis, the blood would have to flow not only back into the uterus, but right back through the fallopian tubes too. Because of the size of the holes that the blood would have to leak back through, this is no more likely with a cup than with a pad or even free bleeding.

Recent research suggests that retrograde menstruation is not the cause of Endometriosis at all, but that it probably comes from a combination of genetic, environmental or developmental factor.


Can I change it in a public toilet?

That's up to you, but the short answer is Yes. You can even wear the cup camping. Just be careful when removing it that you don't drop it (especially if using a port-a-loo!). If no running water is available, you can use a wet wipe (disposable or washable, like lunette wipes, Swipes, Pjur wipes, or my bamboo wipes), a tissue or toilet paper, wet or dry, or rinse it with bottled water. Some women even pee on their cups to rinse them (although I'm not convinced this is a good idea because the pH of urine is wrong for the vagina). Disabled toilet stalls with a sink inside are great for cup users, because you can wash it without having to leave the stall. Remember, as long as the cup is washed properly at least once every 8-12 hours, it's ok to just wipe it out or not rinse at all.


I hate my periods, can this really make me feel better about them?

Again, that's up to you, but many women who use menstrual cups report thatthey look forward to their 'cup time.' It's difficult to explain why, but cups make periods more fun. The fun colours available can help women feel good about wearing them, much like pretty underwear feels nice to wear, even though noone may see it. Many women have reported a sense of 'empowerment' from using a cup, but mostly, they just love not having that feeling of sitting on a wad of wet cotton, or pushing a piece of rough, sand papery rayon inside them.


Why does it have holes in it? Doesn't that cause leakage?

Strangely enough, the air holes are there to prevent leaks. The vagina is a closed 'pocket' so if you put the cup in, then fill it with fluid, the air that was in the cup needs to go somewhere. The holes let the air escape slowly without disturbing the cup. They also help the cup to seal and unseal. When you insert your cup you're pushing air into a smaller space than it was in. The holes allow the air to move out of that space, so there isn't any pressure from inside. When you remove the cup, because all of the displaced air has escaped through the holes, the air holes now allow air to move back into that space so a suction isn't formed. Without air holes the menstrual cup could act like the suction cups you use to hang things on walls, and you don't want that.

Leakage may occur if the holes are blocked, because the air building up needs to get out. This creates a bit of pressure, which causes the seal between the cup and the vagina walls to break, and a little 'cup fart' escapes. Sometimes the air takes some blood with it as it leaves, or even disturbs the cup's placement enough to cause leakage. To prevent this, make sure the holes are clean before your reinsert it.


Can I wear my cup overnight?

Yes. As long as your cup is large enough for your night time needs, it's safe to wear over night. You might find it very useful for clubbing for this reason, just rinse it before you go out and when you wake up.


Can I wear it during sex?

No. Because of where they sit, they're not a designed to wear during penetrative sex (and the stem!!), but can be worn for anything else you feel comfortable with. However, there are the options of using disposable soft tampons or there is a disposable cup (the Instead softcup) that is worn in a similar way to a cervical cap/diaphragm, that can be worn for mess free period sex.

Soft tampons and the Instead Softcups are not contraceptive devices and will not protect you from STIs so you should always always wear a condom.


Can I use it with my IUD?

Most cup manufacturers say that their cup is safe with an IUD. Just be extra careful when you're removing it that you don't catch the strings, and if you feel a bit more suction on your cervix have a another go at breaking the seal.

Because of the increased risk of infection or rejection early on, it's probably best not to use your cup for a couple of months after first getting your IUD. Ask you doctor if you're unsure.