A menstrual cup is a menstrual hygiene device which is inserted into the vagina during menstruation. Its purpose is to collect menstrual fluid (blood from the uterine lining mixed with other fluids). Menstrual cups are made of elastomers (silicone rubbers, latex rubbers, or thermoplastic rubbers). A properly fitting menstrual cup seals against the vaginal walls, so tilting and inverting the body will not cause it to leak. It is impermeable and collects menstrual fluid, unlike tampons and menstrual pads, which absorb it.Elizabeth Gunther Stewart, Paula Spencer: The V Book: A Doctor's Guide to Complete Vulvovaginal Health, Bantam Books, 2002, Seiten 96 und 97, .Leslie Garrett, Peter Greenberg: The Virtuous Consumer: Your Essential Shopping Guide for a Better, Kinder and Healthier World, New World Library, 2007, Seiten 17 bis 19, .
Menstrual cups are bell-shaped, often with a stem, and have walls more than thick. A related product is menstrual discs (sometimes also referred to as cups), which are wider with a flexible basin and sit higher in the body, in the vaginal fornix without blocking the vagina. Although they resemble contraceptive diaphragms, they are not birth control and do not prevent pregnancy.
Every 4–12 hours (depending on capacity and the amount of flow), the cup is emptied (usually removed, rinsed, and reinserted). After each period, the cup requires cleaning. One cup may be reusable for up to 10 years, making their long-term cost lower than that of disposable tampons or pads, though the initial cost is higher. As menstrual cups are reusable, they generate less solid waste than tampons and pads, both from the products themselves and from their packaging.
Reported leakage for menstrual cups is similar or rarer than for tampons and pads. It is possible to urinate, defecate, sleep, swim, do gymnastics, run, ride bicycles or riding animals, weightlift, and do heavy exercise while wearing a menstrual cup. However, incorrect placement or cup size can cause leakage. Most users initially find menstrual cups difficult, uncomfortable, and even painful to insert and remove. This generally gets better within 3–4 months of use; having friends who successfully use menstrual cups helps, but there is a shortage of research on factors that ease the learning curve. Menstrual cups are a safe alternative to other menstrual products; risk of toxic shock syndrome infection is similar or lower with menstrual cups than for pads or tampons. Text was copied from this source, which is available under a Creative Commons Attribution 4.0 International License
Terminology
The terminology used for menstrual cups is sometimes inconsistent. A distinction is usually made between menstrual cups and discs, although both are sometimes referred to as "cups", with terms used for discs such as "disc-shaped cup" or "cervical cup" as opposed to the bell-shaped "vaginal cup".
Menstrual cups are bell-shaped or V-shaped and sit in the vaginal canal, remaining in place through suction, which should be broken for removal. Users insert them after folding the rim using various techniques, and they expand within the vagina after insertion. They are available in many shapes and sizes to accommodate different cervical and vaginal anatomy, as well as different firmness levels. They sit lower in the vagina than discs.
Menstrual discs sit in the vaginal fornix and are placed behind the pubic bone. They have a flexible basin that collects blood by surrounding the cervix, and are wider and shallower than cups. They usually have a higher capacity than cups, and often allow for "auto-dumping" (hands-free emptying when the user bears down while urinating and/or defecating), although this does not work for all users. Users insert them after folding them in half lengthwise. Unlike menstrual cups, they do not create suction. As they do not obstruct the vaginal canal unlike cups, they can remain in place during penetrative sex.
In the 1800s, menstrual cups were called "'catamenial sacks", A 1867 patent describes a sack fitting partly or wholly inside the vagina, suspended from a ring around the cervix, but with the ring held up by a U-shaped wire, which is fastened to the sack at one end and to a belt at the other. Quote:"I construct my menstrual receiver by forming a cup-shaped ring, a, made of rubber, gum, gold, silver, or any suitable substance, which may be made round, or elliptical, or of any shape to fit the os uteri. Around the lower orifice of ring is attached a sack or bag, b, made of rubber or any suitable materials. The ring a rests-around the os uteri, and the bag b rests entirely in the vagina, or may be made of such length as to rest parily outside and partly inside. I insert a small sponge in bag b to absorb the menstrual flux." and were similar external catamenial sacks of "canoe-like form",(1865)(1899) which in turn were similar to catamenial sacks which were waterproof rubber undersheet supports for absorbent pads. These were made from india-rubber or gutta-percha, forms of latex.
Use Menstrual cups are favoured by backpackers and other travellers, as they are easy to pack and only one is needed.
Thorough washing of the cup and hands helps to avoid introducing new bacteria into the vagina, which may heighten the risk of UTIs and other infections. Disposable and reusable pads do not demand the same hand hygiene, though reusable pads also require access to water for washing out pads.
If the hands have come into contact with any chemical that directly trigger sensory receptors in the skin, such as menthol or capsaicin, all traces of the chemical should be removed before touching the mucous membranes.
A UN spec recommends that cups should not be shared; they should only ever be used by one person.
Insertion
The vagina is narrowest at the entrance and becomes wider and easier to stretch further in. Menstrual cups are folded or compressed to insert them, and then opened out once inside. The innermost portion of the cup typically goes into the vaginal fornix (the groove around the cervix). Menstrual cups cannot pass through the cervix into the uterus.
The muscles of the pelvic floor, which surround the vaginal entrance, are relaxed to let the cup pass. Involuntarily tensing the vaginal muscles can make it impossible for anything to enter the vagina without causing pain. Many initially find insertion difficult, uncomfortable, and even painful, but learn to do it within a few cycles. There is little publicly available research on learning to use menstrual cups which compares types of cup or instructions.
A bell-shaped cup is folded or pinched before being inserted into the vagina. There are various folding techniques for insertion; common folds include the "C" fold, the "7" fold, and the punch-down fold. Once inside, the cup will normally unfold automatically and seal against the vaginal wall. In some cases, the user may need to twist the cup or flex the vaginal muscles to ensure the cup is fully open.
In practice, the rim of a bell-shaped cup generally sits in the vaginal fornix, the ring-shaped hollow around the cervix. Some fornixes are much deeper than others. Those with deeper fornixes may use insertion techniques such as inserting the cup partway, opening it before the rim passes the cervix, and then pushing it up into place; or they may press the cup to one side and let it open slowly, the rim slipping over the cervix. If correctly sized and inserted, the cup should not leak or cause any discomfort. The stem should be completely inside the vagina. If it can't be positioned inside, the cup can be removed and the stem trimmed.
Menstrual discs are inserted differently than bell-shaped cups: by squeezing opposite sides of the rim together until they touch, sliding the inner end of the folded cup to the end of the vaginal canal, and tucking the outer end behind the pubic bone. They can be less bulky than a cup, and no bulkier than a tampon. Inserting a disc requires more knowledge of anatomy to get the disc under and around the cervix, not rucked up in front of it. Discs with non-circular rims are designed to be inserted with the widest, deepest part going in first. If they are inserted the wrong way around they may leak. If there are stems or other removal aids, they should be on the end inserted last.
If lubricant is used for insertion, it should be water-based, as silicone lubricant can be damaging to the silicone.
Wear
A bell-shaped cup may protrude far enough to be uncomfortable if it is too long. It may press too firmly against the bladder, causing discomfort, frequent urination, or difficulty urinating, if it is too firm, or the wrong shape. A bell-shaped cup may leak if it is not inserted correctly, and does not pop open completely and seal against the walls of the vagina. Some factors mentioned in association with leakage included menorrhagia, unusual anatomy of the uterus, need for a larger size of menstrual cup, and incorrect placement of the menstrual cup, or that it had filled to capacity. However, a proper seal may continue to contain fluid in the upper vagina even if the cup is full.
While many diagrams show bell-shaped menstrual cups very low in the vagina, with the vagina gaping open, in-vivo imaging shows that the cups sit high, with their rim around the cervix, and the vagina squishes shut below the cup, sealing it inside the body.
If a disc pops out at the outermost edge, either the innermost edge got caught on near side of the cervix rather than tucked into the fornix behind it, or it is too big, or the outermost edge hasn't been tucked behind the pubic bone firmly enough. In either any case it will leak. If it comes loose and starts to slide out when using the toilet, or leaks on exertion (when exercising, coughing, or sneezing), it is too large or too small. Some deliberately choose a disc which will leak when they deliberately bear down on it, but not at any other time.
Emptying
It is possible to deliberately empty a menstrual disc by muscular effort, without removing it (provided it is of a fairly soft material, and the right size). This is done in a suitable location, such as when sitting on a toilet, and is known as "auto-dumping". Bell-shaped cups must be removed to empty them.
The cup is emptied after 4–12 hours of use (or when it is full). Leaving the cup in for at least 3–4 hours allows the menstrual fluid to provide some lubrication.
If sewers are available, menstrual cups can be emptied into a flush toilet, or sink, bath, or shower drain, and the drain rinsed with water. They can also be emptied into a pit latrine.
When using a urine-diverting dry toilet, menstrual blood can be emptied into the part that receives the feces. If any menstrual blood falls into the funnel for urine, it can be rinsed away with water.WECF (2006). Ecological sanitation and hygienic considerations for women - Fact Sheet . Women in Europe for a Common Future, Netherlands and Germany
In the absence of other facilities, menstrual fluid can be emptied into a cathole. This is a single-use hole deep, more than from water (and frequented areas like trails or campsites), ideally dug in organic soil, in an area where the waste will break down fast. Water used to rinse the cup can also be disposed of in the cathole, which is then refilled and concealed.
Removal
Many initially find removal difficult, uncomfortable, and even painful, but learn to do it without problems within a few cycles.
The muscles of the pelvic floor are kept relaxed, to allow the cup to pass out through them. Techniques like squatting, putting a leg up on the toilet seat, spreading the knees, and bearing down on the cup as if giving birth are sometimes used to make removal easier. Because vaginal tenting can make the cup harder to remove, some manufacturers recommend waiting at least an hour after sex before removal.