Menstrual Cups: The Definitive Guide

When you talk to a menstrual cup user about their experiences, they’re usually more than excited to tell you all about it. As a cup convert for more than 10 years, I’m no different. I love to tell everyone and anyone (friends, coworkers, that person behind me in the checkout line at Target) about the virtues of menstrual cups. Because I’m so frickin’ over the moon about menstrual cups (and alternative menstrual products in general), I’ve decided to compile this guide.

A Brief History of the Menstrual Cup

Today, a quick search for menstrual cups on Amazon yields a dizzying 999 results. You can even find Diva Cups and Intimina’s Lily Cup in your local pharmacy. Tampax is now in the menstrual cup game. From high-quality cups made the United States and Europe to imported knock-offs, the cup market has exploded.

In 2007, when I first heard about menstrual cups, there were three cups that were readily available in the United States. The first was The Keeper. Easily the oldest reusable menstrual on the market, The Keeper has been in production since 1987 and is still being produced today. Unlike modern menstrual cups made of silicone, The Keeper is made of latex. In 2006, The Keeper, Inc. started production of the Moon Cup, a silicone version of the original Keeper. The third cup, made available in the mid-2000s, and my cup of choice for many years, is the Diva Cup.

The Diva Cup is largely responsible for disrupting the menstrual product industry. Before the Diva Cup, menstrual cups were strictly the stuff of underground women’s groups and mail-order catalogs. When they came to market in 2001, Diva International got their product into national chain stores on terra firma, changing the cup industry forever.

Why Should You Switch to a Menstrual Cup?

For the cost savings: The upfront cost of a cup is higher than disposables. But you can recoup that cost in just a few months. Cups cost $15-$40 and will last for many years. I have my original Diva cup from 12 years ago and I still use it. The average person shouldn’t quite expect 12 years of use; I have three cups that I rotate and I take good care of them. But 10 years is a perfectly reasonable lifetime for a cup. Let’s compare the cost of cups versus disposables over a ten year period:

So for disposables: Let’s assume you’re going through half a box of tampons and half a pack of pads or liners per month. That’s about $7/ month.

$7 * 12 months * 10 years = $600

For cups: We’ll assume your cup costs $30 and lasts for 10 years. You may want to use a pad or liner a couple of times per cycle as a backup just in case. A quarter of a pack of pads is about $1.75.

$1.75 * 12 months * 10 years + 30 = $240

For the environmental impact: Tampons are made of cotton, a water hog of a crop. And of course, the plastic applicator and plastic-backed pads are filling up landfills and polluting waterways. Even if you’re not interested in a menstrual cup for the savings, you should consider them to help you reduce waste.

Anatomy of a Menstrual Cup

Here are the parts of a menstrual cup and what they do:

  • The Rim is the usually the widest point of the cup. It has a thick ring around it to keep the cup anchored in the vagina.
  • Air Holes are found right under the rim. These holes help you break the water-tight seal between the cup and the vaginal wall during removal. These are easily clogged with blood so take care when washing to keep them clear.
  • The Cup is the main body that holds menstrual fluid. It catches your period blood as it exits your uterus through your cervix.
  • Grip Lines allow you to grasp the menstrual cup to remove it.
  • The Stem sits at the opening of the vagina when the cup is inserted. Pull on it to remove the cup. Most stems can be cut off if you find them uncomfortable; you’ll still have the cup’s grip lines to hold for removal.

Choosing the Right Cup for You

Softness/ Density

Most menstrual cups are made of lovely body-safe silicone. Silicone comes in different densities that affect how soft a cup feels. When choosing the right cup, you need to consider the softness of a particular cup and whether it matches your body’s needs.

Firmness is a critical factor in how a cup will fit. Those with strong vaginal muscles might need a cup that is firm enough to push back against the vagina in order to form a seal. A cup that’s too soft for a vagina with strong muscles may fold or waver under the vagina’s pressure, compromising the cup’s leak-proof seal with the vaginal wall. Softer cups are more comfortable to wear because they don’t push against the bladder or urethra but they may not pop open on their own after insertion.

If you’re athletic or know you have a strong pelvic floor, choose a firm cup. Young women, women who have never given birth, and women who practice kegel exercises regularly have stronger pelvic floors.

If you have a sensitive bladder or a weak pelvic floor, opt for a softer cup. You can tell you have a weak bladder if you tend to pee a bit when you sneeze or jump.

Sizing

Many cups come in two sizes; one for those who have never given birth, and a slightly larger one for those who have. Even if you gave birth via c-section, your vaginal muscles likely loosened during your pregnancy. While the difference between small and large sizes is just a couple of millimeters, choosing the right size can be the difference between a perfect fit and disaster.

There are also some “teen” cups on the market for petite or younger cup users.

Every manufacturer offers a unique product so follow their guidance when choosing your cup. If you have a question about a particular cup from a major manufacturer, visit their website and contact them. All of the major companies have excellent customer service and consumer education.

Length (Measuring Your Cervix Height)

You’re going to have to get acquainted with your cervix in order to find the best menstrual cup for you. That’s because there’s some variation in the length of menstrual cups and there’s also variation in the height of a person’s cervix. The cervix moves up and down in the vagina depending on the time in your cycle and whether you’re aroused. Typically, your cervix will sit slightly lower when you’re getting your period. When you’re aroused, your cervix moves high up in the vagina to accommodate penetration. At other times, it sits somewhere in the middle.

For a good fit, match your cup to your average cervix height during your period. A cervix that sits high in the vagina needs a longer cup and a cervix that sits low needs a shorter cup.

To find your cervix: insert your clean index finger inside your vagina. Go as far as you can reach. At the “end” of your vagina is your cervix. It acts as a barrier between your vagina and your uterus. Your cervix will feel like a round, fleshy nub with an indent in the middle. That indent you feel is where your cervix dilates during childbirth.

To measure your cervix height: measurements should be taken during your period to get the most accurate measurement for a cup. Again, insert your clean index finger inside your vagina. If you can just barely feel your cervix with your entire finger inserted or you cannot reach it at all, you have a high cervix height. If you can touch your cervix with your finger inserted two knuckles deep, you have an average cervix height. If you can fit less than two knuckles before poking your cervix, you have a low cervix height.

Capacity

The average person’s flow is 30-60ml or less total per cycle. A heavy period may exceed 80ml. Your menstrual cup holds about 25ml, depending on the cup you choose. The smallest of cups will hold about a touch more than half of that. If you find yourself changing your tampon or pad every couple of hours, choose a cup with a 30ml capacity at a minimum. If you typically change your feminine products less often because your flow is light, you can safely go with a lower capacity cup.

Recommended Cups

All of the following cups are medical-grade silicone and are recommended by this blog as of the publishing of the post. They’re all are good quality cups with plenty of positive reviews. While there are less expensive cups on the market than these, I don’t recommend cheaping-out and getting the least expensive cup you can find. Less expensive cups like those found on eBay and Aliexpress may not be made of genuine silicone and are not FDA-regulated. While the following cups are more expensive ($25-$40), all of the following brands have excellent customer service that will assist you with any questions or concerns. You can’t get that kind of service from a cheap cup seller.

Cup NameFirmnessSize OptionsSuitable for a high, average, or low cervix?CapacityCostDiva CupModerate3; Teen/ Model 0, Model 1, Model 2

Best for a high cervix

or average with

the stem removed17ml (Teen/ 0)/ 30ml (1 and 2)$34.99Saalt CupFirm2; Small and RegularSuitable for average to low cervixes25ml (Small)/ 30ml (Regular)$26.99LunetteModerate/ Firm2; Model 1 and Model 2Suitable for average and low cervixes25ml (1)/ 30ml (2)$39.99Intimina Lily CupModerate2; Size A and Size BBest for a high cervix (it’s the longest branded cup on the market)28ml (A), 32ml (B)$29.99Super JennieVery Soft2; Small and Large Suitable for average and low cervixes32ml (Small)/ 42ml (large)$37.95Sckoon CupSoft2; Size 1 and Size 2Suitable for average cervixes23 ml (1)/ 30ml (2)$27.99Lena CupFirm (Regular Models)/

Soft (Sensitive models)4; Small, Large, Small Sensitive, Large SensitiveSuitable for average cervixes or low cervixes with the stem removed21ml (Small and Small Sensitive)/ 30ml (Large and Large Sensitive)$24.95FemmycycleSoft3; Petite, Regular, Low-CervixModels available for high and low cervixes.

Note that the unique ring stem should not be shortened17.5ml (Petite)/ 30ml (Reg. and Low-Cervix)$32.50Fan Factory Fun CupVery Soft2; Size A and Size BSuitable for average to high cervixes. Note that stem cannot be shortened20ml (A)/ 30ml (B)$38.99

What If the Cup I Bought Doesn’t Work for Me?

Please consider selling or trading your cup to divert your cup from the landfill. You could trade cups with a friend or sell it here. A properly disinfected silicone cup is perfectly safe to use secondhand.

I also recommend buying your cup from a retailer with a generous return policy. If you’re new to this, you might try several cups before you find your glass slipper and you’re going to want to return them if they aren’t for you. Otherwise, you’ll end up with a pile of unloved cups in the bottom of a drawer like The Island of Misfit Toys. Before you return a cup, wash and boil it to disinfect for the sake of anyone who has to handle your return (or the nightmare scenario of a company reselling your returned cup as “new”).

So many people try one cup, decide that particular cup doesn’t work for them, and then they write-off cups altogether. If your first cup doesn’t work, assess the problem. Is your cup too long for your cervix height? Are you leaking because your cup is too soft for your vaginal muscles? Then, consult the comparison chart above for better options for your body. Keep trying; there’s a “Goldilocks cup” for almost everyone.

Folding, Insertion, Use, and Removal

Folding

A menstrual cup has to be folded in order to insert it into the vagina. Below are three fold methods to get you started. Try all of them and find the one that is easiest for you.

Menstrual Cup Origami

The C Fold– Flatten the cup and fold it in half so that the rim makes a “c” shape.

 

The Punch-Down Fold– Punch down part of the rim with your finger while pushing the rest of the cup in on itself, creating a 45-degree angle for insertion. This is my favorite fold because it’s the most compact.

 

The 7 Fold– Flatten the cup and fold down one side of the rim. The rim should form a number “7.”

 

Once you’ve folded the cup, apply a pea-size dab of lube to the top and spread it over the rim of the cup (but only the rim). Don’t let go of the fold while you apply the lube. Sliquid Sassy is my lube of choice for this task. It’s a thicker water-based lube that won’t run down the side of the cup after it’s applied. Of course, lube isn’t required for insertion but it makes it much more comfortable.

Insertion

You can insert the cup while you are laying down your legs open, squatting on the toilet or standing with a leg up in the shower. If you’ve used tampons, start with the same position that you prefer to insert those.

  • Part your labia and insert the rim of the folded cup into your vagina. Some discomfort is not uncommon. Aiming toward your tailbone, keep the cup folded in your grasp while you push the cup all of the way into your vagina.
  • Stop pushing when the stem of the cup is just inside of the vagina. Remove your fingers.
  • You will probably feel the cup pop open. If it does not open on its own, insert your finger between the cup your vaginal wall. Run your finger along the rim of the cup, making a circle around the circumference. This should open the cup if it is properly inserted. If not, remove and start again. If the cup won’t open after multiple attempts, you may want to try a firmer cup.
  • When the cup opens, grasp cup’s grip lines and gently rotate the cup in a circle. This motion will form a seal between the cup and your vagina, making your cup leak-proof. If you’re unable to twist the cup, you can try pulling it down slightly, then pushing it back up. This up and down motion can help form a seal as well. A sealed cup will resist removal when pulled gently.

Use

When your flow is light or moderate, you can leave your cup in up to twelve hours. When your flow is heavier, you’ll need to empty your cup more often. The exact timing will depend on your flow and the capacity of your cup. The only way to know exactly how often you will need to empty your cup is through your own experience.

While you’re still learning about your body and your cup, wear a pantiliner or pad for backup. In fact, I always wear a cloth pantiliner with my cup. Most of the time I don’t actually need the pantiliner, but it gives me peace of mind. Every menstruating person has felt the anxiety of worrying about leaks and it’s just not worth the anguish. Do whatever you have to do to feel secure.

You’ll be acutely aware of the cup inside you when you first start to use them. This isn’t a tampon; a cup can make its presence known. It will push may against your bladder. But if you’ve chosen the right cup for your body and properly inserted it, you should quickly stop feeling the cup. It’s not quite a “set it and forget it” situation but it’s close.

Removal

While sitting on the toilet with your legs open: insert two clean fingers between your vagina and your cup. Gently pinch the cup, collasping it toward your tailbone. This will break the seal and allow you to remove the cup more easily. Grasp the stem or grip rings of your cup and gently pull it out. Empty your cup.

If you cannot reach your cup immediately, you can use your muscles to push it lower in the vagina. Relax, don’t panic; you will be able to get it out because there’s nowhere for it to get lost. Isolate your vaginal muscles and bear down like you’re giving birth to the cup. After a minute or so, try to remove your cup. It will be noticeably lower in your vagina.

Care and Cleaning

Every time you empty your cup, wash it with mild soap and water before you reinsert it. Pay special attention to the tiny holes around the rim. These holes allow the cup to unseal from the vaginal wall during removal. Unfortunately, they clog easily. When cleaning your cup, be sure to run water through them to keep them clear. Use a “soft” toothbrush to gently scrub your cup if necessary.

To deep clean and disinfect you your cup, you should boil it. To boil your cup: Heat a pot of water on high until it reaches a boil. Place your cup in the pot and leave to boil for 5 to 10 minutes. Repeat every 1-3 cycles or whenever you suspect you’ve had a yeast infection. Don’t let the pot boil dry!

You may find that your cup will become discolored over time. We talk a lot about silicone being non-porous, especially in the context of sex toys. The truth is, silicone is porous. The pores are too small to allow for growth of bacteria but silicone is, however, porous enough to be stained by blood. Some people recommend the removal of stains with a hydrogen peroxide soak. Some cup manufacturers suggest that a peroxide soak may reduce the long term life of your cup. There’s no consensus on this issue. From a scientific standpoint though, genuine silicone and 10% hydrogen peroxide (which is stronger than the 3% peroxide available in pharmacies) have an excellent compatibility rating, so there’s no real reason to believe that it would be damaging. So, if the staining really bothers you, soak your cup.

To soak your cup for stain removal: fill a wide-mouth mason jar with 3% hydrogen peroxide. Drop in your cup. Leave for 1-8 hours, checking every hour for satisfactory stain removal. Rinse and dry.

Cleaning your menstrual cup: boil to disinfect and soak in hydrogen peroxide to remove stains

FAQ

How do I empty my cup in public?

Don’t stress. Simply remove your cup and empty it in the toilet. Wipe the cup inside and out with toilet paper. Reinsert. If you want to rinse your cup in public, take a bottle of water with you and gently rinse it over the toilet. Rinsing isn’t necessary though; just wash your cup normally as soon as you get home.

I’m struggling to remove my menstrual cup. Sometimes I can’t quite reach it. What’s the deal?

You may be using a cup that’s too small for your cervix length. Consult the chart above for some options for people with a high cervix. In the meantime, to remove a cup you cannot reach: bear down and push your cup with your vaginal muscles. Push, take a break, and push again. Repeat until your cup is within reach. Remember that your cup cannot get “lost” because there’s nowhere for it to go beyond your cervix.

My cup won’t open. What am I doing wrong?

Insert your finger between your vagina and your cup. Run your finger around the rim in a circle. The cup should pop open. Alternatively, grasp the grip rings and try to turn your cup in a circle. If these methods fail, you probably need a firmer cup. Refer to the comparison chart above.

I’ve seen you write about the flame test for silicone sex toys. Does that apply to silicone menstrual cups too?

Yes! You can do the flame test to ensure that your cup is body-safe silicone. To flame test: using a long lit match, expose the material to the flame for 5-10 seconds. Genuine silicone should create gray ash or have a slight black burn mark. The ash should wipe away and the cup will be undamaged. Other materials such as TPE/ elastomer and latex are flammable and should burn/ deteriorate immediately.

Note that not all cups are advertised as silicone. A few are made of TPE or latex. Both of these materials are porous and cannot be fully disinfected.

My cup’s stem is poking me and I want to cut it off. Are there any precautions I should take?

Cut a bit at a time and test for comfort. It’s always easier to remove a cup with a stem, so keep that in mind when trimming your cup’s stem.

I’m leaking and I don’t know why. What could be causing this?

There are a few reasons why your cup might be leaking. Your cup may not be fully open. Follow the steps above to ensur that your cup opens after insertion. You may also need to empty your cup more often. While you can wear a cup safely for up to twelve hours, you will start to leak if your cup reaches capacity before that.

Do cups hurt?

They shouldn’t but they can be uncomfortable until you understand how your cup works. That discomfort usually comes from a cup pressing up against the bladder. A softer cup may be necessary to aliviate pressure. As you get to know your body and your cup, you’ll naturally learn how to avoid this discomfort. If you’re in pain, check with your doctor to see if an underlying condition such as vaginismus is the cause.

Can I have sex with a cup inserted?

A traditional cup sits too low in the vagina to allow for intercourse. Intimina’s Ziggy Cup is a reusable silicone cup that looks similar to a diaphragm and is designed to be used during vaginal intercourse.

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