Menstrual cup

From Free net encyclopedia

Image:Disposable menstrual diaphragm.png

A menstrual cup is a type of cup or barrier worn by a woman inside her vagina during menstruation to collect menstrual fluid. Unlike tampons, which are also worn internally during menstruation, the menstrual cup does not absorb the menstrual fluid. The fluid is contained within the cup until the woman goes to the toilet, removes the cup, and pours the contents into the lavatory.

There are two main kinds of menstrual cup currently available to buy in countries like the USA, Canada and UK (or over the internet). The most common kind is a bell-shaped cup made of rubber (latex) or silicone. It is reusable and designed to last for about 10 years, with proper care. Brand names of this type of cup include The Keeper, The DivaCup, Lunette and The Mooncup. The second kind of menstrual cup is currently only manufactured by one company and is called Instead. It resembles the contraceptive diaphragm (although it is not a contraceptive device) and is disposable, designed for one use only.

Menstrual cups are not commonly used; the vast majority of women in Western countries use disposable tampons or disposable sanitary napkins (UK: towels). A number of different companies have attempted to promote the use of menstrual cups during the 20th century; many of these products were withdrawn when they failed to gain widespread popularity. There are currently a growing number of women who are looking for alternatives to brand-name tampons and disposable sanitary napkins (for health, ecological, economic or practical reasons). Other popular alternatives to these products include: ecologically friendly, non-bleached (and often non-GM cotton) or organic tampons; washable cloth sanitary napkins; natural sponges; and menstrual cups.

1 Usage
2 Insertion and virginity
3 Safety
4 Comparisons with tampons and sanitary napkins
5 Insertion, removal and cleaning
- 5.1 Bell-shaped cups
- 5.2 Diaphragm-style cups
6 See also
7 External links

[edit]

Usage

Image:Uterus and vagina with captions.png

Menstrual cups are worn inside the vagina. They are not porous, absorbent or fibrous, so the cup will not scratch or dry the vaginal walls, disrupt the vagina's natural environment, become difficult to remove if worn during the lightest part of a woman's period or leave fibers behind. (This is dependent on the menstrual cup's material as well. Cups made of latex rubber have some small degree of risk that bacteria will embed itself in the cup surface. This is not true for silicone menstrual cups) Nor have they been linked to toxic shock syndrome (see below). All of the above are problems associated with using tampons. Menstrual cups should also help to prevent problems caused by wearing sanitary napkins: outbreaks of vaginal candidiasis (due to the warm, damp environment a sanitary napkin provides); and outbreaks of cystitis (which occur when feces on the napkin transfer E. coli to the urethra or vagina). Menstrual cups can be worn at any time of the month; women can practice inserting and removing one when they are not menstruating, and they can be worn in anticipation of a period to avoid being "caught out" while away from home. A bell-shaped cup can also "hurry on" a woman's period by one or two days, because of the mild suction that it creates. Some women have also reported shorter periods from this mild suction.

Menstrual cups also require changing (or emptying) less frequently than tampons and sanitary napkins. The cups are designed to hold 30 mL (1 ounce) of fluid, which is a third of the entire volume of blood lost in an average woman's period. They can be left in for up to 12 hours before emptying, so it should be possible for most women to empty the cup only two or three times a day; in this way they may avoid having to change or empty it in a public bathroom even if they work full time.

The two different kinds of cups are worn in different positions in the vagina. A diagram of the proper position for a tampon is also included for comparison.

**click on the images to enlarge** - *diagram with labels*
Bell-shaped cup	Diaphragm-style cup	Tampon
Image:Menstrual cup inserted.png	Image:Disposable menstrual diaphragm inserted.png	Image:Tampon inserted.png
The bell-shaped cup is worn low in the vagina. It may work its way higher during the day, which is perfectly natural, but it is not designed to be placed over the cervix. Every bell-shaped cup has a tab at the bottom to make it easier to remove.	Instead is inserted and worn in the same way as a contraceptive diaphragm. It sits over the cervix, and is kept in position by pressure from the pubic bone. To remove, hook a finger over the rim and pull it down past the pubic bone.	A tampon should be inserted up next to the cervix; this is the most comfortable position as it leaves plenty of room for the tampon to expand both widthwise and lengthwise as it absorbs the flow. A tampon has a string stitched through it which hangs clear of the body for ease of removal.

[edit]

Insertion and virginity

Inserting menstrual cups will take some practice, especially if the woman is not already used to using tampons, or is a virgin. For further details on how to insert the different kinds of cups, see below.

Menstrual cups (like tampons) can be used by virgins even from a girl's very first period. The more familiar a woman or girl is with her vagina, the easier using internal products will be. A good way for a girl to do this is to look at diagrams and descriptions of female genitalia and reproductive organs, and to become comfortable with her own body, perhaps using a hand-mirror.

Some (but not all) women are born with a hymen, a thin layer of skin over or around the vaginal entrance (it is perforated to allow menstrual blood out). If the hymen has not already been torn or stretched through exercise or sexual activity, it will be necessary to do so when inserting a menstrual cup for the first time. This may be a little painful, but it is only necessary to do this once. If a woman, for religious or cultural reasons, does not want to interfere with her hymen (if she has one) then neither tampons nor menstrual cups are likely to be appropriate.

If the vagina is dry, it may be difficult to insert a menstrual cup. Try dampening the cup with water. If this is not sufficient, try using a small amount of a lubricant that is suitable both for internal use and the material of the cup (i.e., do not use Vaseline; try a water-based personal or surgical lubricant such as K-Y® jelly instead). The lubricant should be applied to the entrance of the vagina, rather than the cup itself. If too much is used, it may interfere with the ability of the cup to form a seal with the vaginal walls, which is necessary to avoid leaks.

All women who are trying a menstrual cup for the first time should remember to relax and take their time. It is not important to get it right the first time, especially if they are practicing before their period, rather than during.

[edit]

Safety

With proper care, all kinds of menstrual cups are sanitary and safer to use than tampons. They are regulated by the FDA in the United States, and have been used by a number of women for decades. No reported cases of toxic shock syndrome have been attributed to the use of menstrual cups, nor have any other health risks, unlike some other options. It is important to note that the lack of medical studies for menstrual cups and the fact that they have only been used by a small percentage of women means that it cannot be assumed that menstrual cups never cause or aggravate medical conditions, however this is true for all menstrual products.

Since inserting and removing the cups requires that a woman pushes her fingers into her vagina, she must wash her hands with soap and hot water both before and after inserting or removing a menstrual cup. This is true of any internal product (tampons, sponges, contraceptive diaphragm, etc.).

Reusable menstrual cups come with instructions on the proper method of cleaning them each time they are emptied and in between periods. If these are followed, the cups are perfectly safe to reuse for many years, and will not develop an odor. In general, they should only be washed with soap and water at the end of the woman's cycle before putting it away for next month. When removing it before reinserting it, the cup may be rinsed with water, wiped down with a paper towel, or simply reinserted. It is not necessary to rinse it every time before reinsertion.

Cups made from silicone can be sterilized by placing them in boiling water for 5 minutes. Women who are prone to vaginal candidiasis may find this especially useful as the cup may reinfect them if it is only washed in soap and water.

It is worth noting that although tampons (and increasingly sanitary napkins) may come individually wrapped, they are not sterilized; they are merely bleached white. This bleaching is what brought about concerns regarding dioxin in tampons. Commercial sanitary products do not require bleaching, and this only adds to environmental and health problems.

[edit]

Comparisons with tampons and sanitary napkins

[edit]

Common

Advantages

like tampons, they can be worn during sports such as swimming
some women who use sanitary towels and menstrual cups report shorter and less painful periods than when they use tampons
they can be worn for as long as twelve hours at a time before emptying (the maximum time manufacturers usually recommend tampons and sanitary napkins be worn is eight hours)
they do not dry or scratch the vaginal walls or leave fibers behind (as tampons may)
they do not interfere with the vagina's self-cleaning ability (as tampons do)
they have never been linked to toxic shock syndrome (see above)
they will not cause cystitis by transferring E. coli from the anus to the urethra or vagina (as sanitary napkins may)
they will not cause the warm, damp conditions in which candidiasis flourishes (as sanitary napkins do)
unlike tampons, they can be inserted at any time of the month (useful for practicing) and can be inserted when a woman is expecting her period rather than having to wait for it to begin
they have never contained harmful substances such as dioxin, bleach and other chemicals linked to bleaching of commercial tampons

Disdvantages

like tampons, they are worn internally, something with which some women are not comfortable
removal as well as insertion may take some practice, and will be messy if the wrong technique is used
requires access to soap and running water for washing hands before and after removal and insertion

[edit]

Bell-shaped cup

Advantages

they are safer than a tampon, they catch rather than absorb, leaving the vagina's naturally moist environment intact
as there is no waste to dispose of other than the menstrual blood itself, they are ideal for using in situations (like hiking, etc) when a woman would otherwise have to bury her used menstrual products, or carry them with her for the duration of her journey
one reusable cup costs about the same as six-months' worth of tampons and sanitary napkins, but lasts for about 10 years - preventing the disposal of hundreds of menstrual products
since the cup only needs replacing once every 10 years, it is useful for women living or travelling in countries where tampons and sanitary napkins are hard to find or expensive
the manufacturing process may also be less harmful to the environment (no bleaches needed, no use of wood-pulp, for example)
they cause none of the waste of disposable products (compare applicator tampons: a box, individual wrappers, the tampons each with a disposable applicator made of cardboard or plastic, multiply by 10 years)
they do not need woman to hunt around for a bin to dispose of them as with tampons and sanitary napkins (these should NOT be flushed)
they require little room in luggage even when packing for a trip lasting many months
women who have heavy periods can use menstrual cups as an accurate way to measure how much blood they lose each month
they allow women to closely view how heavy their flow is - in short, a learning experience

Disdvantages

like tampons, they usually need be removed before penis/vagina or dildo/vagina intercourse
may not work for all women since everyone is shaped differently
the cup is partly held in position by the muscles in the vagina; these may need to be strengthened if the cup has a tendency to slip too low
they may be pushed slightly out of position (and leak unless repositioned) by an orgasm, a full bladder, a full rectum, or by defecating
they may have to be purchased online, as they are not as easy to find as commercial tampons and commercial sanitary napkins are in the western world
they require a higher initial investment than commercial/organic tampons and commercial/organic sanitary towels; however, the long-term savings are considerable. Moreover, many manufacturers, such as Keeper and DivaCup, offer a money back guarantee.
they require some care (washing and correct storage) while commercial/organic tampons and commercial/organic sanitary napkins can simply be disposed with after use in the bin
they may leak if not correctly inserted

[edit]

Diaphragm-style cup

Advantages

unlike tampons, they can be worn during sexual intercourse (though they are not a contraceptive device - diaphragms can also be used as [re-usable] menstrual cups)

Disdvantages

they cause more non-biodegradable waste than tampons or sanitary towels
they can be costly (although can be reused a few times)
environmental issue due to waste and materials used
like tampons and sanitary napkins they have to be disposed of correctly in a bin
they can be more difficult to insert correctly than bell-shaped cups

[edit]

Insertion, removal and cleaning

[edit]

Bell-shaped cups

The different brands of bell-shaped cups all vary slightly in their design and size. The most significant difference is between The Keeper which is made of latex rubber and The DivaCup and The Mooncup which are both made of medical grade silicone. Women with an allergy or sensitivity to latex should obviously not use The Keeper. Another difference is that The Keeper comes with a very long tab allowing you to customize it for a higher or lower placement. If the tab length creates any discomfort it can be trimmed, as recommended by the manufacturer.

Depending on the brand, this style of cup is sold in two sizes, one designed for women who have never given birth, the other for women who have given birth (through the vagina). The difference in size is slight (the larger cups are about 1/8th inch or 3 mm wider in diameter) but it is important to choose the correct size for the most comfortable fit.

Image:Menstrual cup folded.png

These cups are about 1.5 inches (3.8 cm) in diameter, and up to 2 inches long (from the rim to the base, not including the tab). To insert one into the vagina, it is squeezed and rolled up to make the slimmest shape possible. It should not be much wider than a super-absorbency tampon, so women who are accustomed to inserting tampons should not find this too difficult.

To insert a cup for the first time, a woman should choose a time and place where she will not be disturbed and will be able to relax. Remember that since menstrual cups are not absorbent they can be inserted at any time in the menstrual cycle, which is ideal for women who wish to practice before using it for the first time during their period. They should start by washing the cup and their hands with water and soap suitable for the cup (the latex cup needs to be treated more carefully in this respect in order to preserve the rubber for as many years as possible). Sit on the toilet, squat or stand in a comfortable position. Fold the cup in on itself, as in the diagram, until it is as slim as possible. Hold on to it with a finger and thumb as low down the cup as possible while keeping it rolled up. With the other hand, part the labia, find the entrance to the vagina, and guide the cup up and backwards. Remember that the vagina is tilted backwards, so it might help to imagine aiming for the small of the back. To ensure that the cup unfurls correctly (so the entire rim is making contact with the vaginal walls), gently rotate the cup by twisting the tab. To check that it has fully opened, slide a finger up next to the cup and feel all the way around it. The cup should be seated low in the vagina, but not so low that the tab is uncomfortable. It may work its way higher in the vagina during the day; this is perfectly natural. If a woman is not confident that she has positioned it properly, she can wear sanitary napkins in addition to the cup, until she has perfected the technique.

Since these cups sit low in the vagina, it is not possible to have vaginal sex with one inserted. There is no reason why a woman cannot have an orgasm while wearing a cup; however, it would be wise to check that the cup is still correctly positioned after orgasm. As can be seen in the diagram of a menstrual cup in the vagina shown above, both the bladder and rectum are close to the part of the vagina the cup should sit in. It is possible for a full bladder or rectum to push against the cup and shift it out of its proper position; if a woman needs to relieve herself while wearing the cup, she should do so rather than waiting until later. The muscles involved in defecating are also capable of disturbing the cup somewhat. She should check that the cup is still properly positioned after defecation, especially if she was constipated or had to strain (remembering to wash her hands first).

The cup is held in position by the seal formed with the walls of the vagina, and by pressure from the muscles in the vagina. If the cup seems to slip down, check that it was inserted correctly and that it is forming a seal. If this is not the problem then the user might need to improve the strength of her vaginal muscles through exercises such as Kegels.

The seal that holds the cup in place and prevents leaks may make the cup painful to remove if using the wrong technique. Most cups have pin-sized holes under the rim to make it easier to break the seal. If simply tugging on the tab is not sufficient, then slip one finger up the side of the cup and break the seal that way. If the woman cannot reach the tab when she reaches into her vagina there is no need to panic! She can try squatting (to shorten the vagina) and pushing the cup down with her internal muscles. Grasp the bottom of the cup and pull it gently to remove, remembering to keep it as upright as possible to avoid spilling the contents.

This type of cup is reusable. First, tip the contents into the lavatory. If there is no access to soap and clean water to wash the cup, then wiping it with dampened or dry toilet paper will be enough, but it should be properly washed at the next opportunity. Ideally, the cup should be washed with hot water and soap each time it is emptied. The cups made from silicone can be sterilised between periods in boiling water, but this would damage the rubber of the latex cups. See the manufacturer's instructions for more details. The cup should not smell. If it does develop an odor, this can be remedied by soaking it in vinegar after each period, or storing it in bicarbonate of soda between periods. Menstrual cups, when used properly, are perfectly sanitary (see also safety, above).

[edit]

Diaphragm-style cups

Instead has a diameter of approximately 3 inches (7.5 cm). It has a sprung outer ring, so that it can be squeezed into a slim shape for ease of insertion. It springs back into its correct form once it is inside the vagina.

To insert an Instead cup, first the woman should wash her hands with soap and hot water. She should choose somewhere she feels relaxed and will not be disturbed. Then she should sit on the toilet, squat, or stand in any position she finds comfortable. Next, she should take an Instead cup out of its wrapper, squeeze it into a slim shape, spread her labia and locate the entrance to her vagina with one hand, and gently insert the cup into her vagina with the other. Remember that the vagina is tilted backwards, so it might help to imagine aiming for the small of the back. Instead will spring open when released. Then the woman should push it up her vagina, until she can hook it in position over the pubic bone (this is where it may help to squat, as it shortens the vagina). Finally, she should wash her hands again.

Instead can be left in place for several hours. If a woman is not confident that she has positioned it properly, she can wear sanitary napkins in addition to the cup until perfecting the technique.

Since Instead is positioned high in the vagina, it should be possible to have vaginal sexual intercourse with it in place. But, although it looks like a contraceptive diaphragm, Instead is not a contraceptive device and should not be used as such.

To remove Instead, a woman has to reach up into her vagina (remembering to wash her hands before she begins) and use a finger to unhook it from behind the pubic bone. Remembering that it will be full of blood and to avoid messy spills, she should try to keep it as upright as possible. It is a good idea to practice this at home the first few times, rather than doing it in a public toilet. Once she has successfully removed Instead, she should tip the contents into the lavatory, wrap the cup in tissue and dispose of it in the trashcan or bin provided for sanitary waste. If one is not available, she must wrap it well and take it away with her. (It is important not to flush Instead down the toilet; it will cause a major blockage in the plumbing.) If necessary, she should insert another Instead cup, then wash her hands.

A small percentage of women will be unable to properly insert and use Instead due to the shape or size of their vaginal tracts; however, because the vagina is shaped by elastic (flexible) tissue, this problem is fairly uncommon.

[edit]