Period cups can be pretty polarizing. It seems like people either evangelize about them from the rooftops, or they have a lot of questions and apprehension. For the uninitiated, period cups (also known as menstrual cups) are flexible bell-shaped devices that you insert into your vagina to catch your menstrual fluid, then can empty out however often is necessary based on the heaviness of your flow. Most brands claim you can wear a period cup for up to 12 consecutive hours safely. As such, they’ve been touted as eco-friendly and money-saving alternatives to tampons and pads.
It all sounds straightforward enough, but if you haven’t tried a period cup, shoving one up your vagina and trusting it to stay put, do what it’s supposed to do, and not make a mess on removal can be a lot to ask.
So, to answer all your burning questions regarding period cup use, SELF talked to three ob/gyns: Adeeti Gupta, M.D., founder of Walk In GYN Care and attending physician at Lenox Hill Hospital and Flushing Hospital in New York; Mary Jane Minkin, M.D., clinical professor of obstetrics, gynecology, and reproductive sciences at Yale University; and Sherry Ross, M.D., women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period (who, full disclosure, serves as an ob/gyn ambassador for the Lunette period cup). Here’s everything you need to know about period cups.
1. How do I pick the right period cup for me?
Size is the most important aspect of using a menstrual cup. “You’ll know if you have the right size for your body because it will feel snug, painless, and comfy when inserted,” Dr. Ross tells SELF.
Some brands, like Lena, have two sizes to choose from—a smaller one and a larger one—and they typically have sizing guides online. Other brands, like DivaCup, have more options, including one meant for total period beginners.
“The smaller sizes are ideal for teens, beginners, and those with strong vaginal muscles or a low-sitting cervix,” says Dr. Ross. “The larger sizes are typically designed for anyone who has a heavy flow or has ever delivered a baby vaginally.”
All that said, these are just guidelines. “It may be a trial thing, so don’t be afraid to change sizes if one doesn’t work out,” Dr. Gupta tells SELF.
2. OK, how do I put this thing in?
It might take a little practice, so you probably don’t want to try a period cup for the first time 10 minutes before you have to leave for work. “The insertion of a menstrual cup can definitely have a learning curve, but once you’ve mastered the technique, it’s fairly easy to do,” Dr. Ross says.
The cup is designed to open up inside your vagina and (painlessly) suction to your vaginal walls, which keeps it in place. It should sit below your cervix, the narrow neck-like passage below the uterus that blood flows through to get to your vagina.
That might sound wildly uncomfortable, but it shouldn’t be. As long as your period cup is in correctly, it should feel pretty comfortable, Dr. Minkin tells SELF. But if you want to be really sure it’s in there properly, you can go exploring. “The cup is supposed to cover the cervix, which feels sort of like the tip of your nose,” says Dr. Minkin. “If you feel something like that anywhere outside the cup, you probably have it in wrong.”
Your cup should come with its own set of instructions. Make sure to read those, but here’s the gist of insertion, according to Dr. Ross: After washing your hands, you can insert a period cup while sitting, standing, or squatting. To do that, you fold the cup in half and, with your legs spread, guide it rim-first into your vagina. Once the stem is about half an inch from the opening of your vagina, rotate the cup so it can open all the way up and lock into place.
You might also want to experiment with different folding methods until you find one that’s right for you. The half-fold (also known as the U-fold) is pretty standard, but it’s certainly not the only way. This primer at Put a Cup In It has a few ideas to get you started.
After you insert your period cup, you’ll want to get in the habit of checking if it’s secure. A good way to do this is to run a finger gently around the rim of the cup when it’s in your vagina to make sure there aren’t any gaps and it isn’t twisted up. If it’s suctioned properly, you should be able to feel smooth, clear margins all the way around, says Dr. Gupta. According to her, most people will be able to do this without pain or discomfort—you may want to cut your nails if necessary—but don’t force it if you’re having trouble.
As long as your period cup is in the right spot and you change it often enough, you’re well on your way to avoiding leaks. That leads us to our next question.
3. It’s leaking! Why is it leaking?!
If you don’t think you can blame the leakage on improper insertion or keeping the cup in for too long, it might be too small for your vagina, says Dr. Gupta. Try sizing up to see if that fixes the problem. (We really weren’t lying when we said the most important thing was size.)
You might also have an issue with leaking if you have really heavy periods. Everyone’s cycle is different, but according to Dr. Gupta, if you find yourself having to empty a full cup every two hours or so and sizing up doesn’t solve the problem, that’s a good sign that your period is heavier than average. In this case, Dr. Gupta suggests making an appointment with your ob/gyn to figure out why your period is so heavy, since that can be a sign of a health condition like polycystic ovary syndrome or uterine fibroids.
4. Why might I want to choose a menstrual cup over tampons or pads?
A lot of it is going to be personal preference, but people choose menstrual cups for a few main reasons.
Typically made of medical-grade silicone or latex rubber, they’re reusable and recyclable (just make sure to look into how to recycle yours properly depending on the material), so they’re an environment-friendly alternative and will save you money in the long run, says Dr. Ross. Forking out somewhere in the $ 20 to $ 40 range upfront might seem like a lot for single a period product, but many brands recommend replacing their cups every year or two. Translation: You’ll wind up spending less than you would regularly stocking up on tampons and pads.
Another reason people might gravitate toward cups is because they find them better than tampons or pads when it comes to overnight use and potential leakage, especially for heavier flows, says Dr. Ross. Others choose cups or tampons over pads to avoid constant friction from a pad against their vulva, which can cause irritation, Dr. Gupta says.
Then there’s the question of if using a period cup will reduce your risk of getting a bacterial infection that could cause toxic shock syndrome (TSS). Technically, sure, it’s possible, especially since one theory holds that TSS is more likely to happen when tampons dry out and slightly tear the vaginal tissue, giving bacteria an easier way in. Since menstrual cups aren’t absorbent, that could theoretically lower your risk. But your overall risk of getting TSS is so small that a fear of it shouldn’t be driving your menstrual product choices, says Dr. Minkin. Even when using tampons, your odds of getting TSS are already super low. Like, 30 reported U.S. cases of non-Streptococcal TSS (the kind most likely caused by tampons) in 2017 low, according to the most recent data from the Centers for Disease Control and Prevention (CDC).
5. Why am I having trouble inserting my period cup?
A few things might be going on. For one, you might still just be getting the hang of it. But if you’re pretty sure you’re doing everything correctly and are still having a hard time, Dr. Gupta says there’s a chance the cup you’re using is too big and you should try sizing down. You might also have an unrelated vaginal infection that’s causing pain or irritation, which could become worse while trying to insert or wear the cup.
No matter what’s causing the trouble, if it persists, it’s worth hitting up your ob/gyn. They can assess what might be going on or coach you through the proper insertion technique.
6. How do I stay sanitary?
Make sure you follow the instructions to keep your cup clean and sterilized, both during your period and between cycles.
During your period, you can rinse out your cup and wash it with soap each time you empty it. A lot of brands sell special soap if you’re into that, but they’re not required. Most soaps will do since cups are made out of non-porous materials and you’re rinsing the soap off anyway, says Dr. Gupta. Of course, there is a chance of residue if you don’t clean your cup thoroughly, and perfumed soaps with unknown ingredients can cause vaginal pH changes and make you prone to irritation or infections. So, if you want to bypass that chance altogether, rinsing it out with water and washing it later is totally fine, too, and better than leaving it in for too long, says Dr. Minkin.
You might also want to get in the habit of carrying cleansing wipes. Some are made specifically for menstrual cups; just check the ingredients to make sure they’re fragrance-free and alcohol-free, since those ingredients can be pretty annoying to your vagina, says Dr. Gupta. You could also just use some unscented baby wipes. Either way, this will make your life a lot easier if you find yourself needing to empty your cup in a public bathroom and don’t want to leave the stall to take care of it in the sink. Just make sure to wash it at your next available chance. Cleansing wipes are kind of like dry shampoo—great in a pinch, but not a replacement for washing your hair.
And of course, always, always wash your hands before touching your vagina or period cup. “If you are going to be traveling and will not have access to clean facilities, then maybe for that cycle, go with some other method,” says Gupta.
Between cycles, most brands recommend that you clean and disinfect your cup by boiling it in a pot on the stove.
7. Can I keep a period cup in while I’m having sex?
Because period cups sit low in the vaginal canal, both our experts and the major brands suggest removing yours before any sort of penetrative sex. The cup’s stem can accidentally cause pain to a penis or finger, and anything you insert, such as a vibrator or dildo, can push the cup in deeper, where it might get stuck on your cervix, says Dr. Gupta. But good news: Oral, anal, and external stimulation are all still on the table.
8. Can I use a period cup if I have an IUD?
Yep, totally safe! “You may want to ask your gynecologist to cut the IUD [strings] shorter so it won’t be accidentally pulled with removal of the cup,” adds Dr. Ross. Keep an eye on the string length throughout your period, too. Although your cervix’s position can fluctuate throughout your cycle and change the position of your IUD strings, if they seem to suddenly have gotten way longer and you’re dealing with symptoms like abnormally heavy bleeding, your IUD may have moved. Contact your ob/gyn.
9. I THINK IT’S STUCK. WHAT DO I DO?
Don’t panic! Your cup can’t actually get lost inside your vagina (thank you, cervix), you’re probably just having trouble removing it. The best technique for taking out your cup is pretty simple: You grip the cup, give it a gentle squeeze, and pull it out, says Dr. Gupta. If it doesn’t come out easily, that probably means the seal isn’t broken, which means it’s basically suctioned on there pretty good. In that case, Dr. Gupta recommends inserting one finger between the rim of the cup and your vaginal wall, pushing lightly, then trying again.
If that doesn’t work, it’s likely because you’re tensing your pelvic floor muscles, says Dr. Ross. “Take a deep breath, let your body relax, and try again,” she advises. “[If] you’re still having trouble, bear down as if you were pooping and it’ll ease out.”
Whatever you do, don’t tug at your period cup if there’s resistance. “The negative suction by pulling can cause vaginal injuries sometimes,” says Dr. Gupta. While that’s not incredibly likely, it’s best to steer clear of the risk.
If you still can’t get it out, there’s no shame in going to your ob/gyn for help. You definitely wouldn’t be the first.