For many women, the use of menstrual cups has become a regular phenomenon. Seen as an eco-friendly alternative to tampons and sanitary pads, an increasing number of women across the world are using them.
However, medical experts are now warning against their use — a new study reveals that a poorly positioned menstrual cup may lead to more serious complications such as kidney problems than leakage alone.
What exactly has the research revealed? How harmful can they be? We get you the answers you are looking for.
Doctors in the British Medical Journal highlight how an ill-fitting menstrual cup led to one woman suffering from uterohydronephrosis — a swollen kidney caused by blocked urine flow into the bladder.
The medical paper reveals that a 30-year-old patient had sought medical care due to intermittent pain in her side and blood in her urine for six months. Unable to bear the pain, she had gone to medical experts, who carried out a battery of tests on her.
Scans showed a swollen right kidney and ureter — the tube that carries urine away from the kidneys. The scans also showed that the woman’s menstrual cup was placed next to the opening of the ureter into the bladder.
Owing to this, the doctors asked her not to wear a cup for a month and asked her to return for tests later. When she returned for her second round of tests, the swelling had reduced and she didn’t complain of pain or blood. Moreover, her urine function was normal.
Doctors then surmised that the positioning of the menstrual cup had obstructed the flow of urine, as a result of ureterohydronephrosis.
Six months later when the woman returned for tests and follow-up check-ups, she had become wary of using the menstrual cup, fearing possible complications.
The authors of the paper wrote, “To our knowledge, only a few similar cases have previously been reported. [These] cases were similar to our case.
“In all cases except one, a follow-up [computed tomography scan] or ultrasound was performed which showed regression of the ureterohydronephrosis. In three cases, the women resumed use of the menstrual cup, and none of them experienced resumption of symptoms (unknown follow-up periods). One of them chose a smaller-sized cup.”
The doctors later explained that correct positioning along with choosing the correct cup shape and size is necessary to prevent any side effects on the upper urinary tract.
“Presently, menstrual cups can be bought and used without clinical advice from a health professional, which emphasises the importance of detailed and clear patient information material,” they said.
Menstrual cups, made from silicone, have become widely accepted in recent years. Those who use menstrual cups have hailed the product as they are reusable and sustainable. They are also long-lasting — they can be used for up to 12 hours before being emptied.
But are they safe? A previous report published in The Lancet Public Health found that menstrual cups are safe to use and may be just as effective as other sanitary products in preventing leaks. The paper also said that the cup could be a viable option in poor countries, where access to menstrual products might be limited and costly in remote areas.
Researchers also found that there were no increased health risks associated with the use of the menstrual cup. According to them, menstrual cups did not have negative effects on the vaginal flora — the bacteria that live inside the vagina — that could lead to infections or vaginal discharge.
The study also dispelled worries and concerns regarding toxic shock syndrome (TSS). For the unaware, TSS is caused by the bacteria called staphylococcus aureus or Staph and typically occurs if proper hygiene, such as handwashing before removing and inserting the menstrual cup, is not followed. In extreme cases of TSS, it can cause dizziness.
However, the study showed that there was little to prove that the use of menstrual cups could cause TSS.
Other medical experts also found that when used properly, the risk of severe side effects is extremely rare with menstrual cups.
Across the world, menstrual cups have become widely acceptable. However, first-time users and younger people do find it tricky to use it, especially it comes to removal. One recent survey of 530 young women reported that many found it difficult to remove the menstrual cup on their first try.
So, how should it be worn? Start with clean hands and then fold the menstrual cup and insert it, aiming it towards the base of one’s spine. Once inserted, ensure the cup opens up completely. You can do this by gently twisting or adjusting its position. Experts note that the cup should sit lower than a tampon.
And on removal, don’t pull on the stem. Instead, squeeze the bottom of the cup to break the seal and wiggle it off. As physiotherapist Dr Kate Lough, an expert in pelvic health, told the BBC, “When it’s in correctly, you shouldn’t feel it.”
With inputs from agencies
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