Are menstrual pads my only option?

Q:

I’ve always had a hard time using tampons because I have a tilted uterus, and I end up leaking. Will I have any more luck using a menstrual cup?

A:

You may. About one in five women have a tilted (or tipped or retroverted) uterus, which means the uterus tips backward toward the spine. As a result, the cervical opening to the uterus may be pointed more toward the front, making it tricky to insert a tampon at the proper angle so it doesn’t leak. A menstrual cup, which catches and collects blood rather than absorbing it like a tampon, carries similar leaking risks since it’s inserted just like a tampon without an applicator. However, after some trial and error, you should be able to master its placement to prevent leaks, especially if you opt for a smaller size and insert it lower in your vaginal canal.

But for my patients with a tipped uterus, an option I like even better than tampons or menstrual cups is the menstrual disc (like Softdisc, Amazon.com). It’s inserted like a menstrual cup and collects blood in the same way, but by guiding it with your fingers you place it higher up— right where the cervix meets the vaginal canal. This placement allows the disc to completely cover the cervical opening, which better prevents leaks. And while the menstrual disc may have a similar learning curve to the menstrual cup, it has an added bonus: Because it sits higher in the vaginal canal, you can use it to have sex during your period without blood. And, thanks to the Coronavirus Aid, Relief and Economic Security (CARES) Act, menstrual hygiene products like the disc, cup, tampons, pads and period underwear are now covered by your Flexible Spending Account (FSA) or Health Savings Account (HSA).