Everything you need to know about cups

For starters, a recent review of studies found that cups are as safe and effective as pads and tampons, as well as less expensive

What is a menstrual cup, and how the heck do I get it in there? “The bell-shaped cup is folded and inserted into the vaginal canal to collect menstrual blood,” says Yolanda Kirkham, an ob-gyn at Women’s College Hospital and St. Joseph’s Health Centre in Toronto. “It can be changed less often than pads or tampons and can be reused during each cycle and over many years.” While today’s versions are typically made of medical-grade silicone, the very first menstrual cup—invented by American actor Leona Chalmers in 1937—was latex rubber.

How do I know which size to use? “Every vagina and cervix is different,” says Kirkham. “But in general, try a smaller size if you’re under the age of 30, have never had a baby, have a low cervix or are just intimidated. If your flow is heavy, you’re taller or heavy-set, and have frequent leakage issues, you may want to consider a bigger size or a different brand.”

Any advice for my first time? Tampon users tend to have an easier time transitioning to cups, says Kirkham, who suggests doing a trial run using non-silicone lubricant on a day that you’re not bleeding. Once inserted, the cup will create a seal with the vaginal wall; to remove it, pinch the cup to break the seal. While most cups come with a straight stem, this is intended to guide your hand to the cup—not for removal. Some cups come with ball or loop stems, which may make removal easier.

Will I feel it? Once it’s inserted, a cup shouldn’t be uncomfortable or get in the way of your daily activities, but that doesn’t mean it’s imperceptible. “Some users feel bladder pressure, while others may feel like they have a slower stream or they can't urinate completely while the cup is in,” says Kirkham. “Choosing a softer cup or one without a ridge may help; removing the cup to urinate is also an option.” Many manufacturers also recommend trimming the stem of the cup to reduce irritation to the labia, but make sure to read the instructions carefully to ensure you don’t damage the cup while doing so.

How long can I leave it in for? Up to 12 hours, although women with heavier flows may need to empty and wash theirs more frequently. Consider removing it in the shower at first in order to avoid a bloody mess.

Do I need to worry about toxic shock syndrome (TSS)? This potentially fatal condition is caused by the release of toxins produced from an overgrowth of Staphylococcus aureus bacteria. Menstrual cups, like tampons, pose a small risk of TSS if they are worn too long or not properly cleaned.

Are cups a good option for improving access to menstrual products? “I’m a big fan of using reusable products whenever possible,” says Nicole White, founder of the Saskatoon-based organization Moon Time

Sisters, which provides feminine hygiene products to more than 25 remote northern communities in Saskatchewan. However, she notes, there are some barriers—including access to the clean water that’s needed to wash out a cup. “We just want to provide the full spectrum of options for young women, so they can choose what works best for them,” she says. You can help by donating eco-friendly products to the organization or by designating your online donation to be used to purchase reusable menstrual products, says White. “Zero waste is an end goal I would like to see."