Everything you need to know about menstrual cups

There are way more options for people who menstruate today than there were when I first started my period — everything from period underwear and reusable pads to menstrual discs and cups. In my search to find the best alternatives to tampons, I tried out several menstrual cups to see if any of them could win over a tampon loyalist like myself.

In the process, I discovered some helpful tips that can make the transition to cups a bit easier for anyone.

What's the deal with menstrual cups?

Menstrual cups, which are held in place by vaginal muscles and collect blood in a bell-shaped reservoir, are one of the most popular alternatives for traditional pads and tampons, because you can wear and reuse menstrual cups for up to 10 years, reducing costs as well as personal waste. Most cups are made with medical grade silicone and can cost anywhere between US$20 and US$40. With some minimal upkeep and maintenance (washing after each use and sanitizing after each cycle), you should be able to get years of use from a single cup.

It can be intimidating to try a cup for the first time, but according to Kim Rosas, a menstrual cup advocate who has reviewed more than 100 cups in the last eight years, once you’re able to find and use your perfect cup, it can be even more easy and comfortable than using disposables.

“I think a lot of people assume when you tell people to switch from tampons to a reusable product, like a menstrual cup, or menstrual disc, or even period underwear or cloth pads, they're thinking of sustainability and costs,” she said over the phone. “But I sell people on convenience and comfort, because that's where it really shines for me against tampons or pads. They're just so much more comfortable.”

Figuring out the right fit

In order to get to that place where your cup works with your body to make a period suck less, you have to figure out the right size. The two most important factors to consider are your cervix height and the cup’s diameter. If your cervix is too low in relation to the cup, the cup will feel uncomfortable or even stick out a bit, but if the cervix is high, it can be difficult to remove (I found this out the hard way). If you’ve never given thought to your cervix height before, you can measure with a finger, then compare that length to the cup you’re looking to purchase.

If you have a lower cervix, Rosas recommends the Merula One Size cup and the Hello Low Cervix cup. The Merula has a ladder-like stem that can be trimmed with scissors and a more rounded shape that allows the cervix to comfortably dip inside the cup when needed, while the low cervix Hello cup doesn’t have a stem at all. The Hello cups are also made from TPE, thermoplastic elastomer, so they’re a good option for people with silicone allergies.

For those with higher cervixes, Rosas said that Diva Cups can work well since their cups are longer than average.

As for diameter, most brands have two sizes. Naming conventions vary from brand to brand, but there’s typically a regular size and a smaller version. Smaller diameter cups are typically best for people under 30 who haven’t carried a baby to full term, as cups are held in place by vaginal muscles and those muscles can be relaxed over time or through pregnancy. However, Rosas says you can have had kids or be older and still fit a small cup, especially if you work out regularly or do any exercises with your pelvic floor.

“My favorite thing about this industry is how people brag about their small vagina,” she said, laughing. “I mean, you can be 50 and still have a period and have had 10 kids, and because vaginas work in mysterious ways, you could be more comfortable and have a better experience with a [smaller size].”

Trying them out

The cups I ended up trying were the Kind Cup in its regular size, the Flex Cup in slim fit, and the Saalt Soft Cup in its regular size. Rosas mentioned the Saalt cup as a good "average" pick that could work with most body types, and the Kind cup is a newer addition to the cup market that advertises an ergonomic fit. I was also excited to try the Flex cup because it states that you can remove it similarly to taking out a tampon; I figured using it would be closer to my comfort zone since I have extensive experience with tampons. I didn’t notice a huge difference between the regular or smaller fits between the different cups, but I did notice when the cup materials were softer, because they were harder to fully open when inserted and stay in place.

Inserting a cup is similar to inserting a tampon without an applicator. You collapse the cup by folding it, then use your fingers to insert the cup into the vaginal canal before popping it open to create a seal. There are a wide variety of ways to fold a cup, but I found the C-fold and the Punchdown methods to be the easiest.

With the C-Fold, you simply fold the cup so it looks like the letter C when looking from the top down. This gives the cup enough tension that it'll spring open when released, but not so much that it squirms out of your hand when inserting. The Punchdown is kind of like the C-fold's asymmetrical cousin — instead of pushing the sides of the cup together, you push one side of the cup down to create a tapered shape that's narrow enough to insert and doesn't have as much tension as the C-fold.

The easiest cup for me to insert was the Kind cup, because the asymmetrical silhouette of the cup makes it easy to fold into a narrow point. The Saalt cup was also easy to insert, though it was pretty difficult to tell when the cup was fully open due to the cup’s softer silicone. I was really excited to try the Flex cup, but I found it nearly impossible to insert the first two times I tried it. I even tried using a water-based lubricant to help things along, but it wasn’t until my last day trying cups that I was able to insert the Flex cup comfortably. Flex’s cup is unique in that it uses a threaded stem attached to the side of the cup to automatically break the cup’s suction, so it’s easier to remove. While I loved the idea of a cup that can be taken out like a tampon, I think the stem was also what made it so hard to insert the first few times I tried it.

What they feel like once in...

Once each of the cups was inserted, I wasn’t able to feel or notice them while walking or sitting at my desk, but I didn’t really put them to the test with more rigorous forms of exercise. Wearing the cup was remarkably similar to wearing a tampon in that I didn’t really pay attention to it aside from checking the stems every so often to make sure I could still reach them. Cups sit within the vaginal canal, so you should be able to reach them with your fingers unless you have a really high cervix and they travel up throughout the day. This also means you can't insert anything else into the vagina while wearing a menstrual cup, so period sex is not an option unless you take it out.

...And how to get them out

I struggled the most with my menstrual cups when it came to their removal. While most have a stem on the base of the cup, it’s usually just to help you find the cup’s base rather than to pull it out. The cup creates a seal along the walls of the wearer’s vagina, so just pulling on the cup without breaking the seal would create uncomfortable and dangerous suction. This suction is especially dangerous if you have an IUD, as it can cause your IUD to shift or even pull it out of the uterus. Many menstruators are able to use menstrual cups and an IUD in tandem without issues, but as an IUD user myself, this aspect of menstrual cups made me super anxious.

The Kind Cup was easiest to remove since it had a very long stem that made it easy to find the cup’s base. I pinched the base of the cup to release the suction and was able to pull it out with minimal effort. The Flex Cup also made up for its shortcomings during the insertion process when I had to take it out. The pulling mechanism that breaks the seal worked like a charm, and the cup came out stress-free.

I was a little concerned when it came to the Saalt cup, since it had the smallest stem, and I did have the hardest time removing it. It turns out I have a pretty high cervix, so when it was time to take the cup out, I was barely able to get a hold of the stem, let alone get a grip on the cup’s base. I struggled for a few minutes in different positions, trying to break the cup’s suction, panic calling my friends who’ve used menstrual cups before. Finally, after taking my friend’s suggestion to lean back with my hips on the edge of a seat, I was able to wiggle the cup into a lower position and grab it, but I was a bit emotionally scarred from the whole experience.

Taking out and dumping cups was certainly more messy than taking out a tampon, but I didn’t find managing my menstrual fluid as hands-on as I did with menstrual discs. Since I was just at home, it was super easy to just pull out the cup and rinse it clean in my bathroom sink before reinserting it, but I could see cleaning a cup being an issue if I were traveling without access to running water or in a public restroom. Since I don’t work in an office and won’t be traveling anytime soon, the prospect of cleaning and reinserting my cup doesn't come up often enough for it to be a dealbreaker for me.

The overall verdict

Of the three cups I tested, the Kind cup worked best with my body and was easiest to use with no leaks. The Flex cup was a close second, because I felt so much better taking the cup out knowing I’d already broken the seal, but the design did leak a tiny bit from the hole the stem is threaded through. And although I didn’t have a great experience with the Saalt cup, I’m sure it also works wonderfully for folks who have lower cervixes than mine.

I definitely felt a learning curve while trying these menstrual cups, but now that I have a bit more experience, I’d say it’s ultimately a pretty small price to pay to streamline my period routine by not needing to constantly replace my supply of tampons. While I don’t think I’ll stick with cups while I still have my IUD, I’d definitely give them another try down the line when I don’t have to worry about interfering with my contraception.

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