New Delhi: A new study has found that menstrual cups, an inexpensive and reusable method of sanitary protection for menstruating women, are safe and as unlikely as disposable pads or tampons to leak.
The study, the first major scientific review of the devices, was published on Wednesday in The Lancent Public Health. The researchers said at least 70% of women who have tried menstrual cups said they would like to continue using them.
This research is a review of 43 earlier studies gathering data on 3,300 women. It includes studies conducted on women from rich and poor countries, from different decades since the 1960s, but mostly since 2009.
In many parts of the world, and particularly in India, menstruation and sanitary protection remain taboo subjects. Sanitary protection is either unavailable or unaffordable for many women around the world, as the authors noted of the study noted. In India, many women use a cloth instead of sanitary products, increasing the risk of infections. Several reports show that during menstruation, women and girls are considered “impure” and are forced to stop going to school.
In this context, the authors set out to evaluate if menstrual cups are safe, affordable and effective menstrual products. Menstrual cups are made from medical grade silicone, rubber or latex and collect blood, rather than absorb it, as pads and tampons do. They last from four to 12 hours.
According to AFP, there are two types of menstrual cups: vaginal cup, a bell-shaped product, and a cervical cup, “which is placed around the cervix high in the vagina much like a diaphragm for contraception”. Menstrual cups are reusable and can be used for up to ten years, depending on the product, though they are more expensive than sanitary pads or tampons.
The study found that leakage was “similar or less when using the menstrual cup than when using disposable pads and tampons”. However, its adoption requires a “familiarisation phase”, and peer support seemed to be important for uptake in low and middle-income countries, the study found.
The research did not find any increased risk of infection, but found some incidental case reports of damage. “We identified several incidental case reports of vaginal damage, toxic shock syndrome, or urinary tract complaints after menstrual cup use, and difficulty retrieving the menstrual cup was also reported,” the authors wrote. Toxic shock syndrome is a potentially life-threatening condition and is caused by bacteria which enter the body through foreign objects.
The syndrome was reported by five women. The authors said however, since the overall number of menstrual cup users is unknown, they could not determine if the product is safer than tampons, which are known to boost the risk of toxic shock syndrome.
“For consumers purchasing menstrual products, the results highlight cups as a safe and cost-effective option,” Julie Hennegan from the Johns Hopkins Bloomberg School of Public Health said in a comment, also in The Lancet Public Health.
Yet, even in rich countries, only a fifth of women on average knew about the new devices, three of the studies found.
The study says that its findings can “inform policy makers and programmes that menstrual cups are an alternative to disposable sanitary products, even where water and sanitation facilities are poor”. It notes that providing information, training and following up may on correct may be needed to ensure that the products are used over the long term. “Further studies are needed on cost-effectiveness and environmental impact comparing different menstrual products, and to examine facilitators for use of menstrual cups, with monitoring systems in place to document any adverse outcomes,” the researchers conclude.
In India, efforts are being made to dispel the secrecy and taboo surrounding menstruation and menstrual hygiene. While a large proportion of women still use cloths during menstruation, initiatives encouraging women to use sanitary pads have received an overwhelming response.
Another initiative by the Tamil Nadu Urban Sanitation Support Programme tried to break the silence around menstrutaion, moving beyond taboos, discussing menstrual health, disposing sanitary products and making an informed choice about products.