Menstrual cups are reusable menstrual products, but improper use, poor cleaning and an unsuitable fit can cause problems for some users. Potential complications include vaginal irritation, difficulty urinating and, rarely, toxic shock syndrome (TSS), a serious illness associated with bacterial toxins.
The risks vary, and menstrual cups are generally considered a safe menstrual management option when used according to the manufacturer’s instructions. However, claims about their dangers need to be distinguished from established medical evidence, particularly when discussing infection and TSS.
Vaginal irritation and discomfort
Some users experience discomfort when inserting, wearing or removing a menstrual cup. Possible problems include irritation, pain, allergic reactions and difficulty urinating if the cup places pressure on the urinary tract.
A 2019 systematic review published in The Lancet Public Health examined evidence on menstrual cup use and found reports of pain, vaginal wounds, allergic reactions and urinary complaints. However, the review concluded that menstrual cups were generally a safe option for managing menstruation.
An unsuitable cup size or shape may contribute to discomfort. People who experience persistent pain or difficulty urinating should stop using the cup and seek medical advice. Anyone who has recently undergone vaginal surgery should consult their healthcare provider before using an internal menstrual product.
Toxic shock syndrome is rare but serious
Toxic shock syndrome is a rare, potentially life-threatening illness caused by toxins produced by certain bacteria. It has been reported in people using menstrual cups, although the available evidence does not establish how frequently it occurs among cup users.
The UK National Health Service says TSS can develop during menstrual cup or tampon use and that symptoms can progress rapidly. Symptoms include fever, muscle aches, vomiting, diarrhoea, dizziness and a rash that feels rough like sandpaper.
Anyone who develops symptoms suggestive of TSS while using a menstrual cup should remove it and seek urgent medical attention. The condition requires prompt treatment.
How to use a menstrual cup safely
Good hygiene and following the manufacturer’s instructions can help reduce the risk of complications.
- Wash your hands: Clean your hands before and after handling the cup.
- Clean the cup properly: Follow the manufacturer’s instructions for washing and sanitising the product.
- Observe the recommended wear time: Empty and clean the cup at the intervals specified by the manufacturer.
- Choose a suitable product: A cup should not cause persistent pain or make urination difficult.
- Stop if problems develop: Seek medical advice if you experience persistent irritation, unusual pain, fever or other concerning symptoms.
The US Food and Drug Administration advises users to follow menstrual product instructions, maintain good hand hygiene and contact a healthcare provider if pain, fever or unusual symptoms develop.
Removing a menstrual cup
Removing a menstrual cup should not cause significant pain. Users should follow the product’s removal instructions rather than pulling forcefully or attempting techniques that cause discomfort.
If the cup is difficult to remove, or removal causes persistent pain, seek advice from a healthcare professional.
