Why It Is Time For Us to Switch To Menstrual Cups: A Complete Guide

This post is a part of Periodपाठ, a campaign by Youth Ki Awaaz in collaboration with WSSCC to highlight the need for better menstrual hygiene management in India. Click here to find out more.

Menstruation: Why Is Nobody Talking About It?

Menstruation or women’s reproductive health is a topic that is still considered a social taboo across various cultures all over the world. The process itself is perceived as something too ‘unclean’, ’embarrassing’ or ‘unholy’, which is why womxn still have to talk about it in hushed voices, or not at all. In India especially, menstruation is not treated as a natural and healthy biological function; menstruating womxn are often treated as ‘untouchables’—they are not allowed to enter kitchens or temples, touch male members of the family (let alone have sex), or lead normal lives. In rural areas especially, womxn are not even allowed to stay inside their homes, and often have to retreat to small, unclean huts or animal sheds.

Facts and Figures

Only 36% of menstruating people  in India use sanitary napkins. The rest resort to shocking alternatives like unsanitised cloth, ashes and husk sand. Almost 23% of girls drop out of school every year after attaining menarche and 71% remain uneducated and unaware of the process of menstruation until it happens to them.

An average person with a vagina undergoes around 40 years of menstruation and uses between 12,000 to 15,000 sanitary pads or tampons during their lifetime. Although these products may seem to be an absolute necessity, we need to understand why they aren’t as good as they appear.

1. Toxic Ingredients 

These sanitary products may often contain harmful ingredients such as unwanted dioxins, pesticide residues, fragrances, dyes and unknown toxic components that may be potential carcinogens. According to Chem Fatale, a 2013 report published by Women’s Voices for the Earth, a nonprofit advocacy group based in Missoula, MT:

“Chemicals of concern such as carcinogens, reproductive toxins, endocrine disruptors, and allergens are being used on, or even in, the extremely permeable mucous membranes of the vaginal area.”

“We have so little research on how chemicals affect vaginal health,” says Alexandra Scranton, author of “Chem Fatale… The basic science just isn’t there.” An article by HuffPost talks about how feminine hygiene products may be ‘ticking time bombs’.

2. Exorbitant Prices and Inaccessibility 

According to a good old Wikipedia article, Tampon Tax is the value-added tax that is imposed on sanitary products such as tampons and pads, unlike the tax exemption status granted to other products considered basic necessities. Let’s face it: pads are expensive, but they’re still available to us for use. If we look beyond our privilege, it is pretty evident that people from low-income households or rural areas do not have access to sanitary products, and even if they do, they cannot afford it.

3. A Big NO-NO For The Environment

The most common menstrual products are a veritable cornucopia of plastic. Tampons come wrapped in plastic, encased in plastic applicators, with plastic strings dangling from one end, and many even include a thin layer of plastic in the absorbent part. Pads generally incorporate even more plastic, from the leak-proof base to the synthetics that soak up fluid to the packaging. As a result, almost all of the used sanitary napkins or tampons end up in landfills, or worse, in the ocean. In both cases, it creates a lot of health hazards as well as sustainability issues. Although the plastic can be recycled, it is not accepted due to sanitary reasons.

4. Life-Threatening Conditions 

Toxic shock syndrome (TSS) is a dangerous, life-threatening condition caused by the build-up of Staphylococcus aureus (Staph bacteria) in sanitary napkins and tampons worn for prolonged periods of time. Superabsorbent pads and tampons (no matter how convenient they are for us) pose a huge threat of Toxic Shock Syndrome to menstruating womxn of any age.

What Is A Menstrual Cup?

A menstrual cup is a reusable, flexible, funnel-shaped menstrual hygiene product that is made of rubber or silicone. It is inserted into the vaginal canal where it collects the period blood during menstruation. It can hold more blood than a regular pad or tampon and is an eco-friendly solution to all the problems posed by sanitary pads and tampons.

Menstrual Cups: A Better Alternative 

  1. Reusable 

Menstrual cups are made of rubber or silicone, which is why they can be reused for prolonged periods of time. After every cycle, wash the cup thoroughly with soap and sterilize it in boiling water. Some menstrual cups can be used for up to 10 years at a time.

2. Cost-Effective 

Since cups can be reused, it saves you a lot of money. A menstrual cup costs, on an average, somewhere between Rs 350 to 500. The same menstrual cup can be used for years on end, and even if you decide to replace it every year, it will save you a lot of trips to the pharmacy.

3. Less Frequency 

Since menstrual cups come in different sizes to fit your unique needs, you get to choose how large a cup you want for yourself. A menstrual cup can hold around 20-40 ml of menstrual fluid (depending on the size you choose), which in turn means that you can go for hours without changing and replacing the cup.

4. Maintenance of Vaginal pH

Menstrual cups do not change the pH of your vagina or kill the harmful bacteria, as the ingredients or chemicals in tampons and pads do. This means a healthier vagina and in turn, fewer yeast infections or UTIs.

5. Eco-friendly and Sustainable 

Since menstrual cups can be reused, it means less landfill waste as opposed to pads or tampons; and fewer trees are cut down to make paper-based alternatives. This means that you can do your part in saving the environment.

6. No Pad-Rash/Irritation 

Napkin dermatitis, or pad rash, is a very common condition which affects most people who wear pads during their periods. The skin around your intimate area becomes inflamed, sore or itchy due to the friction caused on the skin by sanitary napkins. Using a menstrual cup solves this problem easily.

7. No Embarrassing Odour! 

Using a menstrual cup ensures that you do not have to go through the horrid smell wafting from your pad or tampon every time you sit down to pee or change it.

How To Insert A Menstrual Cup?

STEP 1: Fold your menstrual cup. A menstrual cup can be folded in various ways. Personally, I prefer the punch-down fold, which is shown in the picture below:

Image result for menstrual cup folds

STEP 2: After this, you have to spread apart your labia with one hand, and insert the cup inside your vaginal canal using the other. If it seems difficult, you can use water-based lube for smooth insertion. The process might sound tedious and scary to some, but do not worry! It only takes a couple of times to master this process.

STEP 3: You can try to contract the muscles of your vagina after inserting it so as to create a tight vacuum inside your vagina. You can tug lightly at the stem attached to the menstrual cup to ensure that it is snugly fit in place.

It is important to remember that once a menstrual cup is inserted properly, you will not be able to feel it inside you. The endometrial lining continues to shed while blood and mucus collect inside the cup. Watch this YouTube video which demonstrates how you can use a cup properly.

Removing A Menstrual Cup:

Wash your hands with soap and sit comfortably on the toilet. Insert your thumb and pointer finger inside the vagina and tug gently at the stem of the cup. Once it is accessible properly, break the vacuum by pinching the cup and pull it out.

Drain the blood inside the toilet and wash the cup with water and soap. When it is clean enough, you can re-insert it inside your vagina, following the steps given above.

Image result for menstrual cup insert

Cons Of A Menstrual Cup:

1. Quite Messy

Using the cup can get a little messy and you might get some blood on your fingers. If you’re squeamish about blood, it might be a little bit of a problem. You can try not to look while inserting or removing the cup and wash your hands immediately. Otherwise, you’re good to go.

2. Difficult Insertion

The process of inserting or removing the cup might be a little difficult to some, especially younger children, people with IUDs and those who have their hymens intact. You may want to consult your gynaecologist in these cases.

3. Maintenance 

If you want to use your cup for a few months or years, you need to sterilize it after each cycle. This might seem a bit tedious but taking care of a single cup is more rational than spending hundreds on sanitary pads.

Photo: Michelle Tribe/Wikimedia Commons.

Frequently Asked Questions

Q. How long can I wear a menstrual cup?

Depending on the brand you are using and your flow, you can wear a cup for up to 12 hours.

Q. Does it hurt to insert the cup inside the vagina?

It does not really hurt to insert the cup inside the vagina, but the pain is relative. If you have vaginismus, it might be impossible to insert the cup. Take a good look at your vagina in front of your mirror. Once you are comfortable with looking at or touching your own body, it takes no effort at all. Regular tampon users should not have any issues using the cup.

Q. How do I figure out my size?

Usually, brands provide a size guide on their website or at the bottom of the pack. Cups come in three different sizes: small (for people who are not sexually active or have a small build), medium (for people who are sexually active but have not given birth vaginally), and large (for people who have given birth vaginally).

Q. Could I get an allergy from the cup?

If you have a latex or rubber allergy, make sure to get a silicone cup. Check the material of the cup before buying it.

Q. Is it safe to use?

Menstrual cups are mostly safe to use. There has been only one report of a person suffering from Toxic Shock Syndrome from using a cup, and that was caused due to the presence of a cut in the inner wall of the vagina. If you have the following conditions, refrain from using a cup or consult your gynaecologist:

  • Vaginismus
  • Uterine fibroids
  • Endometriosis
  • Variations in uterine position

Q. Does it leak?

A menstrual cup generally does not leak if you have inserted it properly. If you have a heavy flow, remember to change it every few hours, otherwise, the cup might leak due to overload of blood.

Q. Can I participate in activities like dancing/swimming/sports with the cup in?

Yes, participating in activities shouldn’t be a problem. You can go swimming with the cup in. Once the cup is inside your body inserted properly, you shouldn’t be able to feel it.

My Recommendations:

  1. Sirona Reusable Menstrual Cup (INR 349)
  2. Pee Safe Reusable Menstrual Cup for Women made with Medical Grade Silicone (INR 299)
  3. Silky Cup Reusable Menstrual Cup for Women (INR 200)

These are the three bands that I have personally tried and tested. Check the size guide before purchasing any menstrual cup. If you face any problem after using the cup, please consult your doctor.

Note: Originally published here. 

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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