When I got my period for the first time, my mother took me outside to sit under the towering great-grandmother jacaranda tree in our yard on Maui. Our bodies planted on the earth, she presented me with a small silk pouch that contained a few totemic items, including an acorn—a sacred symbol of fertility, femininity, and the power of what has yet to come—and a pendulum, for dowsing myself and others with natural and homeopathic remedies. She told me that now, as this sacred rite of blood coursed through me, I was even more deeply connected to the cycles of the earth, the moon, and the sky. There was no part of me that was not affected by the whole of the universe.
In turn, my mother said, I had the power of the universe on my side. If I were humble enough, I could call upon that power for strength, for insight, for healing. Remember this, she taught me: You are not ever separate. You are always that acorn, this tree, the land, the ocean. Even now, I remember. Even when I’m bleeding and crampy and annoyed af that the new season of Grey’s Anatomy isn’t available for binging on Netflix.
I’m keenly aware that not everyone’s entry into menstruation had such a poetic pagan cadence to it. Many period-having people report their first encounters with their cycle were filled with shame, confusion, and intergenerational embarrassment. Parents who hated their own periods and thereby shunned the period presence in their child’s life. Dads who had no idea how to talk about bleeding. Moms who still harbored anger at their own mothers for failing to talk about the biological imperative that ruled one week of their lives each month. I get it. I got lucky.
But I’m here now to talk about it all with you, to witness and then evict any residual shame you might be carrying around your period, and, in particular, to look at how to take a personally and environmentally sustainable approach to perioding—by way of the menstrual cup.
Photo by Haley Davis
This is all a preamble to our deep dive into using menstrual cups, following my over 10 years of usage. Many of you had excellent questions about menstrual cups, so the Q&A below is a combination of my questions and your own.
I also brought in the wisdom of my friend and genius OB/GYN physician, Dr. Benjamin DeLisa, and culled the internet for resources to help answer your questions.
First of all: What qualifies me to pen this here Getting to Know Your Flow?
Hi. I’m Lily. I’m 34 and I’ve had my period for 21 years. I’ve taken every known herb, tincture, antifungal, and antibiotic for issues of the vajay. I have had outpatient surgery for it. I’ve been on and off of hormonal birth control. I have had thousands of hours of sex. My mom taught me that if anything was off in my vagina, it was symptomatic of some larger psychoemotional malaise. I took heed. I want a healthy reproductive system.
The average woman bleeds for 2,470 days in her life, using about 12,000 tampons.
That’s about 7 years of menstruation—were it to be uninterrupted—and 43 years of menstruation overall. (Stats courtesy intimina.com, which—in my humble opinion—makes a sub-par menstrual cup, so don’t get any ideas.)
627,720,000 pounds: The weight of feminine products used by women in the U.S. in a single year.
That’s six times the weight of the Titanic, discarded into landfills or septic/sewage systems. Every. Single. Year. (Again, stats courtesy intimina.com.)
Yuck.
What’s a menstrual cup?
Menstrual cups are small, flexible, reusable cups made of silicone or latex, designed to be folded and inserted into your vagina during your period. They collect your blood, which you then discard every few hours, before cleaning and reinserting the cup.
But aren’t menstrual cups expensive compared to tampons and pads?
In the long run: Absolutely not.
Looking at the numbers above, I’m sure you can guess the answer: They’re not even close to expensive when you look at your feminine product purchasing and usage over a lifetime. Menstrual cups range from about $22-$30, and have no expiration date. If you replace yours, it will likely be for aesthetic reasons alone, as discoloration occurs with no effect on performance. That said, let’s do some quick math.
The average person with a period has said period for about 43 years, bleeding for an average of 5 days per period. Over that time, that person would spend an average of around $4,650 on disposable period-related products. If that person used a menstrual cup instead, and replaced it (for aesthetic reasons) every 5 years, they’d spend approximately $225 on period-related products in their lifetime.
That’s $4,650 for tampons, pads, and other products vs. $225 to replace a menstrual cup every five years.
There are two kinds of menstrual cups: Silicone and rubber.
I have used both. I started with The Keeper, which is latex and quite stiff. After a few years, the smell of latex was bothering me a bit, so I changed to the Diva Cup, which is silicone, and slightly more pliable. I prefer silicone. Now I use Saalt’s cups, which I love for their aesthetic, their company mission, and their function, as well as their options in cup pliability and size.
Different cups also have varying degrees of stiffness or pliability. I prefer one right in the middle. Want a rundown on many of the cups on the market? Check out this chart.
How do I know what size to buy?
Most cups come in two sizes: Simply read the guidelines on the brand’s packaging or website and find the one that makes most sense for you. If you’re not sure, this resource offers a quiz to help you find the right option.
I wash my cup out with hot water and soap every few hours when it’s in use, and/or whenever I take a shower. It feels very clean to me, because I monitor and wash it whenever it’s emptied. I’m not concerned about the blood sitting there for a few hours—it can stay where it came from for another minute. Nota bene: Unlike tampons and pads, if my flow is very light I can leave a cup in for 24 hours without any symptoms at all. It’s recommended that you empty and rinse your cup every 12 hours max, but leaving it in longer won’t cause toxic shock syndrome, like tampons can.
But is it gross?
Call me crazy, but I am seriously into monitoring my situation down there. My mom had ovarian cysts, endometriosis, and endometrial cancer, and I feel it’s my responsibility to stay apprised of what’s happening with The Flow™. I like to see what my blood clots look like, and I appreciate the opportunity to assess the color, density, and quantity of my blood each period cycle.
But does it hurt to get the cup in and out?
In short, no—it shouldn’t. There is a loose, individualized science to getting your cup in and out. Read the instructions that come with your cup and follow them. Make sure you fold the cup properly upon entry and exit. Also make sure you push the cup far enough inside you that it can open up fully. When inserting, think about putting it in parallel to the ground (at a slight upward angle) instead of shoving it straight up. When removing, fold the edge of the cup in as much as you need in order to remove it smoothly and empty its contents.
But does it leak?
Sometimes yes, but no more than I experienced with tampons and pads.
During the day, you shouldn’t have any major leaks if it fits properly. Over time, you’ll start to recognize the feeling of a full cup, so you can take it out before it needs to be changed. And there’s no harm in changing it more frequently if you’re concerned.
At night, I do one of two things to prevent leakage:
- Before the invention of Thinx (more on them below), I fashioned a makeshift pad from a soft, absorbent cloth that I would wash every morning (as fast as washing my hands) and let air-dry to be ready for another use in the evening. This cloth, folded into my underwear, would absorb any leaks that occurred overnight. Of course, the efficacy of this will vary according to your personal flow.
- Now, I own a pair of Thinx period underwear, designed to absorb large amounts of liquid. They’re a literal dream. Also a bit of an investment, also incredibly worth it.
But what do you do with the blood?
You discard it in the toilet, in the sink, or in the shower. (Or, if you are a very strange breed of human being / deeply committed biodynamic gardener like one of my ex-boyfriends, you use it to fertilize your garden—I *do not* recommend this!)
How do I clean the cup?
Each time I empty the cup, I wash it with hot water and soap. Sometimes, for a deeper clean in between cycles, I boil it in hot water to sanitize.
But what if I’m traveling or out of the house and need to empty and clean my cup in a public restroom?
After many years of feeling lost and bloody in public restrooms, I’ve come up with a plan that works very well for me:
- Before you enter the stall, wash your hands well.
- Enter the stall, close the door, remove the cup with your clean hand, and empty the blood into the toilet.
- Pee on the cup to clean it, rotating it to get urine on all parts. Urine is sterile, so this is a good option in a pinch.
- Replace the cup.
- Flush.
- KEEP CALM AND REMEMBER THAT URINE IS STERILE.
The above-mentioned Dr. DeLisa concurs that my method is legit, and does not pose any health risk.
But will the cup get stuck?
No. The menstrual cup comes with a tab at the bottom that will always be accessible to you. Moreover, the cup is made of pliable material that you can fold up inside yourself in order to remove. It may take some getting used to, but it will not get stuck.
And will it affect how I exercise?
Absolutely not—once it’s in, you shouldn’t feel it at all. If exercising causes a sudden increase in your menstrual flow, you may need to change your cup sooner, but that’s about it.
Can I have penetrative sex with the cup in?
Definitely not.
Can I use a menstrual cup if I have an IUD?
I have no personal experience with this, but the general consensus seems to be: Probably, with a great deal of caution and education. You’ll need to know where your IUD strings are, and where the IUD itself is located. Read more on this here.
Will repeated use of the menstrual cup create a suction effect on my cervix or uterus?
For this question, I turned to our venerable physician, Dr. DeLisa. His response: “Using a menstrual cup poses no risk of pulling the cervix down or causing prolapse—the cervix and uterus are too far up for that. If someone is getting the cup stuck or feeling suction in their cervix, they are doing it wrong.”
So why should I use a cup?
To recap: You bleed a lot. You spend A LOT of money on menstrual products. Your vagina is your sacred honey pot of love. You want to minimize waste. You want a healthy vajay. You want to streamline your life. You care about minimizing human waste and maximizing environmental health. You want to be more in touch with your vagina, your hormones, your sexuality, your reproductive health, and your sex. You want to have a more comfortable period.
Or maybe just because you want to say things like sacred honey pot of love when you talk about your period.
Welcome to the menstrual cup life.
Questions? Leave them below. Wishing you an easeful and empowered period time.
