For years pads and tampons have been the standard sanitation during periods. But recently, menstrual cups have been coming up as a new, safer and more environmentally friendly alternative.

While reflecting on their menstrual habits, most women reveal that the switch from tampons and pads to menstrual cups has given them an undeniable payoff. Apart from the fact that you'll be significantly reducing plastic waste, there's also an added ease of use with the reusable cup as they don't require to be changed as often. The cup is also a great investment and doesn't weigh your wallet down recurringly like tampons and pads. "Menstrual cups are very durable and can last for months, if not years if you take care of them properly," Dr Lucky Sekhon, a reproductive endocrinologist and board-certified obstetrician and gynaecologist tells the New York Magazine.

You’ve probably heard of the Diva Cup — the one so popular it's become synonymous with the menstrual cup. It's been around since 2003 but only recently blew up amidst the buzz of more women making the switch from users of disposable pads or sanitary napkins to becoming a menstrual cup user. But what exactly is a menstrual cup?

How Do Menstrual Cups Work?

First, what is a menstrual cup? It’s a flexible cup designed for use inside the vagina during your period to collect blood. The cup collects the menstrual flow rather than absorbing it as tampons or pads do.

Most menstrual cups are made of silicone or rubber. You can use a cup all the way through your cycle, but you might need to change it more often on heavy flow days to guard against leaking. Remove and rinse your cup in warm water after 12 hours, or when you leak through it and then you can re-insert it.

How To Use A Menstrual Cup?

1. Wash Your Hands: Since you have to insert the cup, it's best to wash your hands before you start. You can also wash your cup with some warm water and rinse it carefully before you insert it.

2. Fold And Hold: Get comfortable, you can insert the cup while sitting, standing or squatting. Spreading your legs will help with a more comfortable insertion. Relax. Fold the cup in on itself to make flat, then in half to form a C shape.

3. Insert: Keep it rolled up in the C shape and guide it rim first into the vagina. To check that the cup has fully opened, slide a clean finger up to the cup bottom and feel it - it should be round.

4. Understand Your Flow: A menstrual cup can be emptied about 2–4 times a day and can be used for up to 12 hours, also overnight. Most cups have measuring lines on the cup to help monitor your flow and understand when you bleed heavy or light.

5. Remove And Empty It: Wash your hands and relax your muscles. Grasp the bottom of the cup. To break the seal, squeeze the bottom of the cup. Be sure not to pull it out by holding the stem alone. Tip contents into the toilet. Rinse & Reuse.

6. Sanitize: A menstrual cup should be cleaned thoroughly before and after your cycle, and after emptying. To avoid odour and discolouration, rinse it. First in cold water, and then wash with hot water. A lot of people drop it into a pan of water and boil it over a gas, which is also proved helpful.

Where Can You Buy A Menstrual Cup In India?

It's difficult to find menstrual cups in general stores or medical stores, but the availability of these cups is vast online. Here are are some of the best cups available for beginners and pros alike:

1. Sirona Menstrual Cups: Sirona is an award-winning brand committed to solving those Intimate and Menstrual Hygiene issues which are not adequately addressed. Their wide category of products includes PeeBuddy (a device for women to stand & pee in all unfriendly toilets), Sirona Feminine Pain Relief Patches, Sirona Menstrual Cups etc. Sirona donates a part of their proceeds towards their path-breaking social initiative "AAAN" where they help trafficked sex workers by addressing their Intimate & Menstrual Hygiene needs. You can find them on Nykaa, for 300-350 rupees.

2. SanNap Menstrual Cups: SanNap is a personal healthcare start-up that focuses on the day to day personal hygiene requirement of women. It has a long line of quality sanitary products like sanitary pads, diapers, condoms, tampons and panty liners available at affordable costs. They also have a line of menstrual cups for all sizes and flows. It's priced at 399 rupees and can be found on Nykaa.

3. PeeSafe Menstrual Cups: These cups come in extra small, small and large sizes fit for any type of flow. They are priced at 499 and above, but like any other cup, they are reusable and environment-friendly. They also come with a small bag you can store them in when they aren't in use. You can find these cups on their website.

Though there are several other brands, these are the most common and easy to find in India.

Can Menstrual Cups Cause Infections?

Irritation

Irritation can happen for a number of reasons, and, for the most part, they’re all preventable. For example, inserting the cup without proper lubrication can cause discomfort. In many cases, applying a small amount of water-based lube to the outside of the cup can help prevent this. Irritation can also occur if the cup isn’t the right size or if it isn’t cleaned properly between uses.

Infection

Infection is a rare complication of menstrual cup use. And when an infection does occur, it’s more likely to result from the bacteria on your hands that transferred to the cup than from the actual cup.

For example, yeast infections and bacterial vaginosis can develop if the bacteria in your vagina — and subsequently your vaginal pH — becomes imbalanced. You can reduce your risk by washing your hands thoroughly with warm water and antibacterial soap before handling the cup. You should also wash your cup with warm water and a mild, fragrance-free, water-based soap before and after use.

Toxic Shock Syndrome

Toxic Shock Syndrome (TSS) is a rare but serious complication that can result from certain bacterial infections. It occurs when Staphylococcus or Streptococcus bacteria — which naturally exist on your skin, nose, or mouth — are pushed deeper into the body.

TSS is typically associated with leaving a tampon inserted for longer than recommended or wearing a tampon with a higher-than-needed absorbency. To date, there has only been one report of TSS associated with the use of a menstrual cup.

In this case, the user created a small scrape on the inside of their vaginal canal during one of their initial cup insertions. This abrasion allowed Staphylococcus bacteria to enter the bloodstream and spread throughout the body.

You can reduce your already low risk for TSS by:

• washing your hands thoroughly with warm water and antibacterial soap before removing or inserting your cup.
• cleaning your cup as required, usually with warm water and a mild, fragrance-free, oil-free soap, before insertion.
• applying a small amount of water or water-based lube to the outside of the cup to help in a smooth insertion.

Problems You May Face With A Menstrual Cup

As a noob, you may experience some minor mishaps or bloody spills at the beginning of your cup journey but remember that over the course of time, your body will get accustomed to it. Moreover, the payback will be huge as you won't have to deal with a lot of common issues with sanitary napkins and tampons such as rashes, irritation, constant changes and wastage.

1. Removing the cup can turn messy so prepare to get a little blood on your hands. In the beginning, it may be difficult or awkward to remove the cup and your untrained hand may even spill some blood in the process but you'll get the hand of it over time.

2. Cups can be tough to insert as you may not get the right fold when you insert the menstrual cup. “Menstrual cup usage has a learning curve, like anything else,” Jyothi Parapurath, MD, ob-gyn practising at Caremount Medical Group in New York tells the Self. As explained earlier, repeated practice and exposure to the cup will make the transition easier.

3. There could a chance of you being allergic to silicone or rubber, it's better to cancel out any presence of an allergy before inserting the cup in an intimate area.

4. Leakage, although uncommon, can happen with improper insertion and due to keeping the cup inside for prolonged periods. If that isn't the case, then the cup might be too small for your vagina. You can try different sizes to check if that solves the leaky cup. In case you're still experiencing leakage, you may have really heavy periods.

According to Adeeti Gupta, M.D., attending physician at Lenox Hill Hospital, if you have to empty a full cup every two hours and size isn't the issue, this might indicate a heavier period than average. Dr Gupta suggests visiting your gynaecologist to figure out the cause behind the heavy period as it could be a sign of an underlying health condition.

5. You're having a tough time removing the cup. First, don't panic because your cup cannot get lost inside your vagina. According to the Self, here is a recommended technique by Dr  Adeeti Gupta, a physician  - You grip the cup, give it a gentle squeeze, and pull it out. If it doesn’t come out easily, that probably means the seal isn’t broken, which means it’s suctioned on the vaginal walls pretty well.

In that case, insert one finger between the rim of the cup and your vaginal wall, pushing lightly, then trying again. If that fails, you may be tensing your pelvic floor muscle, in which case you need to allow your body to relax and then try again.

To make it easier, sit in a position as if you were pooping and it'll ease out. Be gentle and do not tug at your period cup even if there's resistance. Dr Gupta explains, “The negative suction by pulling can cause vaginal injuries sometimes,” Although, it's quite rare, it's best to practice caution and steer clear of any risks. If nothing seems to be working, your best bet is visiting your gynaecologist for help. Don't worry, it's not as embarrassing as you might think, at least not for them.

6. Travelling with a menstrual cup may pose problems specifically in public toilets or due to a lack of them. In case you don't want to leave the stall to wash your cup in the sink of a public bathroom, consider carrying cleansing wipes.

There are some that are specifically made for menstrual cups, if not, then make sure the ones you have are fragrance-free and alcohol-free since those ingredients can be pretty irritating to your vagina. You could also use baby wipes since they're devoid of chemicals.

Wipes are just a temporary measure, not a replacement for water, so make sure to wash your cup the next chance you get. Additionally, don't forget the golden rule of washing your hands before touching your vagina or period cup. Pro-tip: If you are going to be travelling and won't have access to clean public washroom facilities or water, then it would be wiser to switch to another method for that cycle.

Benefits Of Using A Menstrual Cup

Now that we've gotten all the problems and technicalities of using a menstrual cup out of the way, we can revel in its perks.

1. The most obvious one is that they're budget-friendly. You pay a one-time price for a reusable menstrual cup, unlike tampons or pads, which have to be continually bought.

2. Menstrual cups are capable of holding more blood; it can hold about 1-2 ounces of menstrual flow. When compared to tampons and pads, it's much more as tampons can only hold up to a third of an ounce and pads can hold 0.2 ounces only. Because they hold more blood, there are fewer chances of leakage, so you won't have to worry about staining bedsheets due to overnight flow.

3. There's no friction against the vulva or rashes. Often pads are guilty of causing an irritating feeling due to the friction from a pad against one's vulva. This is completely eliminated with a menstrual cup.

4. If you suffer from guilt or eco-anxiety of generating tons of waste during your menstrual cycle, this will improve your mental well-being greatly. It's shocking to hear facts like switching to a menstrual cup can save the environment from approximately 16,000 tampons, panty-liners and sanitary pads in your lifetime, which can take between 500-800 years to fully decompose.

After you're aware of the reality of your consumption, you might want to take steps to become more sustainable. The last distressing fact we'd like to discuss is that most sanitary pads are 90 per cent plastic. In comparison, silicon is a much greener material which gradually transforms into its original state (sand) as it degrades. So making the switch would have significant positive consequences for the environment.

5. You can have sex but only with a soft disposable menstrual cup. Otherwise, most reusable cups need to be taken out before you have sex. Don't attempt having penetrative sex with a reusable menstrual cup as the cup's stem can accidentally hurt the penis or finger and if you insert anything inside such as a vibrator or dildo, you risk pushing the cup deeper where it can get stuck on your cervix. However, you can still enjoy oral, anal and external stimulation with no problem at all.

6. You can swim with it. Similar to tampons, menstrual cups can be worn while swimming and most forms of exercise. Since you wear it completely internally, it's safe. However, if you've experienced leaks and haven't mastered the art of handling a menstrual cup, refrain from engaging in heavy sports until it sits inside comfortably.

7. You can use a period cup if you have an IUD (Intrauterine device) but you may want your gynaecologist to assist you in the process of inserting it.

Menstrual cups are daunting to hear about at first since they're much more intrusive than sanitary napkins and made of a completely different material compared to tampons. Even though the current conversation about menstrual cups may sound pressurizing or too drastic a change for you, the choice still rests with you, you can switch to other techniques at your own will.

The only way to know if a menstrual cup is the right choice for you is to buy one and give it a try! They come in various sizes, so sometimes, if the first one doesn’t suit you, the next one will do the trick.