Are Menstrual Cups Safe? What The Science Says

Menstrual cups have become an increasingly popular choice for people seeking a reusable, eco-friendly alternative to tampons and pads. With benefits such as reduced waste, long wear time, and cost savings, they sound almost too good to be true. But one common and important question remains: are menstrual cups safe?

In this article, we dive into the clinical research and expert opinions to bring you a clear, evidence-based look at menstrual cup safety—covering what they are, how they work, the potential risks and how to minimise them, and what the science says.

 

What Is a Menstrual Cup?

A menstrual cup is a small, flexible cup—usually made from medical-grade silicone, rubber, latex, or elastomer—inserted into the vagina to collect menstrual blood. Unlike tampons and pads, which absorb blood, the cup collects it and can be emptied, washed, and reused. Most cups can be worn for up to 8–12 hours, depending on flow, making them a convenient choice for many.

 

Are Menstrual Cups Safe to Use?

The short answer is: yes, menstrual cups are generally safe for most people when used correctly. But let’s look at what the research says.

Clinical Evidence: What the Studies Show

A 2019 systematic review and meta-analysis published in the Cochrane Database of Systematic Reviews analysed data from 43 studies involving over 3,300 participants across high, middle and low-income countries. The review concluded that menstrual cups are a safe and acceptable method of managing menstruation. In fact, leakage levels were found to be similar or lower than those of disposable sanitary products.

Additionally, the Mayo Clinic states that menstrual cups are unlikely to disrupt the vaginal flora or pH when used and cleaned properly.

Do Menstrual Cups Increase Infection Risk?

The same Cochrane review found no increased risk of infections associated with menstrual cup use compared to pads or tampons. However, good hygiene practices are essential to prevent infection, including:

• Washing hands before inserting or removing the cup
• Sterilising the cup between cycles
• Not using the cup if you have open wounds or known sensitivities

What About Toxic Shock Syndrome (TSS)?

Toxic Shock Syndrome (TSS) is a rare but serious bacterial infection historically linked to high-absorbency tampon use. While there have been rare TSS cases involving menstrual cups, the overall risk remains extremely low and is usually linked to improper use, such as wearing the cup too long or not cleaning it thoroughly. A case report published in the Journal of Women's Health found that silicone menstrual cups do not inherently increase the risk of TSS when used as directed.

What Makes Menstrual Cups a Safe Choice?

Menstrual cups are made from medical-grade materials that are biocompatible and safe to be in contact with human tissue. They are free from bleaches, fragrances, or absorbent gels found in some disposables, which can irritate sensitive skin. For those with allergies or sensitivities, menstrual cups are often a more body-friendly option.

 

Who Should Be Cautious When Using a Menstrual Cup?

While menstrual cups are safe for most, they may not be suitable for everyone. Exercise caution and consult your GP or gynaecologist prior to using a menstrual cup if you have the following:

Allergies or Sensitive Skin

Most high-quality menstrual cups are made from medical-grade silicone, TPE (thermoplastic elastomer), or natural rubber latex — materials considered body-safe and hypoallergenic for the majority of users. That said, people with certain skin allergies or sensitivities may react to latex (natural rubber) or fragrances or colourants. Common allergy and sensitivity considerations include:

Latex Allergies

If you have a latex allergy (common among people with hay fever, asthma, or eczema), you should avoid menstrual cups made from natural rubber latex. While latex cups (e.g. the Keeper Cup) are rare, they do exist.

What to use instead: Choose a cup made from medical-grade silicone or TPE, which are latex-free and hypoallergenic.

Silicone Sensitivity

True silicone allergies are extremely rare, but some people report irritation. This is more likely due to: friction or dryness during insertion, incorrect size or firmness or inadequate cleaning, leading to bacteria build-up,

What to try: Choose a softer silicone or TPE cup. Use a water-based lubricant to aid with insertion. Thorough cleaning before first use and between cycles

Fragrance or Dye Sensitivity

Most reputable menstrual cup brands typically do not add fragrances and will offer a clear cup option, which does not contain unnecessary colourants that can irritate sensitive skin or disrupt the vaginal microbiome.

Tip: Choose clear, uncoloured cups from trusted brands if you're highly sensitive.

 

Pelvic Organ Prolapse

Pelvic organ prolapse (POP) occurs when the muscles and ligaments supporting the pelvic organs (bladder, uterus, or rectum) become weak or stretched, causing one or more organs to drop (prolapse) into the vaginal canal.
Using a menstrual cup may:

• Put additional pressure on already weakened tissues
• Cause discomfort or worsen symptoms
• Make insertion or retention difficult if the anatomy has shifted

People with mild prolapse may still be able to use a cup, especially soft, flexible models, but should get guidance from a pelvic floor physiotherapist or gynaecologist.

 

Vaginismus or Vulvodynia

These are conditions involving chronic vaginal or vulvar pain:

• Vaginismus causes involuntary tightening of the vaginal muscles, making insertion of anything (including a cup or tampon) painful or impossible.
• Vulvodynia involves persistent pain or burning around the vulva and inserting or removing a menstrual cup may cause physical pain or trauma, increased inflammation or psychological distress.

Alternatives such as reusable pads or period underwear are often preferred for those with these conditions.

 

Recent Pelvic Surgery or Postpartum Healing

After giving birth or having surgery in the pelvic or vaginal area, the tissues are healing and often more vulnerable to microtears, infection and discomfort or dislodgement of healing sutures.

Most healthcare providers recommend avoiding internal products, including menstrual cups, for 6–8 weeks postpartum or post-surgery, depending on individual recovery.

 

Endometriosis and/or Severe Pelvic Pain

Endometriosis involves tissue similar to the uterine lining growing outside the uterus, often causing severe pain, inflammation, and adhesions. Using a menstrual cup might exacerbate pain, especially during insertion or removal. It may also irritate internal tissues depending on cup's firmness and placement.

However, many with endometriosis still successfully use cups — comfort and compatibility vary widely.

 

Abnormally Positioned Cervix or Uterus

A particularly low or high cervix or tilted uterus (retroverted or anteverted uterus) can affect cup fit and comfort:

• A low cervix may interfere with larger or longer cups. See our guide on Best Menstrual Cups for a Low Cervix. 
• A very high cervix may make retrieval difficult. See our guide on Best Menstrual Cups for a High Cervix. 
• A tilted uterus can cause discomfort or poor suction. Menstrual discs are often better suited to people with a tilted uterus due to their flat-fit design. 

Measuring your cervix height during your period can help determine if a menstrual cup is suitable or which model might work best.

Use with an intrauterine device (IUD)

There’s no strong evidence that menstrual cup use increases the risk of IUD expulsion when used properly. However, there is a small risk, particularly in the first few months after IUD insertion, when the device is still settling into place.

An IUD has small strings that extend slightly into the vagina, allowing you to check the IUD is still in place and for your healthcare provider to remove the IUD when needed.

If the strings are too long or low, they may:

• Become caught between the rim of the menstrual cup and the vaginal wall
• Be tugged on during removal if suction isn’t properly broken
• Increase the risk of accidentally dislodging the IUD

 If you plan to use a menstrual cup long term and are concerned about the strings, a healthcare professional can trim them slightly. However:

• They should not be trimmed so short that they retract into the cervix (as this can make IUD removal difficult later)
• Only a trained medical professional should do this
• String length should still allow for periodic self-checks, if advised

Tips for Using a Menstrual Cup with an IUD: Here’s how to reduce the risk of IUD expulsion:

• Wait a few cycles after IUD insertion before using a menstrual cup, to allow it to settle.
• Choose a cup with a softer rim to reduce pressure on the cervix and vaginal walls.
• Break the suction completely before removing the cup. Pinch the base or insert a finger to release the seal gently.
• Check IUD strings occasionally (if advised by your healthcare provider).
• Consult your GP or gynaecologist before combining both, especially if you’re unsure about your anatomy or string length.

Tips for Safe Use of a Menstrual Cup

Follow these tips to keep your menstrual cup experience safe and hygienic:

• Choose a menstrual cup from a reliable, trusted brand
• Sterilise your cup before and after each cycle
• Wash your hands thoroughly before touching the cup
• Empty and rinse every 12 hours (or more frequently if needed)
• Use a water-based lubricant if insertion is uncomfortable
• Replace your cup every 1–5 years, depending on the brand

 

Menstrual cups, when used properly, are a safe, reliable, and environmentally-friendly option for managing periods. Clinical evidence supports their safety, and millions of users worldwide swear by their convenience and comfort.

Still, they aren’t for everyone—and that’s perfectly fine. The best product is the one that suits your body and lifestyle.

References

• NHS UK – Menstrual Cups: https://www.nhs.uk/conditions/contraception/menstrual-cups/
• Mayo Clinic – Menstrual Cup Safety:  https://www.mayoclinic.org/healthy-lifestyle/womens-health/expert-answers/menstrual-cup/faq-20423985 
• Cochrane Review – Systematic Review of Menstrual Cup Safety: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008998.pub3/full
• Journal of Women’s Health – Menstrual Hygiene Practices: https://www.liebertpub.com/doi/10.1089/jwh.2016.6072