Yes, research shows menstrual cups do not raise any safety concerns when they are used and cared for according to the product instructions. Studies examining infection risk are reassuring, but rare adverse events have been reported and some questions, including menstrual cup use with an IUD, would still benefit from more research.
If you're considering a menstrual cup, it is reasonable to have questions about hygiene, infection, toxic shock syndrome (TSS), cup materials, IUDs and whether an internal period product is suitable for your circumstances.
This guide looks at what current research tells us, where the evidence is limited and the practical steps that can help you use a menstrual cup safely.
Menstrual cup safety at a glance
| Question | What current evidence suggests |
|---|---|
| Are menstrual cups generally safe? | Research to date is generally reassuring when cups are used as directed, although rare adverse events have been reported. |
| Do cups increase infection risk? | Studies have not found a clear increase in infection risk among menstrual cup users across the outcomes studied. |
| Can menstrual cups cause TSS? | TSS is rare but serious and has been reported with menstrual cup use. As with all internal products, hygiene and wear-time instructions are important to reduce the risk of TSS. |
| Are cups regulated in Australia? | Yes. Menstrual cups supplied in Australia must comply with TGO 99 requirements, although individual cups do not require pre-market TGA assessment or ARTG inclusion. |
| Can you use a cup with an IUD? | Possibly, but several studies suggest menstrual cup use may be associated with increased IUD expulsion or displacement risk. |
| Does a menstrual cup hurt? | Some unfamiliarity is common while learning, but significant or persistent pain should be investigated rather than pushed through. |
What is a menstrual cup?
A menstrual cup is an internal period product that sits inside the vaginal canal and collects menstrual fluid rather than absorbing it.
Menstrual cups are reusable and are emptied, cleaned and reinserted during a period, then sanitised and stored between cycles according to the manufacturer's instructions.
Cups vary a lot in: length, diameter, shape, firmness, capacity, stem and removal design and material. Comfort is partly about using a product that fits your anatomy but also about finding a cup that can be inserted and removed without difficulty or pain.
If you are new to cups, read our How to Use a Menstrual Cup guide for step-by-step information about insertion, positioning, removal and care.
What does the research say about menstrual cup safety?
The 2019 systematic review
A major systematic review and meta-analysis published in The Lancet Public Health in 2019 included 43 studies involving 3,319 participants.
The review found that menstrual cups appeared to have a generally favourable safety and acceptability profile. In studies that compared leakage with other menstrual products, cup leakage was similar to or lower than leakage reported with disposable pads or tampons.
The researchers found no adverse effect on vaginal flora in the four studies that assessed it, but they also identified rare reports of:
- severe pain or vaginal wounds
- allergies or rashes
- urinary tract complaints
- toxic shock syndrome
- IUD dislodgement
- difficulty removing a cup requiring professional assistance
What has research found since then?
A 2026 systematic review and meta-analysis examined 11 studies involving 10,268 participants and focused specifically on vaginal health, reproductive tract infections, sexually transmitted infections and the vaginal microbiome.
Across the infections evaluated, the researchers did not identify an increased infection risk among menstrual cup users. Some individual analyses found associations with lower rates of particular infections and vaginal microbiome patterns considered favourable, but those findings should be interpreted cautiously rather than taken to mean menstrual cups prevent infection.
What does this mean in practical terms?
The current evidence indicates menstrual cups as a reasonable period care option for many people but it also tells us that cup use is not risk-free. Product fit, hygiene, removal technique, wear time, material and individual anatomy can all affect the user experience.
Do menstrual cups increase infection risk?
Current research has not found a clear overall increase in infection risk among menstrual cup users. The 2019 review found no adverse effects on vaginal flora in the four studies examining that outcome. The larger 2026 review also found no increased infection risk across the reproductive tract and urogenital infections evaluated.
Good hygiene is important. Wash your hands before inserting or removing a cup, clean the product as directed and follow the manufacturer's guidance for between-cycle sanitising and storage.
What about toxic shock syndrome?
Toxic shock syndrome, or TSS, is a rare but potentially life-threatening response to toxins produced by certain bacteria and menstrual cups have been associated with rare cases of TSS.
In Australia, menstrual cups must include information about TSS as well as instructions covering hygiene, cleaning and maximum duration of use. The product instructions must specify a duration of use that does not exceed 12 hours.This does not mean every cup should be worn for 12 hours. Follow the instructions for your particular cup and empty it sooner when your flow requires it.
What are the symptoms of TSS?
Symptoms can include:
- a sudden high temperature
- vomiting
- diarrhoea
- dizziness or low blood pressure
- aching muscles
- confusion
- a red rash that can look like sunburn
If you think you may have toxic shock syndrome, seek urgent medical care. Call triple zero (000) for an ambulance or go to the nearest emergency department if TSS is suspected.
How are menstrual cups regulated in Australia?
Menstrual cups are classified as therapeutic goods in Australia and must comply with the Therapeutic Goods (Standard for Menstrual Cups) (TGO 99) Order 2018.
TGO 99 covers requirements relating to: permissible raw ingredients, product design, packaging, labelling and information supplied with the menstrual cup.
There is an important distinction, however. Menstrual cups are exempt goods and do not require an individual entry in the Australian Register of Therapeutic Goods (ARTG). This means the TGA does not assess each menstrual cup before it is supplied in Australia.
Manufacturers and suppliers are still responsible for ensuring that products legally supplied in Australia comply with the applicable requirements so ensure you buy from a reputable supplier.
Required product information includes instructions for hygiene and cleaning, a maximum stated duration of use of no more than 12 hours and information about TSS.
Are menstrual cup materials safe?
Most menstrual cups are made from silicone however they can also be made from thermoplastic elastomer (TPE) or natural rubber latex. The exact material should be checked in the manufacturer's product information.
Australian requirements specify permissible raw ingredients and require menstrual cups to be designed to minimise trauma during normal use.
What if you have a material allergy?
If you have a known latex allergy, avoid cups made from natural rubber latex and check the product's material before purchasing.
Likewise, terms such as “medical-grade”, “hypoallergenic” and “body-safe” are product-specific claims. They should be supported by information about the particular product rather than assumed to describe every menstrual cup.
If you experience irritation or a suspected reaction, stop using the product and seek medical advice if the symptoms are persistent, significant or concerning.
Can you use a menstrual cup with an IUD?
Possibly, but this is an area where the evidence deserves particular attention.
A 2023 systematic review found a possible association between menstrual cup use and increased risk of partial or complete IUD expulsion. The studies included in that review produced different results and the researchers noted that the evidence was limited.
Further studies have added to the concern. A study of copper IUD users found higher expulsion rates among menstrual cup users for one of the IUD types studied, while a later case-control study found menstrual cup use was independently associated with IUD displacement.
This does not tell us that every person using a cup with an IUD will experience a problem, nor does it tell us exactly why an association may occur. Possible factors being investigated include cup removal technique, IUD type, anatomy and contact with IUD strings.
If you have an IUD and want to use a menstrual cup:
- discuss cup use with the healthcare professional managing your IUD
- follow the instructions supplied with your IUD and menstrual cup
- release the cup's seal before removal rather than pulling it down while sealed
- seek medical advice if you notice a change in your IUD strings or symptoms suggesting the device may have moved
Read Using Menstrual Cups or Discs With an IUD for a more detailed discussion of the research.
Who may benefit from individual advice before using a menstrual cup?
A health condition does not necessarily mean a menstrual cup cannot be used, but there are circumstances where individual advice can be useful.
After childbirth or pelvic surgery
The appropriate time to return to internal period products after childbirth, gynaecological surgery or pelvic surgery depends on the procedure, healing and individual circumstances. Follow the advice of your healthcare professional rather than relying on a fixed number of weeks.
Persistent pelvic, vulval or vaginal pain
If inserting or wearing a menstrual cup is painful, do not force it. Pelvic floor tension, vaginismus, vulval or vaginal pain conditions and other causes of pelvic pain can affect comfort with internal products. A GP or pelvic health physiotherapist can help assess ongoing symptoms.
Pelvic organ prolapse or a feeling of vaginal pressure
Changes in pelvic support can affect how an internal menstrual product sits. If you experience vaginal heaviness, pressure, a bulge or changes in bladder or bowel function, consider seeking an individual assessment rather than treating the issue as cup fit alone.
Read our Pelvic Organ Prolapse Guide or use our Australian Pelvic Health Physiotherapist Directory.
Known material allergy
If you have an allergy to latex or another material, check the exact cup composition before use and select a product that does not contain your known allergen.
Unexplained bleeding or new symptoms
Unexplained bleeding, significant irritation, ongoing pain or new bladder or bowel symptoms are reasons to seek healthcare advice rather than assuming the menstrual cup is the cause or continuing to experiment with different products.
What about cervix height and cup fit?
Cervix height, cup length, diameter, shape and firmness can affect comfort, positioning and removal. If a cup repeatedly protrudes, slips, causes pressure, becomes difficult to reach or feels uncomfortable once open, the issue may be the product's fit rather than a general safety problem with menstrual cups.
Read How to Measure Your Cervical Position and use the Menstrual Cup Comparison Chart to compare cup dimensions.
How can you use a menstrual cup safely?
The most important step is to follow the instructions supplied with your particular cup. Wear time, cleaning methods, materials and care guidance can differ between products.
Before insertion
- Wash and dry your hands.
- Inspect the cup for cracks, tears, stickiness or other signs of deterioration.
- Check the instructions for cleaning, insertion, removal and maximum wear time.
- Use a comfortable position and avoid forcing insertion.
- Use compatible lubricant if needed and permitted by the manufacturer.
During use
- Empty the cup before it reaches capacity.
- Stay within the maximum wear time stated by the manufacturer.
- Pay attention to persistent pain, pressure or difficulty urinating.
- Do not assume repeated leaks, slipping or collapsing are simply something you need to tolerate.
If you are experiencing a specific problem, use our Menstrual Cup Troubleshooter.
During removal
Do not pull the cup out firmly by the stem alone. Follow the product instructions and release the cup's seal before removal, then guide it out with control.
If the cup is difficult to remove, take your time and avoid repeatedly pulling harder. Our How to Use a Menstrual Cup guide explains removal in more detail.
Cleaning and between-cycle care
Clean your cup during your period and sanitise it between cycles according to the manufacturer's instructions. Approved methods can differ between products, so use the care instructions supplied with your cup rather than household cleaning chemicals or methods that the manufacturer has not recommended.
What are the possible downsides of menstrual cups?
Menstrual cups can be a great period care option, but they do have trade-offs. Insertion and removal can take practice, finding the right size or shape can involve trial and error, some cups may cause pressure or discomfort and reusable products need to be cleaned and stored between uses.
A cup may also leak when it has not opened correctly, reaches capacity or does not suit the user's anatomy. These issues are often better approached as fit or technique questions rather than assuming that all menstrual cups are unsafe or unsuitable.
Frequently asked questions
Are menstrual cups safer than tampons?
There is not enough evidence to rank menstrual cups and tampons as simply “safer” or “less safe”. They work differently and have different risks and practical considerations. Current evidence suggests menstrual cups have a generally favourable safety profile when used as directed, while both tampons and menstrual cups have been associated with rare cases of toxic shock syndrome.
Can menstrual cups cause infections?
Current research has not found a clear overall increase in infection risk among menstrual cup users. A 2026 systematic review found no increased risk across the infections evaluated, although the researchers noted that the number and quality of available studies remain limited. Hand hygiene, correct cleaning and following the product instructions are still important.
Can a menstrual cup cause toxic shock syndrome?
Yes, TSS has been reported with menstrual cup use, although it is rare. Australian menstrual cup requirements include warnings about TSS, hygiene and maximum duration of use. If you develop symptoms such as sudden high temperature, vomiting, diarrhoea, dizziness, confusion, muscle aches or a rash and suspect TSS, seek urgent medical care.
How long is it safe to wear a menstrual cup?
Follow the maximum wear time stated for your particular cup and empty it sooner if your flow requires it. Australian requirements state that menstrual cup instructions must specify a duration of use that does not exceed 12 hours, but this is a regulatory maximum rather than a recommendation that every person should wear every cup for 12 hours. Read How Long Can You Wear a Menstrual Cup? for more detail.
Can you use a menstrual cup with an IUD?
Some people use both, but research suggests menstrual cup use may be associated with increased IUD expulsion or displacement risk. The size of that risk and the factors contributing to it are still being studied. If you have an IUD, discuss menstrual cup use with your healthcare professional, follow both product instructions and release the cup's seal carefully before removal.
What if a menstrual cup hurts?
Stop if inserting, wearing or removing a cup causes significant pain. Cup length, diameter, shape, firmness, cervix position, pelvic floor tension or insertion and removal technique may contribute. A different product may feel more comfortable, but persistent or unexplained pain should be discussed with a qualified healthcare professional. You can also read What to Do If Your Menstrual Cup Is Hurting.
Are menstrual cups safe for teenagers?
Teenagers can use menstrual cups if they are comfortable using an internal period product and follow the supplied instructions. Age alone does not determine whether a cup is suitable. Cup length, diameter, firmness, flow, comfort with insertion and removal and individual preference are more useful considerations. Read our guide to choosing a menstrual cup for teens and first-time users.
Can menstrual cups damage the cervix?
A correctly fitted and appropriately used menstrual cup should not require force against the cervix. Some people can feel pressure or discomfort if a cup is too long, firm or poorly positioned. If the cup repeatedly causes cervical pain or significant pressure, remove it and reassess the product fit rather than continuing to wear it.
Do menstrual cups need to be sterilised?
Follow the manufacturer's cleaning and between-cycle care instructions. At home, methods such as boiling or steam treatment are better described as sanitising rather than clinical sterilisation. The appropriate method depends on the cup, so use the instructions supplied with your product.
The bottom line: are menstrual cups safe?
Current research suggests menstrual cups are a generally safe and viable period-care option for many people when they are used as directed.
The evidence around infection risk is reassuring, including a 2026 review that found no increased risk across the infections studied. Rare adverse events, including TSS, pain, urinary symptoms and difficulty with removal, have been reported, and research increasingly suggests that people using an IUD should be aware of a possible increased risk of expulsion or displacement.
The best approach is to choose a cup that suits your anatomy and preferences, follow its hygiene and wear-time instructions, release the seal before removal and pay attention to persistent pain or other concerning symptoms.
Choose your next step
Considering a menstrual cup and want help choosing?
Take the Find Your Best Fit Quiz.
Want to compare cup materials, dimensions, shapes and firmness?
Use the Menstrual Cup Comparison Chart.
Already using a cup and something isn't working?
Use the Menstrual Cup Troubleshooter.
Using an IUD?
Read Using Menstrual Cups or Discs With an IUD.
Experiencing persistent pelvic pain, pressure or other pelvic symptoms?
Speak with your GP or use our Find a Pelvic Health Physiotherapist in Australia directory.
Related reading
- How to Use a Menstrual Cup
- Toxic Shock Syndrome
- Using Menstrual Cups or Discs With an IUD
- How Long Can You Wear a Menstrual Cup?
- What to Do If Your Menstrual Cup Is Hurting
- How to Measure Your Cervical Position
- Menstrual Cup Comparison Chart
This article provides general educational information and is not a substitute for individual medical advice. Always follow the instructions supplied with your menstrual cup and seek professional advice if you experience persistent pain, unusual bleeding or other symptoms that concern you.
Sources
- van Eijk AM et al., Menstrual cup use, leakage, acceptability, safety and availability: a systematic review and meta-analysis
- van Eijk AM et al., Effect of menstrual cups on vaginal health, reproductive tract and urogenital infections: a systematic review and meta-analysis
- Bowman N and Thwaites A, Menstrual cup and risk of IUD expulsion: a systematic review
- Menstrual cup use and intrauterine device expulsion in a copper intrauterine device randomized trial
- The use of a menstrual cup as a risk factor for displacement of intrauterine devices: a case-control study
- Therapeutic Goods Administration, Tampons and menstrual cups
- Therapeutic Goods Administration, Meeting regulatory requirements for menstrual cups in Australia
- Healthdirect Australia, Toxic shock syndrome