Can You Use a Menstrual Cup or Disc with an IUD?

14 min read
IUD

Some people use menstrual cups or discs with an IUD, but recent research suggests menstrual cup use may be associated with a higher risk of IUD expulsion or displacement. We do not yet know how much the risk varies between different IUDs, menstrual cups or individual users, and there is very little research specifically looking at menstrual discs.

If you have an IUD and want to use a cup or disc, it is worth discussing the combination with your healthcare professional. If you decide to use one, take particular care during removal and know what changes in your IUD strings or symptoms may need checking.

What is the concern about menstrual cups and IUDs?

An intrauterine device, or IUD, sits inside the uterus. Small removal strings extend through the cervix into the upper vagina.

A menstrual cup sits lower, inside the vaginal canal. It opens against the vaginal walls and forms a seal that helps keep it in position.

The concern is that using or removing a cup may move the IUD from its intended position or cause it to partly or completely dislodge out of the uterus.

Researchers have suggested a couple of possible ways this might happen:

  • the IUD strings could be caught or pulled during cup removal
  • forces involved when removing a cup that is still sealed may contribute to displacement

An IUD can also move or be expelled without menstrual cup use, so research needs to separate cup-related factors from the background risk of IUD movement.

Expulsion and displacement are slightly different

IUD expulsion means the IUD partly or completely comes out of the uterus. IUD displacement means it is no longer sitting in its intended position within the uterus. Both are important because an incorrectly positioned IUD may not provide contraceptive protection.

What does the research say?

Earlier research was fairly reassuring, but studies published over the past few years have given us more reason to be cautious about menstrual cup use with an IUD.

2012: no increase in early expulsion was found

An early study followed people after IUD insertion and compared those using menstrual cups, tampons and pads. It did not find a difference in early IUD expulsion during the first six weeks.

This was useful early evidence, but it only looked at a relatively short period after insertion.

2023: a systematic review found a possible association

A 2023 systematic review examined seven publications looking at menstrual cup use and IUD expulsion. The studies did not all reach the same conclusion, but the researchers found enough concern to say that a possible association could not be ruled out.

The review also highlighted major gaps in the evidence, including whether risk changes with IUD type, cup-removal technique, pelvic anatomy, string length or delaying cup use after IUD insertion.

2024: higher expulsion rates were found among menstrual cup users

A 2024 study analysed 1,046 participants from a randomised trial comparing two copper IUDs. By 36 months, IUD expulsion had occurred in 23.2% of menstrual cup users compared with 9.4% of people who did not use a cup.

The association was not the same for both IUDs. Increased odds of expulsion were found with the NTCu380-Mini, but not with the TCu380A.

The study also found more accidental IUD self-removals among cup users. This suggests that at least some events may happen during cup removal rather than as spontaneous IUD expulsions.

2025: cup use was associated with IUD displacement

A 2025 case-control study looked at 747 IUD users whose IUD position was assessed using transvaginal ultrasound.

Menstrual cup use was reported by 41.2% of participants with a displaced IUD compared with 17.0% of those whose IUD was correctly positioned.

After researchers adjusted for other known risk factors, menstrual cup use remained independently associated with IUD displacement, with an adjusted odds ratio of 3.09.

This was an observational study, so it shows an association rather than proving that menstrual cups caused the displacement. Taken together with the 2023 and 2024 research, however, it adds to the reason for caution.

What is the takeaway?

Several studies now suggest an association between menstrual cup use and IUD expulsion or displacement. We still cannot put one reliable percentage on the added risk for every IUD user because studies involve different IUDs, populations and research methods.

What about menstrual discs and IUDs?

We have far less research on menstrual discs and IUDs.

A menstrual disc sits differently from a cup. The back of the disc is positioned in the vaginal fornix and the front rim is tucked above the pubic bone. It does not stay in position using the same type of seal as a menstrual cup.

That difference sometimes leads to the suggestion that discs may be a safer option for people with an IUD, but we do not currently have enough evidence to make that claim.

In the 2024 copper-IUD study, only one participant reported using a menstrual disc without also using a cup, and that participant experienced an expulsion. One case tells us very little about the overall risk.

Some manufacturers state that their menstrual discs can be used with an IUD, but manufacturer guidance does not establish that there is no risk of IUD displacement or expulsion.

At this stage, a disc is best considered a different internal period-care option with very limited IUD-specific research, rather than a proven lower-risk alternative.

Does the type of IUD matter?

Possibly.ย There are two broad types of IUD: hormonal IUDs and copper IUDs. The strongest recent expulsion study involved two copper IUDs, and the results differed between those two devices.

The 2025 displacement study included IUD users more broadly, but it still does not give us a reliable risk estimate for every individual IUD model.

For that reason, it is useful to know which IUD you have when discussing menstrual cup or disc use with your healthcare professional.

The background risk of expulsion also varies between people and over time, so cup use is only one part of the picture.

What if your IUD was recently inserted?

IUDs are more likely to move or be expelled during the earlier months after insertion than later in their use.

Healthdirect currently advises avoiding menstrual cups and tampons for a couple of days immediately after IUD insertion however you may also come across advice suggesting a longer wait before using a cup. There is not enough evidence to show that one particular waiting period prevents cup-associated expulsion.

If your IUD was recently inserted, follow the aftercare advice given by your healthcare professional and ask when they recommend starting or restarting a cup or disc for your particular IUD.

How to remove a cup or disc carefully when you have an IUD

Good removal technique deserves extra attention when there are IUD strings in the vagina.

Removing a menstrual cup

  1. Wash and dry your hands.
  2. Reach for the base of the cup rather than pulling on the stem.
  3. Pinch the base or use the removal method recommended by the cup manufacturer to release the seal.
  4. Guide the cup down slowly and with control.
  5. Take care not to pinch or pull the IUD strings as you remove the cup.

Releasing the cup's seal before removal is good cup technique, but research has not shown that doing this removes the risk of IUD expulsion.

A cup stem is there to help you locate or control the cup. Do not use it to pull a sealed cup straight out.

Removing a menstrual disc

A menstrual disc does not have the same type of seal as a cup, but careful removal is still advised when you have an IUD.

Follow the instructions for your particular disc and use its removal loop, tab, notch or rim as intended. Remove it slowly and avoid catching or pulling on the IUD strings.

Because research on discs and IUDs is limited, there is no removal technique that has been shown to eliminate the risk of IUD movement.

Should you have your IUD strings trimmed?

Do not arrange to have your IUD strings shortened specifically because you use a menstrual cup or disc without first discussing it with your healthcare professional.

String length has been suggested as one factor that could affect how a menstrual cup and IUD interact, but research has not shown that shortening the strings prevents expulsion.

Very short strings may also be more difficult to locate and can make later IUD removal more complicated.

Your healthcare professional can check the position and length of your strings and advise you based on your particular IUD and anatomy.

What if your IUD strings feel different?

Check your IUD thread around once a month so you become familiar with how they normally feel.

Contact your healthcare professional if:

  • the strings suddenly feel much longer or shorter
  • you cannot feel the strings when you normally can
  • you can feel hard plastic rather than just the strings
  • you develop unusual pelvic pain or cramping
  • you think the IUD may have moved or come out

A change in the strings does not necessarily mean the IUD has moved and being unable to find them does not mean it has definitely been expelled. Your healthcare professional can check the position if needed.

If you think your IUD has moved or been expelled and you rely on it for contraception, use another form of contraception and seek medical advice.ย 

When should you contact a healthcare professional?

Seek medical advice if you have significant or unusual pelvic pain, heavy or unexpected bleeding, unusual vaginal discharge, pain during sex, a noticeable change in your IUD strings, difficulty removing a cup or disc or concerns that your IUD may have moved.

If you experience severe pain, very heavy bleeding, fainting or other symptoms that feel urgent, seek prompt medical care.

Choosing a period product when you have an IUD

Having an IUD does not mean you have to stop using reusable period products, but the newer research around menstrual cups is worth considering when deciding what feels right for you.

If you want to avoid an internal product, reusable cloth pads or disposable pads are options that do not interact with the IUD strings.

If you are considering a cup or disc, look at the product's design and removal method and discuss the current evidence with your healthcare professional rather than relying only on a manufacturer's statement that the product can be used with an IUD.

You can compare specific products using our Menstrual Cup Comparison Chart, Menstrual Disc Comparison Chart or Menstrual Products Comparison Hub.

Frequently asked questions

Can you use a menstrual cup with a hormonal IUD?

Some people use menstrual cups with hormonal IUDs, but we do not have enough research to give a reliable estimate of the added expulsion or displacement risk for hormonal IUDs specifically. The strongest 2024 study involved two copper IUDs, while later research found an association between cup use and IUD displacement more broadly. Discuss your particular IUD with your healthcare professional if you want to use a cup.

Can you use a menstrual disc with an IUD?

Some people do, and some disc manufacturers state that their products can be used with an IUD. However, clinical research specifically examining menstrual discs and IUD movement is extremely limited, so we cannot currently say that discs carry less risk than cups simply because they sit differently and do not use the same type of seal.

Can a menstrual cup pull out an IUD?

Accidental IUD self-removal has been reported during menstrual cup use, and the 2024 copper-IUD study found accidental self-removals occurred more often among cup users. It is not always possible to know whether the IUD strings were caught or whether another factor was involved, so careful cup removal is important but cannot be said to remove the risk completely.

Does releasing the cup seal prevent IUD expulsion?

Releasing the seal before removing a menstrual cup is good removal technique and helps avoid pulling a sealed cup down through the vaginal canal. However, research has not shown that releasing the seal prevents IUD expulsion, so it should be considered sensible technique rather than a guarantee of protection.

Should I have my IUD strings cut shorter if I use a menstrual cup?

There is not enough evidence to show that shorter IUD strings reduce cup-associated expulsion risk. String length is something your healthcare professional can assess, and shortening the strings too much can make them harder to locate and may complicate future IUD removal. Do not have them shortened solely for cup use without discussing the pros and cons with your clinician.

Should I stop using my menstrual cup because I have an IUD?

That decision depends on your circumstances and how you feel about the uncertainty in the current evidence. Research now suggests cup use may be associated with IUD expulsion or displacement, but we do not know the exact risk for every IUD or user. Discussing your particular IUD and period-care preferences with your healthcare professional can help you make an informed choice.

How long should I wait after IUD insertion before using a menstrual cup?

Healthdirect advises avoiding menstrual cups for a couple of days immediately after IUD insertion, but there is no well-established waiting period that has been shown to prevent cup-associated expulsion. Because background expulsion risk is higher earlier after insertion, follow your own aftercare instructions and ask your healthcare professional when they recommend restarting a cup.

The bottom line

Recent research suggests menstrual cup use may be associated with an increased risk of IUD expulsion or displacement, although we still do not know the exact risk for every IUD type or user.

Evidence for menstrual discs is much more limited, so their different design should not be taken as proof that they are a safer option with an IUD.

If you want to use a cup or disc, talk with your healthcare professional about your particular IUD, follow the product instructions and take care during removal. If you would rather avoid that uncertainty, an external period product is another perfectly practical choice.

Choose your next step

Want to compare menstrual cups?
Use the Menstrual Cup Comparison Chart.

Considering a menstrual disc?
Use the Menstrual Disc Comparison Chart.

Still deciding between different types of period care?
Visit the Menstrual Products Comparison Hub.

Prefer an external reusable product?
Browse Reusable Cloth Pads & Liners.

Related reading

This article provides general educational information and is not a substitute for individual medical or contraceptive advice. If you have an IUD and are concerned about its position or contraceptive protection, contact a qualified healthcare professional.

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