Could Your Menstrual Cup Be Causing Organ Prolapse?

Menstrual cups have soared in popularity in recent years, hailed as a more eco-friendly way to tackle your period. If you're unfamiliar with them, they're silicone cups that fit into your vagina and collect your period blood, creating far less waste than tampons thanks to their ten year life span.

But, before you buy your MoonCup and phase out using Tampons forevermore, new Chartered Society of Physiotherapy (CSP) guidelines have shed some light on some worrying menstrual cup side effects that you might not have heard about.

The CSP warn that menstrual cups aren't currently regulated in the UK, receive no testing before hitting shelves and offer minimal instructions for application (and removal) on most packaging. While some may argue this makes menstrual cups less intimidating, the CPS states that such poor insertion and removal is, in some very extreme instances, leading to women experiencing organ prolapse.

One woman who, having never suffered from vaginal prolapse in her life, experienced it after using a menstrual cup for the just two months recently spoke out.

She told the Victoria Derbyshire programme that her gynaecologist said the prolapse 'probably happened because of the cup', and 'advised me not to use the cup any more. She was not a fan of them at all, especially in women who've already had kids, like me.'

What is vaginal prolapse and how do you get it?

Vaginal or pelvic organ prolapse, as it's also called, is when 'one or more of the organs in the pelvis slip down from their normal position and bulge into the vagina,' according to the NHS. This can be the womb (uterus), bowel, bladder or top of the vagina.

While prolapse is not life-threatening, it obviously causes pain and discomfort for the women who have to live with the condition, and can be caused by a range of factors, including change of hormones during the menopause, excessive coughing and pressure from excess weight.

The NHS website states that, in stereotypical cases, symptoms can be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed.

Wondering what vaginal prolapse feels like? It can look anything like:

What are the menstrual cup brands saying?

While there is no scientific backing at present to conclusively prove the link between use of the menstrual cup and prolapse, the CSP clearly warns that it's time for clearer safety advice to be put on all menstrual cup packaging. Currently, it varies from brand to brand, with the LilyCup advising you to 'use your vaginal muscles to push the cup out', Organicup advocating 'pulling slightly on the stem' when removing and Mooncup instructing never to pull out without breaking the seal.

In response to the news, Mooncup released a statement that pointed to the quick expansion of menstrual cup brands and called for better regulation all round. 'We agree with the Chartered Society of Physiotherapy calling for cups to be better regulated. In fact, shouldn't all internal sanitary products be better regulated? There's misleading information around using a menstrual cup circulating, with some products even being sold without any instructions for use.'

What are the experts saying?

The main thing to focus on, according to Dr Anita Mitra of @gynaegeek, is making sure the seal is broken before removing the cup from your vagina. Although she adds that, in general, she would encourage women not to panic. 'It's rarely a single factor that causes prolapse but women should not be bearing down or pulling out their cups forcibly.'

Female health physiotherapist Tiffany Sequeira of @gynaegirl agrees, warning that if you pull your menstrual cup out and, in turn, pull onto this vacuum, you're essentially dragging down the walls of your vagina from the inside. However, she adds that you bear down on our pelvic floor muscles several times a day, and other factors can increase your risk of prolapse, too. 'Persistent coughs and constipation can all predispose somebody, but the controversy lies in women being encouraged to "push down' to remove menstrual cups".'

While pushing down is never advised, Sequeira continues to note that she'd only expect women using a menstrual cup to experience prolapse if they've had other underlying symptoms, caused by other factors, for a while.

How to use a menstrual cup properly: expert advice

We asked Sequeira, as a female health expert, exactly how she'd advise women insert a menstrual cup To insert:

To remove, Sequeira seconds the instructions on the MoonCup website.

What should I do if I think I'm suffering from vaginal prolapse?

It's worth noting that prolapses are common, with around 40 per cent of women over the age of 40 said to go through them, menstrual cup or not.

If you think you may be suffering from any of the symptoms listed, the NHS website advises you book a GP appointment and ask for a referral to a gynaecologist or female health physiotherapist.

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