A properly inserted<unk>  (blue) will form a seal against the vaginal walls, as shown. Blood flow from the uterus (red) is captured in the<unk> . The<unk>  is first folded or pinched and then inserted into the vagina. It will normally unfold automatically and create a light seal against the cervix. In some cases, the user may need to twist the<unk>  or flex the vaginal muscles to ensure the<unk>  is fully open. If correctly inserted, the<unk>  should not leak or cause any discomfort. The stem should be completely inside the vagina. If it is not, the stem can be trimmed. There are various folding techniques for insertion; common folds include the c-fold, as well as the punch-down fold. If lubrication is necessary for insertion, it should be water-based, as silicone lubricant can be damaging to the silicone. After 4–12 hours of use (depending on the amount of flow), the<unk>  is removed by reaching up to its stem to find the base. Simply pulling on the stem is not recommended to remove the<unk> , as this can create suction. The base of the<unk>  is pinched to release the seal, and the<unk>  is removed. After emptying, a<unk>  should be rinsed or wiped and reinserted. It can be washed with a mild soap, and sterilized in boiling water for a few minutes at the end of the cycle. Alternatively, sterilizing solutions (usually developed for baby bottles and breast pump equipment) may be used to soak the<unk> . Specific cleaning instructions vary by brand. Advantages * When using a<unk> , the menstrual fluid is collected after it flows from the cervix and is held in liquid form. With tampons, liquid is absorbed and held in semi-coagulated form against the cervix. *<unk> s are known for their flexibility. Activities like swimming, hiking or heavy sports may be easier while using<unk> s relative to other feminine hygiene products. * If a user needs to track the amount of menses produced (e.g., for medical reasons), a<unk>  allows one to do so accurately. * Users employ about 1-2 liters of water to clear<unk> s. Acceptability studies A large Fleurcup<unk>  (center) can hold about 3 times as much liquid as a large tampon A 2011 randomized controlled trial in Canada investigated whether silicone<unk> s are a viable alternative to tampons and found that approximately 91% of women in the<unk>  group said they would continue to use the<unk>  and recommend it to others. In a 1991 clinical study involving 51 women, 23 of the participants (45%) found rubber<unk> s to be an acceptable way of managing menstrual flow. In a pilot project among refugees in Uganda, 87% used the<unk>  consistently over 3-months. In a randomized controlled feasibility study in rural western Kenya, adolescent primary school girls were provided with<unk> s or menstrual pads instead of traditional menstrual care items of cloth or tissue. Girls provided with<unk> s had a lower prevalence of sexually transmitted infections than control groups. Also, the prevalence of bacterial vaginosis was lower among<unk>  users compared with menstrual pad users or those continuing other usual practice. After six months,<unk>  users were free from embarrassing leakage or odor, and could engage in class activities and sport without humiliation or being teased. Access to water and hygiene Boiling a<unk>  * Cleaning a<unk>  in a public toilet can pose problems as the handwashing sinks are usually, though not always, in a public space rather than in the toilet cubicle. Some manufacturers suggest wiping out the<unk>  with a clean tissue and cleaning the<unk>  at the next private opportunity. The user could also carry a small bottle of water to rinse the<unk>  privately over the toilet. Another option is to use wet wipes. Since<unk> s only need to be emptied after half a day or less often (unless the flow is very heavy) many users do not have to empty them in public toilets, but rather wait until they return home. * A lack of clean water and soap for handwashing, needed before inserting the<unk> , presents a problem to women in developing countries. Insertion requires thorough washing of the<unk>  and hands to avoid introducing new bacteria into the vagina, which may heighten the risk of UTIs and other infections. Disposable and reusable pads do not demand the same hand hygiene, though reusable pads also require access to water for washing out pads. * Because<unk> s require boiling once a month, this can be a problem in developing countries if there is a lack of water, firewood, and good hygiene practices. Other options currently in use, such as rags that are washed, may be less hygienic. * Removing a<unk>  can be messy. Sometimes menstrual blood can spill during removal, although many women remove the device while hovering over a toilet to catch such spillage. When using a urine-diverting dry toilet, menstrual blood can be emptied into the part that receives the feces. If any menstrual blood falls into the funnel for urine, it can be rinsed away with water. Leakage<unk> s collect menstrual fluid inside the vagina and generally do not leak (if emptied often enough and inserted properly). Some women have experienced leakage due to improper use or<unk>  size. For example, a<unk>  may leak if it is not inserted correctly and does not pop open completely and seal against the walls of the vagina. Some factors mentioned in association with leakage included menorrhagia, unusual anatomy of the uterus, need for a larger size of<unk> , and incorrect placement of the<unk> , or that it had filled to capacity. However, a proper seal may continue to contain fluid in the upper vagina even if the<unk>  is full. The frequency of reported leakage for<unk> s is similar or lower than for tampons and pads.
Menstrual cup
Cloth menstrual pad
Menstrual pad
Menstrual cycle
Ovarian reserve
Vaginal ring
Sleep sex
Sex after pregnancy