Can Using a Menstrual Cup Worsen Pelvic Organ Prolapse? Expert Answers

Menstrual cups have gained popularity of late because it is sustainable, cost-effective, and a comfortable alternative to traditional products. However, women who are dealing with pelvic floor issues, is this a safe choice? This topic often brings up valid concerns about safety and comfort. A common question that arises is whether the suction created by menstrual cups can have a negative effect or worsen pelvic organ prolapse (POP). POP involves the weakening of pelvic muscles and ligaments. Therefore, the concern that introducing a product inside vagina may cause additional downward pressure, is completely valid. 

To help separate fact from fiction, we reached out to Dr Monica Agarwal, Associate Director, Department of Obstetrics and Gynaecology at Cloudnine Group of Hospitals, Chandigarh.

Can Using a Menstrual Cup Worsen Pelvic Organ Prolapse?

Dr Agarwal says that menstrual cups are a safe, eco-friendly, and effective menstrual hygiene option for most women. She adds, “However, women with pelvic organ prolapse or those at high risk of developing it should exercise caution and seek medical advice before using one.”

The expert explains further, “Pelvic organ prolapse occurs when the muscles and ligaments supporting the bladder, uterus, or rectum weaken, allowing these organs to descend into the vaginal canal. While there is no strong scientific evidence that menstrual cups directly cause or worsen prolapse, improper use may place unnecessary strain on the pelvic floor. Pulling a cup out without first breaking its suction can increase downward pressure on already weakened tissues. Similarly, using an oversized cup or repeatedly inserting and removing it incorrectly may cause discomfort in women with existing prolapse.”

Tips To Choose The Right Menstrual Cup

Dr Agarwal says that if you have POP, and you are choosing to use a menstrual cup, here are some tips for you:

• Always break the suction seal by pinching the base before removal rather than pulling on the stem.
• Select the correct size.
• Maintain proper hygiene.
• Avoiding prolonged wear beyond the recommended duration is equally important.

Dr Agarwal says that another important point to note is that women with mild prolapse may still be able to use a menstrual cup comfortably after consultation with their gynaecologist. “But those with moderate to severe prolapse may find it difficult to keep the cup in place or experience pressure, discomfort, or leakage. In such cases, alternatives like sanitary pads or period underwear may be more suitable,” she adds.

How Menstrual Cups Impact Women’s Pelvic Muscles

A 2023 scientific study, published in the Women and Health journal, examined how using a menstrual cup over time affects the muscles of the pelvic floor. The researchers analysed a group of ten healthy young women. They used a menstrual cup for three complete menstrual cycles. The researchers measured the women's pelvic muscle strength, vaginal resting pressure, and overall muscle tone using specialised tests. The results depicted that using the menstrual cup enhanced the maximum voluntary squeezing strength of the participants' pelvic muscles. 

Moreover, the study noted that women were also able to engage in a higher number of sustained pelvic muscle contractions. This indicates improved muscle endurance.The study also measured a noticeable decrease in the natural resting pressure inside the vagina. These findings show that wearing a menstrual cup causes measurable, physical changes to how the pelvic floor muscles function. Therefore, study concluded that menstrual cups offer an overall positive experience for women, while subtly enhancing certain aspects of pelvic floor muscle function.  

When To Seek Medical Attention

Dr Agarwal says that women experiencing the following symptoms should seek prompt medical evaluation rather than attributing these symptoms to menstrual cup use:

• Feeling of heaviness in the pelvis.
• A bulge in the vagina.
• Urinary leakage.
• Difficulty emptying the bladder.
• Persistent pelvic discomfort. 

“Ultimately, menstrual cups are not a known cause of pelvic organ prolapse. The health of the pelvic floor depends more on factors such as childbirth, ageing, obesity, chronic constipation, heavy lifting, and persistent coughing. If used correctly and after medical guidance where necessary, menstrual cups remain a safe option for most women,” concludes Dr Agarwal.

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Conclusion

To summarise, menstrual cups do not directly cause pelvic organ prolapse. However, women who are struggling with this condition need to be extra careful and follow proper usage. Some of the safety practices they need to follow is to break the suction seal completely before removal and choosing the correct cup size. Women with mild prolapse can often continue using cups comfortably. But those with moderate to severe cases may need to opt for other gentle alternatives such as period underwear or pads. If you experience persistent pelvic heaviness, discomfort, or unusual bulging, consult your gynaecologist immediately to find the safest menstrual hygiene solution for you.