Menstrual cups safe and effective, scientific review suggests

Menstrual cups safe and effective, scientific review suggests

Four studies within the review (293 participants) compared leakage between different sanitary products and found that levels were similar between menstrual cups and pads and tampons, while one found that leakage was significantly less.

Anna Maria van Eijk, from the Liverpool School of Tropical Medicine in the United Kingdom, and colleagues looked at the data of 3,300 women and girls in 43 earlier studies.

"We aimed to address this by summarizing current knowledge about leakage, safety and acceptability of menstrual cups, comparing them to other products where possible", she explained in a journal news release.

Made from medical grade silicone, rubber or latex, the cups collect blood rather than absorb it, as pads and tampons do. Cups are ideally emptied every six hours, but they can be used for a longer time. One $40 cup can last 10 years, while a year's supply of tampons or pads costs $60 to $120, reports the New York Times. Further worldwide research will be needed to provide more information on acceptability, to monitor adverse events, to assess best practice to shorten the familiarisation phase, and to more reliably assess cost-effectiveness and environmental effects.

Researchers said menstrual cups could provide a significant advantage for users in settings where sanitation facilities and adequate water are not readily available. Menstrual products are also rarely discussed and many women have difficulties in choosing the right product - or even worse, can't afford the proper menstruation products.

But just how safe and effective are the devices?

They have been around since the 1930s, and still, many who menstruate are unaware of the alternative to pads and tampons: the menstrual cup. In all studies, the adoption of the menstrual cup required a familiarisation phase over several menstrual cycles, but the learning curve wasn't steep - and once women got the hang of it, complications were surprisingly rare.

They found studies that showed a positive effect associated with the use of menstrual cups such as decreased stress around leakages. The authors identified five women who reported pain, three who reported vaginal wounds, six who reported an allergy or rash and nine who reported urinary tract complaints.

On the other hand, cheap, safe and effective means of menstrual care are needed.

Menstruation can have astronomical results on girls' schooling in particular, as well as women's experience of work. The study also revealed that they weren't detrimental to a woman's natural vaginal flora. So, policy makers need to know which sanitary products to include in menstrual health programs and puberty-education materials.

Commenting on the study, Dr Julie Hennegan from the Johns Hopkins Bloomberg School of Public Health, said: "For consumers purchasing menstrual products, the results highlight cups as a safe and cost-effective option". Sanitary protection remains unavailable and unaffordable to many women around the world, the authors noted.

Studies that had looked at the risk of toxic shock syndrome had sample sizes of only a few hundred participants and Wiles said that was too small to draw a conclusion on the safety of menstrual cups. "Authors found that awareness of menstrual cups was low, and that only 30 per cent of websites with educational materials on menarche included information about menstrual cups".

"There's a possibility of developing toxic shock syndrome, but the risk of TSS is 1 in 100,000", Leena Nathan, MD, ob-gyn at the Ronald Reagan UCLA Medical Center in Los Angeles, previously told Health.

Given the limited number of reports on the use of menstrual cups, the authors also caution that other potential issues can not be excluded, including use of menstrual cups in combination with IUDs. "Due to risks of dislodging the IUD, there may need to be a system of checking the IUD strings". However, some of the studies included in the analysis were ranked as low quality and some had not been peer-reviewed. Most of the studies depended on self-reporting, which might have overestimated the use of the menstrual cup. "In common with other members of the Menstrual Cup Coalition, I have found that lack of knowledge and misconceptions about menstrual cups prevent global NGOs and governments from including cups in their menstrual health programming, typically offering only disposable or cloth pads".

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