Do menstrual cups (MCs) cause uterine prolapse?
The issue raised by an article in the BBC is actually NOT that MCs cause uterine prolapse. The issue is that two women report they are concerned that unclear/incorrect instructions on some brands of MCs may cause women to use them incorrectly, and this MAY have been associated with uterine prolapse.
As noted in the BBC article, a systematic review in the Lancet, covering 43 studies, found MCs to be safe. WoMena’s medical advisors confirm this, and note that MCs have not been associated in any causal way with pelvic organ prolapse. It also makes no sense physiologically speaking since it’s the uterine ligaments that are stretched and stressed leading to prolapse (that menstrual cups go nowhere near) whereas the vagina is meant to be elastic and stretch in the vaginal walls (e.g. with cup insertion/removal) does not cause prolapse.
The recommendation in the BBC by The Chartered Society of Physiotherapy (CSP) is that manufacturers should include better safety advice for women, that is that instructions for ALL brands should be clear/correct. They provide one (very simple) instruction video on how to insert/remove. WoMena training includes more detail, as the video indeed is only an introduction.
WoMena very much agrees with the recommendation by the CSP. It is part of our long-standing advocacy to push for clearer standards, labeling, testing, and registration of menstrual products. In recognition that all products may have questions related to standards, a series of discussions (organized by a range of actors, e.g.WASH United for Menstrual Hygiene Day, the African Coalition for Menstrual Health Management, the Menstrual Health Alliance of India, and the Reproductive Health Supplies Coalition) is focusing on both pads, tampons and MCs. WoMena is providing some of the backgrounds for MCs.