119. Menstrual Cups & Discs: Periods Without the Leaks

What if your period didn’t mean constant bathroom trips, backup pads, or worrying about leaks? In this episode, Dr. Monica Minjeur explores menstrual cups and menstrual discs—their benefits, differences, and how to find the right fit for your body. You’ll learn what makes medical-grade silicone safer for your vaginal microbiome, how to troubleshoot leaks, and why these products can help you feel clean, confident, and in control.

If heavy cycles, irritation, or frustration with traditional products have been holding you back, there’s a better way. At Radiant Clinic, we help women understand their cycles—because knowledge brings confidence.

Learn how to restore confidence in your cycle health—book a free discovery call at radiantclinic.com

Transcript

Speaker 2: 0:02

Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. What if your period didn't have to mean constant bathroom trips, backup pads, or worrying about leaks? Today we're going to be talking all about menstrual cups and menstrual discs. We'll discuss why so many women love them, who they work best for, how to pick the right one, what to do when they don't work perfectly, and how to know if this is the right fit for you. So let's get started with a patient story of mine, who we'll call Candace. Now, Candace was a 28-year-old pediatric nurse, and she had long 12 hour shifts that she worked at the hospital. She typically had fairly heavy flow on day one and two, and she was having a really challenging time making sure that she was able to get to the bathroom every two hours or so during those first few days of her cycle to change her tampon. On night shifts, bathrooms weren't always close, and she felt anxious every cycle, worrying about layering multiple layers, like pads and extra things in order to prevent bleeding through her tampons. A coworker told her about her menstrual cup, and Candace tried one, but found that it was very frustrating and she had a lot of leaking on day one, so she put it aside and talked with me about it at her next visit. After discussing this further at a follow-up visit with me, I let her know that there are different sizes, different shapes of cups, as well as we discussed menstrual discs. I reviewed with her that sometimes there is some trial and error to finding the right fit for her, but we talked through some of what she would need, and I made a recommendation for a specific disc that I thought would be better. So based on what she was telling me, we said that she needed either to utilize a softer, shorter cup or a menstrual disc. Instead, I talked her through how to make sure she had the right fit, and after she found the right product for her, Candace was able to go an entire 12 hour shift. Leak free. She was able to stop carrying around an extra bag of supplies and felt like she was clean for the first time at work. She said to me at her next visit, I finally forget that I'm even on my period for those first couple of days. So if you've never heard about menstrual cups or discs, let's talk a little bit about what they are and how they're different. So a menstrual cup is typically bell shaped. It sits in the vaginal canal below the cervix and creates a gentle seal or suction. You typically will empty the cup by removing the cup completely, dumping it into the toilet, rinsing it out, and replacing again. A menstrual disc as opposed is a flat rimmed basin, and it's a little bit bigger, and it typically sits in the vaginal fornix, which is the area that sits right behind your cervix and there's no suction with these. They're held in place. By anatomy and the front end of it sticks up underneath your pubic bone. Now, typically with these, you can empty them either by removing the cup, or you can actually empty it if you bear down while you're on the toilet. So if you push a little bit as if you were having a bowel movement, this can also cause the menstrual disc to automatically empty. So what are these made of? And that's the big thing that really makes them different than many other products that are out there. Almost all menstrual cups and discs are made from a medical grade silicone. This is an inert, non-porous latex free material. It's typically hypoallergenic and it's unlikely to leach any sort of additive. Now silicone collects rather than absorbs. And so because of that, it doesn't deplete the vagina of regular moisture or leave behind any nasty fiber residues. And oftentimes we see this for people, especially if they're using tampons, they'll notice fibers or cotton or threads can sometimes get stuck behind. So when there's fewer fibers, less dryness, this oftentimes means less friction, less irritation, and many users will report less odor, less problems with infections, because the vaginal microbiome is less disrupted. However, as with any internal product, you can still theoretically have toxic shock syndrome, but the risk seems to be incredibly low with these medical grade silicon products, especially if you use them correctly, clean them appropriately and make sure that you are changing them out only with clean hands. We also wanna make sure that you're using FDA registered devices from reputable brands and washing your hands before insertion and removal, and ideally cleaning, boiling, or sterilizing your cups or discs between each cycle. So again, why do people love these? The biggest reason that many, many women switch to them is they have an incredibly long wear time. Most women can keep them in anywhere from eight to 12 hours, depending upon your flow. They are marketed and typically approved to be left in for a 12 hour timeframe. So theoretically, this means that you're only having to change and replace it twice a day. Most discs especially, and many menstrual cups have a higher capacity than most tampons, which means that once you find the one that's the right fit, you oftentimes will actually have fewer leaks. Many women also switch to them because of the cost savings and lower waist. They're more environmentally friendly, and many menstrual cups or discs can be reused for years with the proper care. And then finally, many people, like I mentioned, report less problems as far as dryness, odor, irritation, as opposed to tampon usage or bulky pads. Now, disposable cups and discs do exist, and these are s. Single use menstrual discs and a few disposable cups that are out there. Now, these are a little bit different. They're typically made from medical grade polymers, which is a little different than the silicone, and they're designed for a single use up to 12 hours, depending upon the brand. Now these are great for travel. Um, if you're trying to just use one up or try to see, is this something that would be an okay fit before investing in a reusable one? And many people will find the disposable discs are great for travel or if they don't have the ability to clean them and store them and rinse them and keep them in good shape in between those travel. Now the downside to this is there is a higher long-term cost and more waste, but they are a nice option if you want to consider it before you invest in a reusable one. In general, all menstrual cups and discs can be a little bit tricky to get the right size, the right firmness, so they come in grades anywhere from soft to firm. Cervix height can make a big difference, and there is definitely a learning curve as far as the insertion and removal process. So we're gonna talk through a couple of things as far as how to determine the right fit for you and what makes more sense, A cup versus a disc. So a. First thing that I typically will talk patients through is to know what your cervix height is during your period. Now, this is going to mean a slight internal exam. I usually recommend checking your cervix length when you're in the shower. So if you stick a fingertip inside the vaginal canal and you can feel your cervix with very little of your finger in, you are going to want to choose a shorter or low profile cup. Or a menstrual disc instead because they don't have the height to'em. If you can get a couple of knuckles in and you still aren't feeling your cervix, you've got a higher cervix and oftentimes you'll want either a standard or a longer cup, but a disc can also work well. So if you don't know exactly your cervix height or your just guessing, or you don't want to do that internal exam, a disc is a good fit across the board. It does not make a difference where the cervix fits. The next step to consider is to match the firmness that you are looking for in your menstrual cup or disc. So women who are athletes have a stronger pelvic floor or are used to running more or lots of more exercise, or maybe you're up and down with kids a lot during the day. You may need. Firmer cups or discs in order to prevent them from collapsing. On the flip side of things, if you are more tender in the pelvic area, more prone to cramps, or especially if you're postpartum, many of those women will often prefer a softer cup in order to reduce pressure and firmness that they notice internally. The other thing to take into consideration is, is that there's different volumes that are available. So if you're somebody who has heavier flow, you wanna pick a larger capacity cup, anywhere from 30 to 40 milliliters or more. Or you may consider using a disc. Many discs can hold up to 50 milliliters or more depending upon the size on heavier days. Again, most women will prefer a disc because it means fewer bathroom trips, but again, a cup sometimes is preferred, depending upon your preference. Now when it comes to inserting these, oftentimes women look at them and they get really overwhelmed. They think, oh my goodness, this looks way too big for what I can fit internally. And there are lots of different methods as far as inserting a cup or a disc. The most common that we typically will teach in our office if you are using a menstrual cup is as called either the punch down or the C fold. And basically what that is, it's going to be folding. The menstrual cup itself in half so that it looks like it's making a little C before inserting it. And when you can kind of pinch it down into that size, it's only a little bit bigger than what a tampon would be. The punch down means that you just take one side of the menstrual cup and you literally punch it down onto the inside of the cup. Now when you're inserting with a menstrual cup, you're wanting to angle it back towards your tailbone and aim back. Once it's inside, you wanna let it fully open and then either slightly rotate the cup itself to allow it to pop open. Or sometimes you need to sweep a finger around the rim to check the seal and make sure that everything is enclosed around that area. Now a disc is a little bit different. Most discs, you're going to just fold up the two edges so they're next to each other, and then stick it in straight and tuck behind your cervix on the back end. And again, as I mentioned at the beginning, you're gonna push that. Forward rim up behind your pubic bone. Now I realize a lot of these are really challenging to describe when I'm just talking through them. There are tons of different YouTube videos and images and different things that are out there, especially on the brand manufacturer's website. Many of them have instructions for how to insert, so it seems a little bit daunting, but I promise there's lots of information out there. Now, the other big area that women oftentimes have issues with is removal. So big time issues as far as it's gonna spill everywhere. I'm having problems, I'm in a public restroom. So with a menstrual cup, remember you're gonna have suction that's there. So you always wanna make sure that you're pinching the base in order to break suction and then remove slowly. With a disc, it's a little bit different in that you need to typically hook a finger either under the front rim or under the pull tab and slide it out level in order to avoid spills. So we always recommend when you're first learning this, do it over the toilet, do it while you're in the shower. That way you can really get the hang of it, but ideally sliding it out. So that it's horizontal or to the floor in order to avoid any spills. So what are some real world problems that can occur and how can you fix those or how can you troubleshoot? So maybe you've tried this menstrual cup or disc and you're like, eh, it's okay. I don't love it, but maybe it's not the right fit for you. So if you find that it's leaking immediately, right? So I go in, I put it in, and within 15 or 20 minutes, I'm noticing, man, there it's, it's spilling everywhere. So either it's the wrong size for you, or it may just not be fully opened or placed in the right location. So you may want to just try a different fold, rotating it to open, or you may need to change the firmness or size altogether. If you find that, hey, it's actually okay early in the day, but it's leaking later in the day, it may be that you have a higher flow compared to the capacity that your cup can hold, so either empty it more frequently or use a higher capacity option. Oftentimes a disc can be a great option in these cases if you find that you're having. Pressure. Pain or cramping with a cup in the cup may be sitting too high in the vaginal canal, or it might be too firm or too long, and so you may wanna try a softer or smaller cup or switch to a disc altogether if you have difficulty removing it. Oftentimes this is because you have a tight pelvic floor or you're having a hard time relaxing those muscles. So I always recommend, especially when you're learning. Sit down on the toilet in order to try and remove it. Try and relax your pelvic floor. Push down a little bit. Pinch to release suction. If it's, if it's a, if it's a menstrual cup. And try a removal in the shower, I promise it will come out. It's just a matter of getting the right technique. Again, if you're having problems with messy removal, always remove over the toilet, keep it level, and practice removing it slowly. Other issues that we find is if you notice that there's odor to the cup or the disc, or it's staining, again, making sure that you're. Thoroughly cleaning, boiling, or sterilizing between cycles. And again, each manufacturer's gonna have different guidelines for how to keep that process sterile. If there's just mild staining that's typically cosmetic only and is not going to cause a problem. Now there are a few safety notes that I want to make sure that we go through briefly. And again, most of these are going to be on the manufacturer's website or in the device instructions themselves, but hygiene is incredibly important here. So always make sure that you wash your hands before insertion, before removal, and then always rinse your cup or your disc with water and a mild fragrance-free soap in between each use. Be between each menstrual cycle. You want to boil the cup or sterilize the cup five to 10 minutes. Again, following the brand guidelines. As far as wear time, many brands will allow or recommend that you can use them up to 12 hours. Again, you may need to empty it more frequently on heavier days, but definitely don't recommend use beyond 12 hours without changing it out, washing it, rinsing it, and making sure everything is is sanitary. If you are postpartum or if you have had any recent internal surgical procedures from a gynecologic standpoint, we always want to make sure that you're avoiding any sort of internal products until your healthcare professional has cleared you to make sure there's no infection risk, make sure that tissue is healing appropriately, et cetera. If you have any active infection, significant pain, or sudden cycle changes, stop using any internal devices and seek medical evaluation. We always wanna rule out any other causes of heavy bleeding or discomfort. And then another common question we get asked is, is it okay to have intercourse during my menstrual cycle? And interestingly enough, some discs are marketed as compatible with intercourse. Comfort and consent obviously should always be first of line, and be aware that there may be some mess potential. Now, most cups are typically not designed for intercourse because they do sit lower and they typically have some sort of a stem on them. But again, some of them can be utilized. So just a matter of having that dis. Discussion with your partner. Some people choose to avoid altogether, but for some they find that there's no major issues when they're using the appropriate devices. And then I wanna just give one additional consideration for if you are an individual who has an IUD. So the first is that, again, cups will create suction. So always, always, always make sure to break the seal before removal so that you avoid pulling on those strings. Now discs typically are a little bit easier if you have an IUD. They don't rely on suction, but it can still hook the strings if it's placed incorrectly. So please be mindful of it. If you've had an IUD recently placed, discuss timing with your clinician before starting a cup or a disc. Now in our practice, we typically don't recommend an IUD, and so if you're thinking about ditching your IUD all together, I would encourage you to go back and listen to episode number 43. That talks all about rethinking IUDs. You can also learn a fertility awareness method for charting your cycles in order to help avoid pregnancy, if that's your intention. Or to get further clarification for what might be going on with your menstrual cycles, if there is something wrong as far as abnormal cycles, heavy bleeding, irregular cycles, and for that you can go listen to episode number 91, which talks more about charting your cycle. So just one other quick piece of advice here. If you are new to this world and you are looking to figure out what should I do, cup versus disc, there are lots of online quizzes to help you find the best fit for you. It will oftentimes walk you through different questions like, have you delivered a baby? How active are you? Are you able to feel your cervix position? And based on answering those questions, it will make recommendations for a particular brand as well as. Size and flexibility and all of those things so that you can have a good place to start if you are not sure if a cup or a disc is right for you. I find that many women are more comfortable with a disc. They have a lower learning curve. They are more forgiving as far as placement and location, and they seem to have less troubles as far as making sure that you get it just perfect to prevent leaking. My recommendation is to pick one device. And commit to two to three cycles of practice before you decide if it's not for you. If a particular device is not working well for you, no problem. Switch it up. If you're somebody who has heavy flow plan, multiple emptying times, but again, a disc oftentimes is gonna be your best fit and able to be changed only every eight to 12 hours throughout the day. Imagine if your period felt clean. Contained and predictable without feeling like you had to carry a purse full of supplies everywhere. Over a few cycles of practice, you can find a cup or disc that fits your anatomy, holds your flow, and can stay comfortable through work, workouts, and sleep. That kind of confidence can turn your period from a monthly disruption into a routine that you have more control over. This can help improve your confidence and your overall health.

Speaker: 19:15

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