The complete guide to menstrual cups: How to use, clean and choose
- Josie Shillabeer
- May 5
- 10 min read
Your complete guide to menstrual cups by Nutritional Therapist Josie Shillabeer. Learn how to use, clean, choose your size, plus safety, costs, and FAQs.
If you have ever wondered whether a menstrual cup might be a healthier, cheaper, more comfortable alternative to tampons and pads, this guide covers everything you need to know. From how they work and how to use one, to choosing the right size, cleaning and sterilising properly, and what to do if things do not go to plan on the first try.
In this article, we will cover:
What is a menstrual cup?
Menstrual cup vs tampon, pad, period pants and menstrual disc
Why choose a menstrual cup?
Who can use a menstrual cup?
Are menstrual cups safe?
How to choose your first menstrual cup
How to use a menstrual cup
Common menstrual cup problems and how to fix them
How to clean and sterilise your menstrual cup
Common questions about menstrual cups
Our recommended menstrual cup
What is a menstrual cup?
A menstrual cup is a small, reusable, bell-shaped device that sits inside the vagina and collects menstrual blood instead of absorbing it. Most modern cups are made from medical-grade silicone, with a few options in latex or thermoplastic elastomer. They form a gentle seal with the vaginal walls, hold significantly more blood than a tampon, and can be worn for up to 12 hours at a time. Menstrual cups are not new; they were first patented in 1937 but only entered mainstream awareness in the early 2010s as part of the zero-waste movement. Today they are widely available across the UK and used by millions of people worldwide.
Menstrual cup vs tampon, pad, period pants and menstrual disc
A quick comparison of the main period products on the market:
Tampons: absorbent, disposable cylinders inserted into the vagina. Most contain bleached cotton, plastic, and sometimes fragrances. Must be changed every 4 to 8 hours to reduce the risk of toxic shock syndrome (TSS).
Pads: available in two forms, disposable pads or reusable pads. Both are worn externally, are attached to underwear using an adhesive or poppers, and are absorbent. Most pads are made of plastic, increasing endocrine disruptors, reducing breathability, and can chafe.
Period pants: absorbent, reusable, worn like normal underwear. They are a great option for the first day of a period when you are more tender, as a backup worn alongside a menstrual cup for those who feel uncomfortable inserting menstrual care products. Many are made from plastic, so take care to look for those made from the most natural materials possible, e.g. organic cotton.
Menstrual discs: collect blood rather than absorb it, sit higher in the vaginal canal at the base of the cervix, and are removed by reaching in and pinching the rim. Available in both reusable and disposable versions.
Menstrual cups: collect blood rather than absorb it, sit lower in the vaginal canal, held in place by suction. Reusable, lasting up to 10 years with proper care.
Why choose a menstrual cup?
Here are the key reasons people choose to switch to a menstrual cup.
Cost. The average cost of having a period in the UK sits at around £130 a year. A menstrual cup is a one-off purchase of around £25, lasting up to 10 years. Even allowing for replacement, the lifetime saving runs into the thousands.
Health. Medical-grade silicone is inert, nonporous, and chemical-free. Conventional tampons typically contain plastic fibres, residues from bleaching, fragrances, and other unwanted chemicals. The vagina is filled with lots of blood vessels and is a warm and moist environment, making it the perfect place for absorbing anything that you put near it. When you insert a tampon, the likelihood of the plastic and chemicals found within it getting into your bloodstream is high. If you don’t believe that the skin can absorb external compounds, just think about how pessaries, creams, and patches work. Not only can traditional tampons put you at risk of toxic shock syndrome, but they have also been linked to long-term health issues, such as cancer, inflammatory conditions, and toxin accumulation. Menstrual cups carry a much lower risk of toxic shock syndrome than tampons and do not disrupt the natural vaginal pH.
Sustainability. A single person uses an estimated 11,000 to 16,000 disposable period products in a lifetime. A menstrual cup replaces almost all of them. This is one of the highest-impact zero-waste swaps you can make.
Freedom. Most cups can be worn for up to 12 hours at a time. That means no rushing to find a bathroom every couple of hours, no carrying spare tampons, no overnight worry. For travel, exercise, work, and sleep, the difference is significant.
Body literacy. Using a cup means becoming familiar with your own anatomy, learning where your cervix sits and how it changes through your cycle, and understanding your flow in real terms (volume, colour, clotting). For many people, this is genuinely empowering.
Comfort. Once you have found a menstrual cup that fits you perfectly and cut the stem to your specifications, it is not something you should feel. Unlike tampons with their external strings or pads that can chafe. They can be so comfortable that you may need to set a reminder to change it!
Who can use a menstrual cup?
Most healthy adults can use a menstrual cup. There are a few situations where it is worth speaking to your GP or a specialist first:
If you have an IUD or coil. A 2020 review found a small but increased risk of IUD expulsion in cup users. The risk is low but worth discussing with your GP, particularly in the first few months after IUD insertion.
In the immediate postpartum period. Wait until your six-week check-up at a minimum, and longer if your healthcare provider advises.
If you have a very low cervix. Some cups will sit too high, causing discomfort. Shorter cups or menstrual discs may suit better.
If you have certain pelvic floor conditions or vaginismus. Insertion may be uncomfortable. Speak to your gynecologist.
For everyone else, a menstrual cup is a safe, well-tolerated option.
Are menstrual cups safe?
When used correctly, yes. The published research on menstrual cups consistently shows them to be safe and effective.
The major safety considerations are simple:
Wash your hands thoroughly before insertion and removal
Sterilise your cup before first use and between cycles
Do not leave a cup in for longer than 12 hours
Replace your cup every 5 to 10 years, or sooner if it shows signs of damage or significant discolouration
Toxic shock syndrome with menstrual cups is extremely rare, but not impossible. Following the steps above significantly reduces your risk.
Know the symptoms of toxic shock syndrome
Toxic shock syndrome (TSS) is rare but serious, and symptoms come on quickly, usually within a few hours. If you use any internal period product, it is worth knowing the signs.
Key symptoms include:
Sudden high fever, typically above 39°C
Flu-like symptoms: chills, body aches, headache, sore throat
A widespread sunburn-like rash, often on the palms and soles
Vomiting or diarrhoea
Dizziness, fainting, or feeling lightheaded upon standing (a sign of low blood pressure)
Muscle aches
Confusion or disorientation
Red, bloodshot eyes, or redness of the mouth, throat, or vagina
If you develop any of these symptoms while using a tampon, menstrual cup, or any internal period product, remove the product immediately and seek urgent medical help.
How to choose your first menstrual cup
Choosing the right cup is the single biggest factor in whether you have a good experience or a frustrating one. Look at four things:
Size. Most brands offer at least two sizes. The smaller size is usually recommended for those who have not given birth vaginally, are under 30, are petite, or have a lighter flow. The larger size is recommended for those who have given birth, are over 30, or have a heavier flow. These are guidelines, not rules.
Firmness. Softer cups are gentler on the bladder and more comfortable for those with a sensitive pelvic floor. Firmer cups are easier to pop open but can feel more noticeable. If you are unsure, start softer.
Capacity. If you have a very heavy flow, look for a cup with a higher capacity so you are not emptying it constantly.
Stem type. Some cups have a long, thin stem; others have a flat tab or a ribbed base. The stem can usually be trimmed to fit. A ribbed base makes removal much easier once you trim or remove the stem entirely.
If this feels like a lot, the easier route is to start with a brand that offers a sizing quiz and a money-back guarantee, so you can try it without risk. Our recommended brand is covered later in this guide.
How to use a menstrual cup
The first cycle is always the steepest learning curve. By the second or third cycle, most people find inserting and removing a cup much easier, with many reporting that is easier to insert than a tampon. Give yourself ample time in a calm environment when you first start using a cup.
Before you insert:
Wash your hands thoroughly with soap and water
Rinse the cup under running water (a wet cup is easier to insert)
Find a comfortable position. Sitting on the toilet, squatting, or standing with one foot raised all work.
Three folds to try:
C-fold: flatten the cup and fold it in half so the rim forms a C.
Punchdown fold: push one side of the rim down into the base of the cup so it forms a triangle. Smaller insertion point, ideal for first-timers.
7-fold: flatten the cup, then fold one corner of the rim diagonally so it forms a 7.
Insert the folded cup into the vagina, aiming towards the base of your spine rather than straight up. Once inside, let it open. You should feel or hear a small pop or release as it opens and seals.
Check it has opened:
Reach in and run a finger around the rim. If it feels round, it is open.
Give the base a gentle twist or rotate it. This helps form a tight seal.
Gently squeezing the base of the cup a few times can help to build a vacuum holding the cup in place, reducing leaks.
To remove:
Wash your hands
Bear down gently with your pelvic floor to lower the cup
Reach in and pinch the base of the cup to break the seal. Pulling on the stem alone will be uncomfortable.
Slowly ease the cup out, keeping it upright
Empty into the toilet, sink, or shower drain
Rinse with cool water and reinsert
Common menstrual cup problems and how to fix them
The cup will not open. Try running a finger around the rim once it has been inserted. Pull the rim gently away from the vaginal wall to let air in. Squatting during insertion often helps or you can try a different folding methods. If your cup is the wrong size, it will struggle to open fully.
The cup keeps leaking. A seal may not have formed, the cup is the wrong size or capacity, or you have left it in too long. Check the seal by twisting the base after insertion. If leaks are persistent, try a different fold or a different size.
You cannot reach the cup to remove it. Do not panic. The cup cannot get lost. Relax, breathe, and bear down with your pelvic floor as if you were having a bowel movement. Squatting helps. Once you can grip the base, pinch to break the seal and ease it out.
There is suction discomfort on removal. You are pulling without breaking the seal first. Always pinch the base before easing the cup out.
You feel the cup throughout the day. Either it is sitting too low, the wrong firmness, or the stem needs trimming. Reposition higher, or trim the stem to fit.
How to clean and sterilise your menstrual cup
During your period: Empty, rinse with clean water, reinsert. If you are out of the house, rinse with bottled water, or give it a quick wipe with clean tissue. You do not need to sterilise between insertions on the same cycle.
Before first use and between cycles: Sterilise by boiling for 5 to 7 minutes in a small saucepan, or use a microwave steriliser. Make sure the cup is fully submerged.
Storage: Keep your cup in the breathable cotton bag it came with. Never store in an airtight container, which traps moisture and encourages bacteria. Make sure you cup is dry before storing it.
Replacement: Most cups last 5 to 10 years with proper care. Replace if you notice changes in flexibility, sticky residue that will not wash off, persistent odour, or visible damage.
Common questions about menstrual cups
Can you use a menstrual cup overnight? Yes. Up to 12 hours is the standard guideline, which covers a full night’s sleep with a buffer.
Can you swim with a menstrual cup? Yes. The seal prevents water from entering and prevents leaks. Swimming pools, the sea, and hot tubs are all fine.
Can you exercise with a menstrual cup? Yes. Many people find cups more comfortable than tampons for running, yoga, cycling, and weight training, partly because there is no string and no sense of dryness.
Can you use a menstrual cup with an IUD? Possibly, but speak to your GP first. A 2020 review found a small increase in IUD expulsion among cup users. Most people use them safely together, but it is worth a conversation with whoever fitted your IUD.
What if my cup gets stuck? It cannot get lost. The cervix blocks any passage further into the body. Relax, breathe, squat, and bear down with your pelvic floor. Once you can grip the base, pinch to break the seal.
Do menstrual cups smell? No. Menstrual blood only develops an odour when it meets air, which does not happen with a cup.
Will I get used to it straight away? Most people need 1 to 3 cycles to feel completely confident. The first cycle is usually the hardest. By the third, it is second nature.
Can I use a menstrual cup if I am a virgin or have never used tampons? Yes. The vagina is highly elastic and a cup will not affect the hymen any differently to a tampon.
Our recommended menstrual cup
After testing several menstrual cups over the years, the one our founder Josie has used and recommended for the past six years is the Ruby Cup. It is made from soft, flexible medical grade silicone, comes in two sizes, includes a sizing quiz on the brand website, offers a 120-day money-back guarantee, and donates a cup to someone facing period poverty for every cup sold. Click here to read Josie’s in-depth review.
Final thoughts
A menstrual cup is one of the simplest, highest-impact clean living and sustinability swaps you can make. Cleaner, cheaper, more comfortable, and significantly better for the environment. The first cycle takes practice. The reward is years of fuss-free periods.
If you have questions we have not covered here, send them through and we will keep this guide updated. Or sign up for our newsletter for honest, practitioner-curated recommendations across every puzzle piece of natural health.
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