The study combined data from medical studies and grey literature — such as conference abstracts, reports and theses — for which participants reported their experiences of menstrual cups or their willingness to use them.
Menstruation can affect girls’ schooling and women’s experience at work, increasing their disposition to urogenital infections if they use poor quality sanitary products.
Now the first review and analysis of the use of menstrual cups globally, that includes 43 studies and data from 3,300 women and girls, to be published in The Lancet Public Health Journal on Wednesday suggests they are safe and result in similar, or lower, leakage than disposable pads or tampons.
“Despite the fact that 1.9 billion women globally are of menstruating age — spending on average 65 days a year dealing with menstrual blood flow, few good quality studies exist that compare sanitary products,” senior author Professor Penelope Phillips-Howard from Liverpool School of Tropical Medicine, UK, said.
The study hence summarised current knowledge about leakage, safety and acceptability of menstrual cups, comparing them to other products. It combined data from medical studies and grey literature — such as conference abstracts, reports and theses — for which participants reported their experiences of menstrual cups or their willingness to use them.
The authors from Liverpool School of Tropical Medicine, Tata Institute of Social Sciences, Mumbai, Kenya Medical Research Institute, Edinburgh Royal School of Tropical Medicine and Bill and Melinda Gates Foundation compiled global information on the availability and costs of menstrual cups, conducted preliminary estimates on waste savings and examined puberty education materials to assess the extent to which menstrual cups are referred to as an option.
Although there are 199 brands of menstrual cups available in 99 countries, awareness is low — cups were only mentioned in 21 of 69 websites containing educational materials on puberty from 27 countries. Menstrual cups collect blood flow, rather than absorbing it as with pads and tampons. Like tampons, they are inserted into the vagina, before being emptied every 4-12 hours. The materials used to make them are medical grade silicone, rubber, latex or elastomer and can last up to ten years.
The review identified the products usually used in low middle income countries, which include cloths, cotton wool, tissue paper and other pieces of material, as well as disposable pads. Leakage and chaffing are a common concern.
For estimations on costs of disposable pads and tampons, the study explored prices for commonly used products in six countries (the US, the UK, India, Spain, China, and Canada). Preliminary evidence on the cost and waste savings associated with using menstrual cups suggests that over 10 years, a single menstrual cup could cost much less than pads or tampons, the study said.
A cup could cost roughly 5-7 per cent of the cost of using 12 pads (on average $ 0.31 each) or tampons (on average $ 0.21 each) per period.
Over 10 years, a cup is estimated to create 0.4 per cent of the plastic waste generated by single-use pads or 6 per cent of that produced by using tampons.
In a linked comment, Dr Julie Hennegan from the Johns Hopkins Bloomberg School of Public Health, USA, says: “For consumers purchasing menstrual products, the results highlight cups as a safe and cost-effective option. Critically, findings indicate that menstrual education resources are not providing a comprehensive overview of products to support informed choices. 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.”
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