Experience and adaptability of menstrual cup as a menstrual hygiene management method among its users in Kerala


  • Sreedevi C. Department of Community Medicine, Govt Medical College Palakkad, Kerala, India
  • Jayasree A. K. Department of Community Medicine, Govt Medical College Kannur, Kerala, India
  • Shilu Mariam Zachariah Department of Community Medicine, Govt Medical College Palakkad, Kerala, India
  • Divyamol N. Department of Community Medicine, Govt Medical College Palakkad, Kerala, India
  • Deepak K. S. Department of Community Medicine, Govt Medical College Palakkad, Kerala, India




Menstrual cup, MHM, WASH, Menstruation


Background: Inadequate menstrual management has long been a major health issue. A growing number of women are turning to menstrual cups as a viable and secure choice. Because it is not an absorbent like tampons, the risk of infection and other severe health problems is rare or absent. Current study is conducted to assess the perceived benefits and difficulties faced by those who use menstrual cup as a method of menstrual hygiene management (MHM) technique.

Methods: A cross sectional study was undertaken among 211 women who had used menstrual cup for at least six consecutive cycles. Participants were selected using snowball sampling and data was collected by an online questionnaire.

Results: Mean age of participants was 32.16 years and majority got information regarding cup from friends or online sources. Experience of insertion and removal became significantly easier after the third time use onwards. Majority of the health problems and economic difficulty for purchasing MHM products significantly got reduced after starting the use of cup. Few reported allergy and irritation 6 (3%), rashes 2 (1%), dryness 5 (2.5%) and infection 4 (2%). Difficulty in availability of clean water 15 (7.2%), access to clean toilet 3 (1.4%), need for privacy 8 (3.8%) and difficulty in sterilization while travelling 44 (21.2%) were other reported challenges. Improvement in attendance 78 (38.4%), work participation 115 (55.8%), economic benefit 190 (91.3%), health benefits 143 (70.4%) and social activity158 (76.7%) were reported by participants after starting cup use.

Conclusions: Menstrual cup is a safe and comfortable alternative. Health concerns are significantly less compared to other MHM products. More awareness campaigns and better availability of cup should be there in the community.



Sumpter C, Torondel B. A systematic review of the health and social effects of menstrual hygiene management. PloS one. 2013;8(4):e62004.

Garg S, Sharma N, Sahay R. Socio-cultural aspects of menstruation in an urban slum in Delhi, India. Reproductive Health Matters. 2001;9(17):16-25.

Balamurugan SS, Bendigeri ND. Community-based study of reproductive tract infections among women of the reproductive age group in the urban health training centre area in Hubli, Karnataka. Indian J Community Med. 2012;37(1):34.

Van Eijk AM, Sivakami M, Thakkar MB, Bauman A, Laserson KF, Coates S et al. Menstrual hygiene management among adolescent girls in India: a systematic review and meta-analysis. BMJ open. 2016;6(3):e010290.

Pena EF. Menstrual protection. Advantages of the menstrual cup. Obstet Gynecol. 1962;19(5):684-7.

Juma J, Nyothach E, Laserson KF, Oduor C, Arita L, Ouma C et al. Examining the safety of menstrual cups among rural primary school girls in western Kenya: observational studies nested in a randomised controlled feasibility study. BMJ open. 2017;7(4):e015429.

Phillips-Howard PA, Nyothach E, Ter Kuile FO, Omoto J, Wang D, Zeh C et al. Menstrual cups and sanitary pads to reduce school attrition, and sexually transmitted and reproductive tract infections: a cluster randomised controlled feasibility study in rural Western Kenya. BMJ open. 2016;6(11):e013229.

Kakani CR, Bhatt JK. Study of adaptability and efficacy of menstrual cup in managing menstrual health and hygiene. Int J Reprod Contracept Obstet Gynecol. 2017 Jul;6(7):3045-53.

Howard C, Rose CL, Trouton K, Stamm H, Marentette D, Kirkpatrick N et al. FLOW (finding lasting options for women): Multicentre randomized controlled trial comparing tampons with menstrual cups. Can Family Physician. 2011;57(6):e208-15.

George AM, Leena KC. Experiences of the Women Using Menstrual Cup on Free Will-A Qualitative Inquiry. Online J Health Allied Scs. 2020;19(3):10.

North BB, Oldham MJ. Preclinical, clinical, and over-the-counter post marketing experience with a new vaginal cup: menstrual collection. J Women's Health. 2011;20(2):303-12.

Ademas A, Adane M, Sisay T, Kloos H, Eneyew B, Keleb A et al. Does menstrual hygiene management and water, sanitation, and hygiene predict reproductive tract infections among reproductive women in urban areas in Ethiopia? PloS one. 2020;15(8):e0237696.

Medhi A, Nigam S, Pendharkar O, Hegde A, Borkar R. Menstrual Cups: The Sustainable Future for Women Hygiene in India. Center for Open Sci. 2021.

Beksinska ME, Smit J, Greener R, Todd CS, Lee ML, Maphumulo V et al. Acceptability and performance of the menstrual cup in South Africa: a randomized crossover trial comparing the menstrual cup to tampons or sanitary pads. J Women's Health. 2015;24(2):151-8.




How to Cite

C., S., A. K., J., Zachariah, S. M., N., D., & K. S., D. (2022). Experience and adaptability of menstrual cup as a menstrual hygiene management method among its users in Kerala. International Journal Of Community Medicine And Public Health, 9(2), 918–923. https://doi.org/10.18203/2394-6040.ijcmph20220263



Original Research Articles