No Scientific Causation Between Menstrual Cups and Pelvic Organ Prolapse

A recent rumor suggests that menstrual cups cause vaginal prolapse, or the condition in which the pelvic floor muscles weaken and internal organs protrude into the vaginal space. But the reality is just that—a rumor.

A statement by Put A Cup In It (PACII) said it perfectly:

Prolapse is not uncommon and the use of menstrual cups is on the rise meaning more prolapse sufferers will be cup users. This does not equal a correlation… Until there is actual evidence that supports the “guesses” put forward in this article regarding cups leading to prolapse our stance is that light bearing down is no more likely to cause a prolapse than your daily bowel movement.

That being said, let’s break down the science behind what causes pelvic organ prolapse and how (surprisingly) common it is among women.

Who gets pelvic organ prolapse?

According to the Office on Women’s Health, pelvic floor disorders affect 1 in 5 women in the U.S., or roughly 20%. While pelvic floor disorders cover a wide range of conditions such as a lack of bladder and bowel control, pelvic organ prolapse itself affects 3% of women. 

What are the symptoms of pelvic organ prolapse?

Symptoms depend on which organ is being affected (bladder, urethra, uterine, small bowel, rectum), but here are the most common:

  • A feeling of pressure or discomfort on the pelvic area
  • Urinary leaks or chronic urination
  • A lower backache
  • Painful intercourse
  • Vaginal spotting or bleeding

What causes pelvic organ prolapse?

Pelvic organ prolapse can be caused by a variety of things, and according to healthcare professionals, menstrual cups is not one of them.

  • Pregnancy and vaginal childbirth
  • Constipation
  • Hysterectomies
  • Obesity
  • Smoking (that leads to chronic coughing)
  • Menopause and aging

Gynecologist Alyssa Dweck, MS MD FACOG says:

Pelvic floor muscle weakness is quite common and typically due to genetic factors, pregnancy and being above ideal body weight.  Menstrual cup use is unlikely to contribute to risks already present.

How do you treat pelvic organ prolapse?

Since the most common form of pelvic organ prolapse is cystocele, and typically caused from childbirth, the best treatment is through kegel exercises. These exercises are designed to strengthen, or restrengthen, pelvic floor muscles. If your prolapse is affecting your bowel, clean eating and a fiber rich diet can help remove any straining movement. 

A pessary, or medical device that is worn internally to help keep the organs in place, is also a common treatment. The most extreme cases call for a hysterectomy or surgical removal of the affected organ. 

How can you prevent pelvic organ prolapse?

Again, kegel exercises are the best way to prevent any type of pelvic organ prolapse, however, it is important to note that they can be caused by factors outside of your control, such as aging or family history. Things you can control are maintaining healthy eating habits and opting out of smoking, since both of these things can cause pressure on pelvic organs. 

Dr. Shreelata makes the following recommendation:

The first thing to consider is the type of menstrual cup you’re using – vaginal cups sit lower in the vagina whilst cervical cups sit further up, covering the cervix. I would recommend that you are comfortable and undisturbed in a quiet location when removing your menstrual cup, to relax your pelvic floor muscles. Make sure you have washed your hands and dry them completely to get a good grip of the stem. Squatting or resting a foot on the edge of the bath can make it easier to feel the stem of the cup. Pinch the cup to release the seal and then gently pull it down and out. If this doesn’t work, you can try to hook your finger around the cup to drag it down with care. In some cases, you may need to consult a doctor to help remove menstrual cups (more commonly cervical cups as they sit higher up in the vagina), but this is not common. There is currently little evidence to suggest that using your pelvic floor muscles to bring the cup lower in the vagina can alone cause pelvic floor prolapse.

If you do have prolapse and are using a menstrual cup, we encourage you to speak with your healthcare provider about what the best options are for you. Likewise, if you are experiencing any pain or discomfort while using a menstrual cup, we encourage you to find a cup that’s better suited for your body or finding an alternative method that works for you. 

We are stoked to live in a time with tons of options, and even more stoked to hear that menstrual cups provide so many women with happy and healthy periods.

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