Combining a menstrual cup with an intrauterine device (IUD) raises questions about safety and compatibility. An IUD is a highly effective form of birth control, and menstrual cups offer a reusable alternative to traditional period products. While generally possible to use both simultaneously, certain precautions are important. The IUD resides inside the uterus, separate from where a menstrual cup sits in the vaginal canal. Despite this separation, considerations are necessary to ensure IUD effectiveness and comfort.
Understanding the Concerns
A primary concern when using a menstrual cup with an IUD is the potential for IUD displacement or expulsion. While some older research indicated no increased risk, more recent studies suggest a possible association. For instance, a 2020 study observed higher IUD expulsion rates among menstrual cup users, particularly with certain copper IUD types. A systematic review also highlighted this possible association, with reported rates ranging from 3.7% to 18.6%.
Potential displacement involves two main factors. First, suction created by the cup’s seal can pull on the IUD if not properly broken before removal. Second, accidental tugging of IUD strings can occur. During cup removal, a finger or the cup’s rim might catch the IUD strings, potentially dislodging the device.
Best Practices for Safe Use
Practicing specific techniques helps ensure safe menstrual cup use with an IUD. Always break the menstrual cup’s suction seal before attempting removal. This is done by pinching the cup’s base or inserting a finger alongside to release the vacuum, preventing any pulling on the IUD. Never pull the cup out by its stem alone, as this maintains suction and increases the risk of dislodging the IUD.
Proper cup positioning is also important. The cup should sit lower in the vaginal canal, away from the cervix where IUD strings are located. After insertion, check that the IUD strings are inside the cup and not caught between the cup’s rim and the vaginal wall. If IUD strings feel too long or are frequently caught, a healthcare provider can trim them shorter, which may reduce the risk of accidental pulling. Many experts recommend waiting 6 weeks to 3 months after IUD insertion before using a cup, allowing the IUD to settle into place.
Recognizing Potential Issues
Monitoring for signs of IUD displacement or expulsion is an important part of using a menstrual cup. Regularly checking the length of your IUD strings can help detect any changes; if they feel suddenly longer, shorter, or if you can no longer feel them, it could indicate that the IUD has moved. Some individuals may also feel the IUD itself, which is a clear sign of displacement.
Other indicators of a potential issue include new or unusual pelvic pain, severe cramping, or changes in bleeding patterns, such as heavier or irregular bleeding. If any of these signs occur, or if you suspect your IUD has moved, contact a healthcare provider immediately. While waiting for a medical evaluation, it is advisable to use a backup birth control method to prevent unintended pregnancy.