Menstrual discs offer a modern alternative to traditional period products, collecting menstrual fluid instead of absorbing it. Unlike menstrual cups, which rely on suction and the strength of the vaginal walls, discs are positioned high in the vaginal fornix. Pelvic organ prolapse (POP) occurs when pelvic organs, such as the bladder, uterus, or rectum, descend into the vagina due to weakened support structures. Since POP alters the internal anatomy, a common question is whether a menstrual disc can maintain a secure fit. The successful use of a disc depends on the specific type and severity of the anatomical shift.
Anatomy and Mechanical Considerations
A standard menstrual disc is secured by tucking its forward rim behind the pubic bone, which acts as a shelf. The disc’s posterior rim rests in the vaginal fornix, the space surrounding the cervix. This placement makes the disc less reliant on the muscular tone of the vaginal canal compared to a menstrual cup.
Pelvic organ prolapse disrupts this structural framework, fundamentally changing the available space and support. A cystocele (bladder prolapse) causes the anterior vaginal wall to bulge downward, potentially interfering with the pubic bone tuck, the disc’s primary anchor. A rectocele (rectal prolapse) causes the posterior vaginal wall to push forward, which may reduce the depth of the vaginal fornix where the disc’s back rim should rest.
Uterine prolapse, where the uterus and cervix descend, directly reduces the internal length of the vaginal canal. If the cervix is low, a disc may not have enough space to tuck securely behind the pubic bone, risking constant slippage or discomfort. Prolapse at Stage 2 or higher can compromise the necessary room for the disc to function correctly. Success relies on finding a product that adapts to the altered angles and reduced space without causing pressure on the descended organ.
Selecting a Menstrual Disc Based on Prolapse Type
Selecting the right disc requires careful consideration of its physical properties in relation to the altered anatomy. Diameter is a primary factor, as a smaller disc may be necessary to accommodate a lower cervix or reduced vaginal length caused by uterine prolapse. If a disc is too small, however, it may not span the full distance needed to tuck securely behind the pubic bone, leading to slippage.
Firmness refers to the rigidity of the disc’s rim, and this choice involves a trade-off for users with prolapse. A softer rim may be more comfortable and place less pressure on a cystocele or rectocele, helping avoid symptom aggravation. Conversely, a firmer rim provides greater stability and may be more successful in maintaining the tuck behind a potentially displaced pubic bone or in a less supportive vaginal structure.
Determining the correct size begins with measuring the cervix height, which can be complicated by prolapse. It is best to check the cervix position during menstruation, when it naturally sits lower, by inserting a clean finger until the firm, round tip is felt. The measurement from the vaginal opening to the cervix tip indicates the maximum effective diameter the disc should span. If the cervix is very low or if a prolapse is visibly protruding, a disc may not be the appropriate choice, and a pelvic health consultation is necessary.
Techniques for Safe Insertion and Removal
Successful use of a menstrual disc with prolapse often requires modifying standard insertion and removal techniques. Insertion should be performed in a position that relaxes the pelvic floor muscles, such as deep squatting or standing with one leg raised. Aiming the disc downward toward the tailbone helps guide the posterior rim into the deepest part of the vaginal fornix, which may be less accessible due to a rectocele.
Securing the disc involves using a clean finger to lift the anterior rim and ensure it hooks completely behind the pubic bone. If the pubic bone’s “shelf” is shallow due to anatomical changes, a firmer disc may be easier to tuck, but the tuck must be checked carefully to ensure the disc is fully seated. A common issue is “auto-dumping,” where the disc slips partially to empty its contents during a bowel movement or urination due to pelvic muscle relaxation.
To manage auto-dumping, users must gently reposition the disc by tucking the rim back behind the pubic bone immediately after using the toilet. Removal must be done gently to avoid pulling on the vaginal walls, which can strain weakened tissues and exacerbate prolapse symptoms. Hooking a finger under the rim or using the disc’s removal loop, if present, requires slow, steady traction while keeping the pelvic floor relaxed.
When to Consult a Pelvic Health Specialist
While menstrual discs can be a good option for individuals with mild prolapse, they are not a treatment for the condition. Disc use should be discontinued immediately if it causes new or increased symptoms like pain, a feeling of heaviness, or difficulty emptying the bladder or bowels. These symptoms suggest the disc is putting excessive pressure on the prolapsed organ or not fitting correctly.
Individuals with more severe prolapse, typically Stage 3 or 4, where the organs are protruding significantly outside the vaginal opening, should avoid internal menstrual products entirely. Professional guidance is also necessary if a person has recently undergone any pelvic or prolapse surgery. Consulting a pelvic floor physical therapist or a gynecologist is the most responsible step before introducing a menstrual disc to an anatomy affected by prolapse.