A menstrual cup is a flexible, bell-shaped device, typically made from medical-grade silicone, that is inserted into the vagina to collect menstrual fluid instead of absorbing it. A common question among those who try them is whether the cup itself can increase the intensity of menstrual cramps or cause a new form of abdominal discomfort. We will investigate the scientific distinction between true menstrual cramping and the mechanical discomfort that a cup might cause.
Understanding Menstrual Cramps
The characteristic pain known as primary dysmenorrhea, or common menstrual cramps, originates in the uterus. This pain is biologically driven by prostaglandins, lipid compounds released by the uterine lining before and during menstruation. These compounds cause the uterine muscle walls to contract rhythmically to shed endometrial tissue. Stronger contractions restrict blood flow, causing temporary oxygen deprivation (ischemia), which triggers the sensation of pain. The severity of the cramps relates directly to the amount of prostaglandins released and the intensity of the contractions.
The Link Between Cup Use and Uterine Pressure
A menstrual cup does not chemically interact with the body to trigger prostaglandin release, meaning it cannot directly cause primary dysmenorrhea. True cramping is a physiological event of the uterus, separate from the vaginal canal where the cup sits. However, the cup’s presence can introduce mechanical forces that mimic or exacerbate existing cramp-like sensations. The reported discomfort is often a sensation of pressure or ache, rather than the wave-like pain of uterine contractions. This mechanical irritation occurs when the cup interacts incorrectly with sensitive pelvic structures. If the pain immediately starts or stops with the insertion or removal of the cup, it is likely mechanical discomfort, not true dysmenorrhea.
Identifying Mechanical Causes of Discomfort
The sensation of cup-related cramping is most often attributed to three specific mechanical factors.
Strong Vacuum Seal
The first is a strong vacuum seal, which keeps the cup in place and prevents leaks. If the cup is placed too high or seals directly around the cervix, the resulting suction can pull on the cervix, a structure connected to the uterus. This pulling can lead to referred pain or a sharp, cramp-like feeling, especially upon removal if the seal is not broken.
Incorrect Placement
The second mechanical issue involves incorrect placement, particularly if the cup is pressing against the cervix itself. The cup should sit in the vaginal canal below the cervix. If the cup is too long or inserted too high, the rim can press against the cervix, causing a dull ache or pressure discomfort.
Size and Firmness
The third common cause relates to the cup’s physical properties, specifically its size and firmness. A cup that is too firm or too large can exert excessive outward pressure on the vaginal walls and adjacent organs, such as the bladder. This constant pressure creates sensations of pelvic discomfort or a frequent urge to urinate, which a user might interpret as worsening cramps.
Adjusting Usage for Pain Relief
Addressing the mechanical causes of discomfort often requires simple adjustments to the cup’s use or selection.
Adjusting Insertion and Removal
A primary action to relieve pain is ensuring the strong suction seal is fully released before removal. Users should pinch the base of the cup to let air in and break the seal, rather than simply pulling on the stem, which can cause painful tugging on the cervix. Proper positioning is also crucial, and the cup should be inserted horizontally, aiming toward the tailbone, instead of straight up. This ensures the cup opens lower in the vaginal canal and sits comfortably beneath the cervix.
Product Selection
If mechanical pressure from the cup itself is the persistent issue, switching to a different product may be the solution. A softer, more flexible cup material will exert less pressure on the vaginal walls and bladder, which can alleviate chronic discomfort. Alternatively, selecting a cup with a shorter length or smaller diameter can prevent it from pressing against a low cervix or being too wide for the anatomy. If the cup’s stem is causing irritation at the vaginal opening, it can often be trimmed down for comfort.