A menstrual cup is a reusable option that collects menstrual flow rather than absorbing it. Successful use depends heavily on understanding internal anatomy, particularly the position of the cervix. The cup must be placed correctly below the cervix to collect the flow, and its location determines the appropriate cup size and insertion technique. Knowing where the cervix sits is the first step toward achieving a leak-free and comfortable experience.
Understanding Cervix Placement and Height
The cervix is the lower, narrow part of the uterus that connects to the top of the vagina. To locate it, ensure your hands are clean, then gently insert a finger into the vaginal canal until you feel a distinct structure at the end. The cervix feels firm and smooth, similar to the cartilage at the tip of your nose, distinguishing it from the soft vaginal walls. You may also be able to feel a small dimple or opening in the center, which is the os, where menstrual fluid exits the uterus.
Measuring the distance from the vaginal opening to the cervix determines your personal cervix height, which is an important factor in cup selection. The position of the cervix is not static, as it can move higher or lower throughout the menstrual cycle, often sitting at its lowest point during menstruation. By using the “knuckle method” during your period, you can estimate this height: reaching the cervix at the first knuckle suggests a low cervix, at the middle knuckle is average, and if you can insert your entire finger without reaching it, you likely have a high cervix.
Foundational Insertion Techniques
Before attempting to insert the cup, it is important to relax the pelvic floor muscles, as tension can narrow the vaginal canal and make insertion difficult. Finding a comfortable position, such as squatting, standing with one leg raised, or sitting on the toilet, can help make the process easier. Always wash your hands and the cup with mild soap and water before each use to maintain hygiene.
The cup must be folded to reduce its size for insertion; two common methods are the “C-fold” and the “punch-down fold.” The C-fold involves flattening the cup and folding it in half to create a ‘C’ or ‘U’ shape. The punch-down fold pushes one point of the rim down into the center, creating a smaller insertion point. Once folded, the cup should be guided into the vagina at a horizontal angle, aiming back toward the tailbone, following the natural curve of the vaginal canal. The cup should be inserted until the body of the cup, but not necessarily the stem, is fully inside the vagina.
Adjusting Cup Placement for Different Cervix Positions
The primary goal is for the rim of the menstrual cup to sit just below the cervix, creating a seal that catches the flow as it exits the os. If the cup is positioned too high, it may shift in the wider part of the upper vagina, known as the vaginal fornix, leading to leaks. Conversely, if the cup is placed too low, the stem may protrude and cause irritation.
For individuals with a low cervix, the limited space requires a shorter cup to prevent the stem from sticking out. When inserting a shorter cup, the rim should seal around the cervix, not suction onto it, which can cause discomfort. You must ensure the cup is not pushing directly against the cervix, as this can cause cramping and may reduce the cup’s capacity.
If you have a high cervix, the cup may ride up further into the vaginal canal, sometimes making the stem difficult to reach for removal. In this case, a longer cup or one with a longer stem may be preferred to ensure easy retrieval. After insertion, you may need to use your pelvic floor muscles to gently bear down, which can help bring the cup lower within reach.
A tilted or retroverted cervix, which is positioned off-center, requires a slight adjustment to the angle of insertion. You may need to aim the cup slightly to the left or right to ensure the rim fully encompasses the cervix and creates a complete seal. Trial and error with the angle is often necessary to find the spot that prevents the cup from sitting beside the cervix, which is a common cause of leakage.
Confirming a Successful Seal and Proper Fit
After the cup is fully inserted, confirm that it has opened completely and formed a seal against the vaginal wall. Gently run a finger around the base of the cup just above the stem. If you feel any noticeable dents or folds, the cup has not opened fully and may leak. Gently rotate the cup or press lightly on the vaginal wall to encourage it to pop open.
A gentle tug on the stem provides another confirmation of the seal; if you feel resistance, a suction has been created and the cup is secure. The cup should not slide down easily when pulled, indicating a proper fit. Finally, ensure you cannot feel the cervix inside the cup itself, as this can break the seal or cause discomfort. If the cup feels uncomfortable or causes cramping, remove it and try re-inserting it lower.