Using a menstrual cup comes down to folding it, inserting it at the right angle, letting it pop open to form a seal, and removing it by breaking that seal before you pull. The learning curve typically takes two or three cycles, but once you have the technique down, a single cup can be worn for up to 12 hours at a time and last for years. Here’s everything you need to know to get started.
Choosing the Right Size
Most brands offer two or three sizes based on a combination of age, birth history, flow volume, and cervix height. The small size is generally designed for people under 30 who haven’t been pregnant. The larger size is for people over 30 or those who have given birth or carried a full-term pregnancy, because both age and pregnancy can relax the pelvic floor muscles that hold the cup in place. If you’re fairly active, though, exercise can tighten those muscles enough that you may not need the larger size even if you fit the age or birth criteria.
Flow matters too. Some brands size specifically by flow: a smaller cup for light to moderate days and a larger one for heavy flow. If your period regularly soaks through a tampon in under four hours, start with a higher-capacity cup.
Cervix height is the factor people most often overlook. Your cervix sits at the top of the vaginal canal, and its position shifts throughout your cycle. To check, insert a clean finger during your period and note how far in you can reach your cervix (it feels like the tip of your nose). If you can barely reach it, you have a high cervix and will want a longer cup. If it’s easy to reach, you have a low cervix and need a shorter cup. Brands like MeLuna make specifically shorter models for low cervixes.
How to Insert a Menstrual Cup
Start by washing your hands thoroughly. Then get into a comfortable position: standing with one foot propped on the toilet seat, sitting on the toilet, or squatting. Relaxation makes a real difference here. Tense muscles will fight you. Taking a deep belly breath and releasing as you exhale, the same feeling as finally being able to use the bathroom after holding it, helps the vaginal muscles soften.
Fold the cup to make the opening small enough to insert. Two folds work well for beginners:
- C-fold: Press the cup flat, then fold it in half so the rim forms a C shape.
- Push-down fold: Use a finger to press one side of the rim down into the cup, creating a narrow point. This fold tends to pop open more easily once inside.
Hold the folded cup with the fold facing downward (toward the floor). Aim toward your tailbone, not straight up. This is the most common mistake. The vaginal canal angles back, so inserting horizontally rather than vertically lets the cup slide into place naturally. Watch your wrist as you insert. If it twists upward, you’re likely pushing the cup at the wrong angle.
Don’t push the cup too deep. The stem should sit just inside the vaginal opening, no more than about half an inch in. Inserting too high is a common cause of leaks and makes removal harder.
Creating a Seal
Once the cup is in, it needs to fully open and form a light suction seal against the vaginal walls. This seal is what prevents leaks. Grip the base of the cup (not the stem) and rotate it one full turn in either direction. If it spins easily, it’s open. If it resists, the cup is still partially folded.
Run a clean finger around the rim to feel for dents or folds. If you find any, try giving the base a gentle squeeze or rotating it again. Some people find it easier to let the cup pop open before it’s all the way in, then rotate and push it the rest of the way as one fluid motion. This works especially well if you have strong pelvic floor muscles or a tighter vaginal opening.
Experimenting with different folds can help too. If the C-fold doesn’t open reliably for you, the push-down fold often pops open more easily because its narrower point creates a stronger spring action.
How to Remove It
Wash your hands first. Get into the same position you used for insertion, squatting or sitting on the toilet. Bear down gently with your muscles as if you’re having a bowel movement to push the cup lower.
Insert your thumb and index finger until you can feel the base of the cup. If you can only reach the stem, pull it gently to bring the base within reach, but don’t yank the cup out by the stem alone. Once you have the base, pinch it firmly. This breaks the suction seal. You may hear a small release of air. Then slowly pull down while continuing to pinch the base, keeping the cup upright to avoid spills.
If the seal won’t break by pinching, slide a finger alongside the cup and gently press it against the vaginal wall to let air in. Or locate the rim with your fingertip and push it inward slightly. Wait until you feel or hear the suction release before pulling down.
Never try to pull the cup out without breaking the seal first. The suction can cause real discomfort.
Cleaning Between Uses
During your period, empty the cup, rinse it with water, and reinsert. Plain water is fine for mid-cycle rinses. At the end of your period, sterilize the cup by placing it in boiling water for up to 10 minutes. Don’t leave it longer, as prolonged boiling can degrade the silicone over time.
Avoid antibacterial soap, scented soap, oil-based soap, baking soda, bleach, hydrogen peroxide, rubbing alcohol, vinegar, and dish soap. All of these can damage medical-grade silicone or leave residues that irritate vaginal tissue.
A lab study published in Applied and Environmental Microbiology found that simply rinsing a cup with water between uses doesn’t fully remove bacterial biofilm. The researchers suggested that using a second cup and sterilizing each one by boiling between uses offers better protection. If you’re concerned about hygiene, keeping two cups in rotation is a practical solution.
Emptying in Public Restrooms
This is the part that worries most new users, but it’s more manageable than it sounds. A few approaches work well when you don’t have a private sink:
- Water bottle method: Bring a small water bottle into the stall. Empty the cup into the toilet, then rinse it over the bowl with the water. A sports cap gives a pressurized jet that cleans more effectively.
- Wipe and reinsert: Wash your hands before entering the stall, empty the cup, wipe it thoroughly with toilet paper or a clean tissue, and reinsert. Check that no small paper fragments are stuck to the cup before putting it back in. Give it a proper rinse when you get home.
- Two-cup rotation: Carry a second clean cup in a small pouch. Swap the used cup for the clean one and deal with washing when you’re home.
- Accessible stall: Restrooms with accessible stalls often have a private sink inside. These are an easy option when available.
Since a cup can safely stay in for up to 12 hours, most people only need to empty it morning and evening, avoiding the public restroom situation entirely on lighter days.
Why Your Cup Might Leak
Leaking almost always comes down to one of three things. First, the cup hasn’t fully opened. If there’s a dent or fold in the rim, blood flows right past it. Second, the cup is sitting too high, next to the cervix instead of below it. When the cervix isn’t inside the cup’s opening, blood drips around the outside. If you’re leaking but the cup is nearly empty when you remove it, placement is likely the issue. Third, the cup is simply full. If you’re finding it three-quarters full or more at removal, you need to empty it more frequently or switch to a higher-capacity size.
Menstrual Cups and IUDs
If you use an IUD, be aware that menstrual cups can increase the risk of displacement. A clinical trial published in Contraception found that cup users had three times the odds of IUD expulsion over 36 months with certain IUD designs, and accidental self-removal (pulling the IUD out along with the cup) was significantly more common among cup users. The risk appears higher with smaller-framed IUDs. Breaking the suction seal completely before removing the cup is essential, and checking that your IUD strings are in place after each removal is a good habit. Talk to your provider about whether a cup is appropriate for your specific IUD type.
Toxic Shock Syndrome Risk
Menstrual cups are not TSS-free. A laboratory study in Applied and Environmental Microbiology found that cups actually allowed higher bacterial growth and toxin production than tampons, likely because the cup introduces more air into the vaginal canal, which helps the bacteria thrive. Toxin levels increased with larger cup sizes. The risk of menstrual TSS remains rare overall, but cups require the same precautions as tampons: empty within the recommended 12-hour window, wash your hands before handling, and sterilize between cycles. Signs of TSS include sudden high fever, vomiting, diarrhea, a sunburn-like rash, and dizziness. Remove the cup immediately if these symptoms develop.