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Can You Use a Menstrual Cup With an IUD?

Medically Reviewed by Brunilda Nazario, MD on January 22, 2021

When you have your period, you may prefer using a menstrual cup instead of tampons or pads. Menstrual cups are becoming more popular because they’re reusable, long lasting, and eco-friendly.

But if you have an IUD, there are a few things to consider before you use a menstrual cup.

What Is a Menstrual Cup?

A menstrual cup is a small, flexible cup you put in your vagina to collect blood when you have your period. It’s usually made of silicone or rubber.

Unlike tampons and pads, a cup doesn’t absorb the blood that flows from your uterus. Instead, it collects the blood. You empty the cup when it’s full or if it leaks, about every 12 hours or so. You remove the cup, empty it, rinse it, and put it back in until the end of your period.

There are advantages of using a menstrual cup instead of tampons or pads. It’s easy to use once you get the hang of it. It costs less than other methods, creates less waste, has no odor, and doesn’t need to be changed as often.

“It’s all about freedom for menstruating people,” says Nicole E. Williams, MD, a gynecologic surgeon at the Gynecology Institute of Chicago.

There are downsides too. It may be hard for you to put in and take out. It can also be messy. You have to sterilize the cup after each period. Not all menstrual cups fit perfectly.

And if you have an intrauterine device, or IUD, it might get dislodged if the menstrual cup pulls on the strings. If your IUD comes out of place, you might get pregnant.

Should You Use a Menstrual Cup With an IUD?

“The quick answer up until recently was yes, it’s safe,” says Shieva Ghofrany, MD, co-founder of the women’s health site A Tribe Called V. “The IUD sits inside the uterine cavity, while the menstrual cup sits inside the vagina.” If they’re in separate places, they shouldn’t interfere with one another.

Until recently, experts believed using a menstrual cup was no riskier than using a tampon or pad with an IUD. A 2011 study found that women who used a menstrual cup didn’t have extra risk of losing their IUD.

But newer research suggests there may be more risk. In April 2020, a study published in Obstetrics & Gynecology found that women who used a menstrual cup had a higher rate of dislodging their IUD than women who used tampons or pads.

While it was only one study, Ghofrany says, it does mean we need to keep it in mind. It’s important to know how to use your menstrual cup the right way.

How to Use a Menstrual Cup With an IUD

Take these steps to lower the odds of your IUD coming out when you use a menstrual cup:

  • Keep your menstrual cup away from your IUD strings. “Be sure the strings don’t get caught in between the edge of the cup and your vaginal wall, where they can get pulled on when your cup is coming out,” Ghofrany says. They should be inside your cup.
  • Watch for changes in your strings. Check your strings regularly. If you know how they usually feel, it’ll be easier to know if something changes. If they’re longer than normal, for example, it may be a sign your IUD has moved.
  • Ask your doctor for shorter strings. They can cut your IUD strings to a better length for you. "Make sure your IUD string isn’t so long that when you remove your cup, the IUD gets tugged out along with it,” Williams says.
  • Break the seal. Your menstrual cup should create suction when you put it in. When you’re ready to take it out, make sure you break the seal first. If you don’t, you may cause too much pressure, and that can dislodge your IUD. Try pressing your cup into a C-shape before you take it out so you don’t have to pull on the base.
  • Get the right size. Not all cups have the same fit. Some brands may sit lower in your vagina, while others are higher and closer to your cervix. Ask your doctor which one is best for you.
  • Consider an alternative. Try a menstrual disc instead of a menstrual cup. It’s less likely to affect your IUD because it uses less suction.

Talk to your doctor about which menstrual cup is right for you and what you can do to lower the chances of moving your IUD.

WebMD Feature

Sources

SOURCES:

Cleveland Clinic: “Tired of Tampons? Here Are Pros and Cons of Menstrual Cups.”

Nicole E. Williams, MD, FACOG, FACS, Gynecology Institute of Chicago.

Shieva Ghofrany, MD, Coastal Obstetrics & Gynecology, Stamford, CT.

Bedsider: “Can menstrual products mess with your birth control?”

The European Journal of Contraception & Reproductive Health Care: “Do menstrual cups increase risk of IUD expulsion? A survey of self-reported IUD and menstrual hygiene product use in the United States.”

Obstetrics & Gynecology: "Menstrual Cup Use and Intrauterine Device Expulsion in a Copper Intrauterine Device Contraceptive Efficacy Trial [OP01-1B]."

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