I have been planning a sticky on menstrual protection, so here it is. “Feminine hygiene” has been episodic through the millennia. Many cultures simply isolated menstruating women and they stayed in special huts where the women took care of themselves with whatever creativity they had. Some women over the centuries used animal skins, worn out clothing or simply shields that allowed drainage. During the nineteenth century, old bed sheets torn into long strips and then folded became the standard. You can still these on drying lines in some parts of rural Europe. Commercial products appeared in the early twentieth century with Kotex being the first commercially successful brand. Tampons appeared in the 1930s and the various cups after that. The first cup was invented by a Danish ballerina and became somewhat known among female athletes. A wonderful history of menstrual products is at www.mum.org
Most of us started with napkins. Mainly because our mother’s demanded that and we could not figure out how to use tampons without help – which we did not want to ask for. To this day, these two products absolutely dominate the market. The products that are less known, less used and less sold are the “menstrual cups.” There is one disposable on the market and there are three brands of reusable cups. All three have websites with descriptions and instructions and they are for sale through these sites – Keeper, Moon Cup and Diva. The Keeper is latex and should be avoided by women with latex allergy but the same company makes the Moon Cup. I used a Keeper for over seven years until it developed small cracks in the rim. I have used a Diva since. The Diva and the Moon Cup are silicone and I have no idea how long they will last.
When you first look at these, you wonder, “How?” Really, quite simple – a few times in and out and you will be comfortable. They come in two sizes – one for women with no children and one for women who have borne children. One of them also recommends that women “over 30” use the larger size. I am well over thirty but have had no children. I am still wearing the “small” size and probably will until menopause. I have never had an accident with either the Keeper or the Diva and often wear it up to ten hours at a stretch without “draining” it. It is recommended that every several hours it be removed, rinsed and re-inserted. I often wear it all day for work; remove it for a few hours getting ready for bed and reinsert for the night. I have gone more than the recommended limit of twelve hours and always wear it overnight.
The instructions for use are quite clear – on the website and with the product. They are inconvenient to use in public facilities. The removal, rinsing and reinserting requires a degree of privacy. I prefer to remove mine standing in the shower but have accomplished what needs to be done behind a tree on a bike trail. Although I keep tampons in the car and my desk drawer for surprises, I use the Diva exclusively. These are quite expensive up front but when you consider how many tampons I would have used in the seven years with the Keeper, they are cheaper in the long term. I have read medical articles questioning the possibility of nerve damage behind the anterior vaginal wall as a result of the constant (not noticeable) pressure. I am aware of no documented cases of damage and have never noticed this in myself.
There is one disposable cup on the market – Instead. It looks like a flexible (but deep) cervical cap and comes in one size. I have tried these but have had poor results. If the size fits you, great; otherwise, accidents do happen. I was never able to sleep through the night without marking my territory. My girlfriend has had satisfactory results with Instead but uses a Diva regularly. Instead is marketed as the only menstrual protection that can be left in place during sex. Eva and I have found this works and makes menstrual sex less messy. With neither of us having a penis, a tampon works, too. We have each tried with men and found that it works quite well but there are still some tracks. Instead has the same difficulties of use in a public facility as do the other cups. Although it does not have to be rinsed and re-inserted, you do have to “dig deeper” to remove it than the reusable cups and then have red fingers to put your clothing back in place. I find the Diva to be less messy when changing. Instead is flexible and I have never been able to remove one without spilling; the Diva and Keeper are more rigid and less likely to spill.
As an aside, I have one patient who fills an Instead with vaginal jelly and uses it as contraceptive cervical cap! Not sold as such but women can be inventive.
A monthly supply of Instead is a lot cheaper than buying a Moon or Diva. But the savings over the years are considerable. The cups are not for everyone but I cannot imagine returning to tampons on a regular basis. I have driven the length of England without changing; ridden 100 miles on a bicycle; sailed through lengthy storms on the North Sea and, even, forgotten about it and left it in place for thirty-six hours (not recommended!). Check them out at their websites.
OP: Brandye 06/04/2007
Posted: 23 Sep 02:32
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