All posts by jmascari

what you should know about menstrual cups

I saw an email about groups on campus giving out free menstrual cups, and I was curious about trying one out. I like the idea of having a more sustainable option compared to tampons or pads, but I’m worried about it being messy or uncomfortable to insert or remove. I was also thinking about getting an IUD soon and was wondering if the menstrual cup would interfere with it. 

– Curious about Cups

Dear Curious about Cups,

Menstrual cups are a great alternative to pads and tampons and definitely worth trying out if you think they might be right for you! Not only are they more sustainable, but they can also be a super cost-effective option compared to pads and tampons. If you take advantage of the campus initiative, your cup will be free and could last you up to five years with proper cleaning and care! If you buy one later, it will cost anywhere from $6–40 depending on the brand that you chose, meaning you’re still spending less than you would on tampons or pads over several years. 

Lots of brands make menstrual cups, and they are typically bell-shaped and made of flexible, medical-grade silicone. Unlike pads and tampons, the cups do not absorb blood but simply collect it. This means it will need to be emptied about every 6–12 hours, depending on how heavy your flow is. If you are interested in tracking your menstrual fluid volume for personal or medical reasons, menstrual cups are a great choice. For many people, menstrual cups can be changed less often than pads or tampons, making them a convenient option! Furthermore, compared to tampons, menstrual cups also have the advantage of reducing period odors.

To insert your cup, you will need to fold it. There are many options for how to do this and lots of online tutorials showing different folding styles. If you are nervous, you can watch videos and/or practice folding your cup before you go to insert it. Don’t be afraid to try a couple of different shapes to find the one that works best for you! Once inserted, simply twist the cup using the stem at the bottom to create an airtight seal against the vaginal canal. If inserted properly, you shouldn’t feel the cup, and it shouldn’t leak. If you experience any discomfort, calmly remove the cup and try again. You can also use lubricant or water on the rim of the cup for easier insertion.

If you are still concerned about the insertion of your cup, you can explore different menstrual cup sizes. The size you choose may be dependent on your age, your anatomy, and whether you have given birth vaginally. Many companies sell small, medium, and large cup sizes and will have specific information to guide you in selecting the appropriate size for you! The size you select may also impact how frequently you have to change the cup. 

Mess when removing the cup is definitely a common concern and worth considering if you choose to use a menstrual cup. To remove the cup, simply pull the stem down slightly so that you can squeeze the bottom of the cup to break the seal. This is crucial for an easy and painless removal. Pull down to remove the cup and empty it into the sink or toilet. 

Ideally, you should wash the cup with gentle soap and warm water after each use. If you are in a shared or public restroom, this can be a challenge. Many companies sell wipes that can be used to clean the cups inside of the stall. If you are in a pinch, you can wipe the cup out with toilet paper and reinsert, but try to avoid doing this after more than one use and wash thoroughly afterward. 

Luckily, because they can be changed less often, you may be able to avoid changing them during the day. If you want privacy, change your cup and wash it with you in the shower! Obviously, menstrual cups are not ideal for everyone, and if doing this would make you uncomfortable, it might be worth sticking to other options. 

If you do decide to get an intrauterine device (IUD) as contraception, you probably shouldn’t use a menstrual cup. The suction of the cup creates an increased risk of dislodging or removing your IUD. However, if you still want to use a menstrual cup with an IUD, you could potentially lower your risk of IUD dislodgement by going to your healthcare provider and having your IUD strings shortened. Furthermore, it is important that you are careful when removing the cup and always break the seal before pulling it out. 

If you have any further questions or specific concerns about menstrual cups, Sexual Health and Wellness providers at University Health Services are there to help and can provide you with specific advice. You can make an appointment by calling (609) 258-3141. 

– The Sexpert

Sources:

https://www.webmd.com/sex/birth-control/features/menstrual-cup-iud

https://putacupinit.com/

https://newsnetwork.mayoclinic.org/discussion/menstrual-cups-vs-tampons-things-you-might-not-know-about-the-cup/

https://store.lunette.com/blogs/news/how-to-clean-menstrual-cup-in-public-toilet

https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/how-do-i-use-tampons-pads-and-menstrual-cups

https://beyouonline.co.uk/blogs/news/how-do-you-fold-a-beyou-menstrual-cup

Curious and Careful: About PrEP

Dear Sexpert,

Pill icon

I’ve seen a couple of ads for a drug for people at risk for HIV. What exactly qualifies as “at risk” and how safe/effective is this drug?

Signed,
Curious & Careful

Dear Curious & Careful,

You’re right, PrEP, or Pre-Exposure Prophylaxis, can be used in prevention of human immunodeficiency virus (HIV). PrEP is a prescription pill (commonly sold under the name Truvada®) designed for daily use by people who are HIV-negative and at substantial risk for HIV exposure. PrEP is a combination of two drugs, tenofovir and emtricitabine. If used correctly and consistently, it has been shown to reduce risk by up to 92%. Additionally, many health insurance plans cover PrEP.

There are several situations that can qualify a person to be considered at substantial risk. The Centers for Disease Control and Prevention (CDC) recommend PrEP for anyone who meets any of the following circumstances:

  • is in an ongoing relationship with an partner who is HIV-positive;
  • is not in a mutually monogamous relationship with a partner who recently tested HIV-negative;
  • is a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the last six months;
  • is a heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status, who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners); and
  • has injected illicit drugs in the past 6 months and who has shared injection equipment or been in drug treatment for injection drug use in the past 6 months.”

If you fall into any one of these categories, or feel that you may benefit from PrEP, schedule an appointment at Sexual Health and Wellness (SHAW) or your primary health care office to discuss with a clinician whether this is an option for you. It’s important to keep in mind this is solely a preventative drug for people with on-going risk of being infected with HIV, and is not recommended for those who have had a single incidence of potential, high-risk exposure.  (There is a different medication, called PEP, or post-exposure prophylaxis, in those instances.)

Additionally, PrEP is a drug that needs to be taken on a daily basis. Like birth control or other daily-prescribed drugs, irregular use will decrease its effectiveness. Anyone prescribed PrEP should return

to their health care provider every three months for consistent HIV monitoring and follow up. PrEP is not 100% effective at preventing HIV acquisition and does not protect you from other sexually transmitted infections (STIs). Precautions should still be taken to reduce your risks, including using a condom with every intercourse, getting HIV tested with your partner(s), practicing less risky sexual behaviors (e.g., oral sex while using a barrier method), reducing your number of partners, and/or sterilizing injection equipment or joining a substance treatment program.

Best of luck and be safe,
The Sexpert

Information regarding PrEP retrieved from Centers for Disease Control and Prevention (CDC).

Condom Queen: What if my partner doesn’t want to use a condom?

Dear Sexpert—

I just started dating a new guy, and he’s really great! But there’s one thing he does that makes me kind of uneasy: he’s really resistant to wearing condoms when we have sex. He always comes up with some excuse and tries to make me feel good about it, and sometimes I go along with it. Usually, I am a real stickler about condom use, so it worries me that he is so against using them. On the one hand, I want to tell him to wear one; but on the other, he’s made it seem like wearing one is a deal-breaker and I don’t want to lose him over it. What should I do?

–Condom Queen

 

Dear Ms. Queen,

There are a lot of different factors and attitudes that go into decision making and preferences, especially when it comes to something as intimate as sex. You have already decided that your preference is to use a condom every time, without exception. However, your boyfriend has other preferences.

Communication is the best way to improve sex. Talk with him about his dislike of condoms at a time when you’re not engaging in sexual activity. Figuring out his reasoning questions may help the two of you to come to an agreement about condom use. It is possible that he has had a bad experience with condoms in the past, or maybe he has not found one with the right fit. Trying out different condom styles or having open communication about wants and needs is a great way for him to see the fun of safer sexual experiences.

It seems like that you are concerned your boyfriend will end things if you push him. You have the right to make a decision for yourself, and he has the right for himself; but when you are making decisions that impact your partner, any and all decisions must mutually be agreed upon. I know it feels like saying something may put your relationship with him in jeopardy, but not saying something could also put your and his safety at risk (See the Sexpert archives.).

Be prepared with a response for the excuses, like “You’re just so sexy, I can’t wait” or “It’ll feel so much better without one”. Having condoms on-hand will discredit his “I can’t wait” argument, and it’ll make it easier for you to stay strong in your decision. Keep some condoms in your purse or bedside table for easy access. (You can get 10 FREE condoms, daily, at McCosh.) Also, there are many ways in which using condoms can be a fun part of the fun of your sexual experiences. Using the ultra-thin, ribbed, or heat-activating varieties or even adding a dab of lube to the inside and outside of the condom can all enhance the overall sexual experience for you both. If you aren’t interested in trying these options, you can always refer to the recent study published in The Journal of Sexual Medicine that stated that both men and women enjoy sex as much with condoms as without. This might alleviate his concerns, or at least make him more open to trying condoms.

When communicating about safer sex with your partner, feel free to be creative with ways to cooperate and come to a conclusion that makes you both happy. Just being willing to acknowledge his desires or worries may get him to acknowledge yours.

Good luck,

~The Sexpert