Selecting a menstrual cup to use with an IUD

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16 August 2012 @ 12:08 pm

I'm looking for advice on using a menstrual cup with my ParaGard IUD.

My doctor recommended against using my Diva Cup with my IUD as she thinks it could dislodge it. This seems to be a subjective opinion rather than a documented fact, so I'm exploring other menstrual cups that are shorter/smaller, which seems less likely to affect the IUD strings. (She didn't seem to know what one was and had me bring mine in. Then she said that it's designed for your cervix to sit inside it, which would make string interaction more likely.)

I'm late-20s, nulliparous, and I do exercise, so my pelvic floor muscle tone is pretty good. I'm an experienced Diva Cup user.

I've had the IUD for a month and am on my first period. It's about the same flow thus far as when I was on the pill, which equates to about .25 oz or so in a 12 hour period. My cervix is anywhere from 2-3" from my vaginal opening, with it being lower during my period. My strings are cut to about 1" past my cervix and I don't plan to have them cut shorter.

I loved my Diva Cup, but I did feel it was the maximum size I could fit comfortably. The only problem I ever had was urine leakage with a very full bladder and a sneeze or the like and a feeling like it was partially blocking my urine flow. I now think that perhaps it was too large for me.

I'm considering the following cups in the following order:
Meluna Classic small - 40 mm long
Lady Cup small - 46 mm long
Lunette small - 47 mm long

Also, the Meluna and am on my first period. It's about the same flow thus far as when I was on the pill, which equates to about .25 oz or so in a 12 hour period. My cervix is anywhere from 2-3" from my vaginal opening, with it being lower during my period. My strings are cut to about 1" past my cervix and I don't plan to have them cut shorter.

I loved my Diva Cup, but I did feel it was the maximum size I could fit comfortably. The only problem I ever had was urine leakage with a very full bladder and a sneeze or the like and a feeling li

Tags: buying decisions, divacup, iud, lady cup, lunette, meluna

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kimie_catclaw on August 16th, 2012 05:22 pm (UTC)

I use a large soft Meluna with my Mirena, no issues (although I've only had to use it a couple of times since I had the IUD placed.)

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teacupcake89 on August 16th, 2012 05:36 pm (UTC)

Teresa who owns femininewear.co.uk has compiled the advice for using a cup with an IUD from a variety of cup companies which you can read here: http://www.femininewear.co.uk/iuds-24-w.asp which might help confidence in using your cup!

I think there is also a post on IUDs in the community FAQ in the side bar.

Try looking through the posts with the iud tag and there is loads of great advice and references to cup use in the lj comm http://iud-divas.livejournal.com/ :)

have you tried turning your Diva cup inside out? (so it's shorter)this will give you an idea of how much short a cup you want.

As the Diva cup is one of the longest cups available and you had no problems with it being too long/sticking out etc, I'd suggest a similar length or shorter length but with a long stem cup but with a narrower rim/width than your Diva. here is the link to the size charts with mini Meluna measurments: http://sizecharts.livejournal.com/

and photo comparisons here but check out the latest albums not just the Diva album: http://menstrualcups.friendhood.net/f52-moderator-s-photo-library

the ladycups are quite slippery/trickyier to remove because of its slick texture and no grip rings.

I definitely wouldn't suggest a small meluna if you have a high cervix as it'll ride right up there!!

also your height and weight/build are irrelevant as our insides don't reflect what's on the outside :)

Good luck! :)

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kaw2 on August 16th, 2012 05:54 pm (UTC)

Thanks for all the links!

I definitely wouldn't suggest a small meluna if you have a high cervix as it'll ride right up there!!

I thought that a menstrual cup sits just above the pelvic floor, not high in the vaginal canal like a tampon. In that case, a shorter cup would just help keep it away from the cervix and the IUD's strings, which is why I assumed a shorter cup would be ideal. Am I incorrect in my understanding?

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juliiie87 on August 16th, 2012 06:15 pm (UTC)

Most cup users report their cup sit (o) around their cervix. There are some individual exceptions, but also countless users with a long vaginal canal who report having to bear down a lot and literally wrestle with their vagina to retrieve their cup. The fact is, the vagina being a slick muscle, cups tend to climb up there on their own. So I really wouldn't recommend getting the shortest cup out there. Also, compare the vast difference in capacity between your Diva and a Mini Meluna !

I "think" what you want is a cup that is easy enough to break the seal, and just be very careful not to yank it out without breaking the seal first, this way you should be fine.

There are mixed reviews of what makes a cup easiest to remove. Softer cups tend to create a stronger vacuum effect, and you usually need to slide a finger in next to the body of the cup to release the seal, which is why I advise against super short cups (unless your vagina is this short, obv.). This method works very smoothly with my very soft Cuplee and Meluna. Firmer cups are reportedly easier to break the seal and hold better against strong muscles, but I find they require more strength to squeeze them and release the seal.

What you do want anyway, is big, numerous, effective anti-suction holes. I also don't think you should go for something significantly shorter than your Diva. For the peeing issues, a softer cup is likely to put less pressure on your bladder and feel more comfortable, even if it's wider. Stiffness comparison chart : http://menstrualcupinfo.wordpress.com/cup-stiffness-comparison-chart/ Other than that... see comparison pictures (especially the top ones since the Diva album is older and doesn't have all the brands). Good luck in your research and ask away if you have more questions ! ;)

Edited at 2012-08-16 08:10 pm (UTC)

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teacupcake89 on August 16th, 2012 06:16 pm (UTC)

yes, basically IGNORE those diagrams that show a tiny cup at the bottom of the vagina with loads of space above it!! :)cups (and diva cups especially because they are so long) kinda take up all the space between your cervix and the vaginal entrance.

cup companies often instruct to 'place the cup low' so users have less difficulty digging it out if they have a small cup and high cervix. However, cups will ride up and sit wherever they want to even if you 'place it low down', which is usually underneath or around your cervix.

so you WANT it to sit underneath your cervix :)and be long enough for you to reach the stem/base for removal (a very small cup will ride up and be tricky to reach/remove if you have a high cervix)

after insertion I would check that the strings are inside the cupif they are long enough(not pressed between the vaginal wall and the cup)

some users have also had success enlarging the Diva cup's tiny holes to help with breaking the seal during removal.

hopefully some of this makes sense/helps! :)

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juliiie87 on August 16th, 2012 06:22 pm (UTC)

I don't have an IUD, but I wouldn't worry too much where the strings are when you insert the cup, as many IUD wearer report the strings naturally curl up around their cervix after some time. I'd just be super careful not to tug on them for removal. :)

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kaw2 on August 16th, 2012 07:09 pm (UTC)

Interesting. I was definitely confused because every brand's website states that it sits low, at the base of the canal, which is also my experience. But you're all saying that it only sits low if it reaches up to your cervix and doesn't have the room to slide upwards.

So in that case, I would want to get a cup that's the same length, but a bit less in diameter.

And to work best with an IUD, I need to be able to break the suction, which means large holes. I've never had an issue breaking the suction on my Diva Cup though, so does that mean that it would be an appropriate cup to use?

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juliiie87 on August 16th, 2012 07:18 pm (UTC)

I guess it would be ok if you know how to effectively break the suction, yes. My Cuplee sits low too, because it's fairly long compared to the length to my cervix. I can actually sort of feel my cervix inside when I reach up to remove. Which is good, in the sense that this way I /you don't have to tug on the stem like mad to remove it. I thought maybe the Diva is not the best because it has faily tiny holes compared to other brands, but it's entirely up to you to determine how safe it is. :)

Diameter doesn't make that much difference in my opinion, do you mean because of your bladder issues ? I think softness makes more difference in that department.

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juliiie87 on August 16th, 2012 08:29 pm (UTC)

Interesting link I found : http://www.livejournal.com/tools/memories.bml?user=menstrual_cups&keyword=iud&filter=all
(and the whole iud-divas comm, of course ! ;) )

Edited at 2012-08-16 08:30 pm (UTC)

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teacupcake89 on August 17th, 2012 09:56 am (UTC)

ooh!! totally bookmarking this! haha :)

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lebannen on August 16th, 2012 07:23 pm (UTC)

I used a MCUK for a year with a copper IUD, and part way through the year got a large fleurcup as well (to help deal with the increased flow). Then I got the IUD removed on purpose, it didn't get pulled out accidentally or anything.

The most important thing is to remember to break the seal before taking it out, and especially not to pull too hard just in case the strings are caught somewhere. If you've been drinking it's REALLY important to be careful, because being careful is a lot harder when you left some of your finer motor skills in the bar. Sometimes the strings stay curled up, sometimes they might come down inside the cup (I was always a bit worried about potentially pinching them inside the cup), sometimes they might end up outside the cup (but my strings were apparently quite long, so YMMV with that).

I found the mooncup easier to remove than the fleurcup, but that could just have been because I was more used to it.

Good luck!

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kaw2 on August 17th, 2012 04:57 pm (UTC)

If you've been drinking it's REALLY important to be careful, because being careful is a lot harder when you left some of your finer motor skills in the bar.

Ha! The nice thing about the cup is that if I go out at night, I would generally have emptied it before and would be good until the next morning. Hopefully it'll remain the same now.

Sometimes the strings stay curled up, sometimes they might come down inside the cup (I was always a bit worried about potentially pinching them inside the cup), sometimes they might end up outside the cup (but my strings were apparently quite long, so YMMV with that).

I've never considered the possibility of pinching them inside the cup with removal... That's good to note. I just thought the issue would be them being pulled between the cup and vaginal wall. Or when I twisted the cup to get suction. But thanks to the FAQs here, I learned that I probably don't have to twist it!

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kuradi8 on August 16th, 2012 07:43 pm (UTC)

Some cups say you can use them with an IUD, others say you shouldn't, and yet others say to ask your doctor. I say that's their legal departments talking, not their medical advisors.

I've had IUDs for decades and been using a variety of cups (some say it's OK, others say not) for 4-5 years -- all without issue.

There's no reason to get another cup unless you want one that's different from your Diva. You're already an experienced cup user, so you know how to insert and (especially) remove without causing suction or distress to your cervix, etc. If you want another cup, use the guidelines and charts at http://sizecharts.livejournal.com/ to pick another one that you think will fit and suit you, and go for it -- whether it says it's coil-friendly or not. I don't think it makes a darn bit of difference.

Edited at 2012-08-16 09:37 pm (UTC)

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kaw2 on August 17th, 2012 05:01 pm (UTC)

I'm beginning to think you're right. Same thing with regards to what a doctor says about it. I think it's the lack of studies for companies and doctors to fall back on.

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kuradi8 on August 17th, 2012 05:58 pm (UTC)

FYI, my Gyno thinks cups are WONDERFUL! She had never heard of them before me. I was having profuse bleeding issues and brought in a calendar of how much I'd lost each day. "How did you measure this?" I showed her my cups and then gave her a link to the size charts. Next visit, several nurses asked if I still had my cup with me because they wanted to see too. She recommends them to many patients now, especially those who should keep track of their blood loss.

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rubykins02 on August 17th, 2012 12:04 am (UTC)

My Gyno said I could use my Diva with my Mirena. In fact she said I could use it immediately after the iud was inserted. She was very familiar and supportive of the use of cups.

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omnialia on August 17th, 2012 09:27 am (UTC)

When I had an IUD, my cervix was really sensitive... I couldn't even stand using tampons. I'd suggest a SOFT cup because it much have less forceful suction and less likely to interfere with the string or irritate the cervix!

I gave up after only 4 months with the IUD. It was so incredibly painful and I literally had a non stop period the whole time... I had to get prescription pain killers because that IUD hurt the whole time. I had it removed and it didn't stop hurting for almost half a year later. Just not for everyone!

Good luck :) I wish I could have used a cup back then....

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wiesoauchimmer on August 17th, 2012 12:15 pm (UTC)

i've used a large fleurcup and a XL meluna with my IUD.

what i did was:
- make sure the seal was properly broken every time
- grabbed it as close to the base as possible to avoid trapping the strings in the pinch
- remove the cup slowly and carefully

i did that for the two years i had my IUD in and never had a problem (removed it because i wanted another kid)

i'd say, as long as you are able to break the seal reliably every time, there is no reason to give up on your diva.

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kaw2 on August 17th, 2012 05:12 pm (UTC)

Huge thanks to everyone who commented! You've given me the confidence to trust my gut and go back to using my Diva Cup. I might investigate another cup to fix the urination issue, but it was such a minor and infrequent issue that it's not worth it. I'd rather stick with a cup I know (and love).

Between the one 2011 study that shows no statistical difference in IUD expulsion and feminine product and all sorts of anecdotal evidence stating that cups are fine with an IUD (just use it with common sense), I'm going back to my Diva Cup. It seems like the main risk is pulling on the string when placing or removing the cup and knowledge of my anatomy and the cup, and being careful and aware, minimizes it. That slight risk weighed against the cup vs pads vs tampons makes the cup win hands down.

(I've tried sea sponge tampons - awesome compared to conventional tampons - and regular tampons recently and both have made me really concerned with pulling on the IUD string with their removal. I feel like I'll have more control with the cup rather than just pulling a tampon out and hoping that the IUD string didn't get caught.)

Thanks!

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kuradi8 on August 19th, 2012 02:20 pm (UTC)

FYI, just for size comparison...

You mentioned the small MeLuna Mini. It is 40mm long. Your Diva is 57mm long. This userpic shows the two side by side. Quite a difference, eh?

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kaw2 on September 19th, 2012 09:57 pm (UTC)

Just wanted to follow-up in case it helps anyone.

I just finished my first cycle using my DivaCup with my ParaGard IUD and aside from some initial leaking, it was just fine!

I believe the leaking was due to my attempt to change my insertion/sealing method since I was afraid it would disrupt my IUD. (I would punch down, insert, and twist.) I don't believe I was getting a seal without twisting it. Once I went back to this method (with a 7-fold instead of a punch down), it worked beautifully. It's so slick in there that I can't imagine the cup "grabbing" the string(s) as I twist it.

I also feel pretty confident now that there's really no way a cup could expel an IUD, unless the user holds the string(s) when pinching the cup bottom while pulling it out. I was so tentative and worried the first few insertions and removals that somehow I created suction I never experienced before and all was fine. After all, it was created with the understanding that a penis would rub around in there and create suction of its own.

So thanks to everyone for helping me feel confident enough to give it a try! I again feel comfortable during my periods.

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kaw2 on September 19th, 2012 10:01 pm (UTC)

One more note: DivaCup revised their website and they now say that their cup can be used with an IUD, and that lots of their consumers do it successfully, but to check with your doctor.

I think that just further confirms that it's lack of knowledge/studies that has cup manufacturers and doctors saying that cups and IUDs are incompatible.

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