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The Menstrual CupMenstrual Hygiene With Less Environmental Impact

To identify the key insights or developments described in this article
1 Credit CME

Approximately 1.8 billion individuals menstruate every month. Therefore, the need for effective and affordable menstrual products is paramount.1 Most widely available menstrual products, such as sanitary pads and tampons, are disposable and of high plastic content; menstrual products in the US alone contribute to 240 000 tons of solid waste per year.2 The menstrual cup is a typically reusable, flexible, self-retaining intravaginal menstrual fluid collection device. Increasing public knowledge and acceptance of the reusable menstrual cup can reduce waste, simplify menstrual hygiene, and provide accessibility for resource-poor communities. Although disposable products may be convenient because they do not require cleaning, menstruating individuals may be motivated to use menstrual cups for environmental concerns and reduced need for purchasing hygiene supplies. For many menstruating individuals, and some clinicians, there are persistent concerns related to menstrual hygiene product safety outside of the use of sanitary pads. The goal of this article is to expand clinician knowledge about the safety and best practices of menstrual cup use to support patients who choose this product.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Judith Simms-Cendan, MD, Division of Pediatric Adolescent Gynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL 33136 (Jss153@med.miami.edu).

Published Online: March 17, 2023. doi:10.1001/jama.2023.1172

Conflict of Interest Disclosures: None reported.

References
1.
UNICEF. Menstrual hygiene. Accessed March 6, 2023. https://www.unicef.org/wash/menstrual-hygiene
2.
US Environmental Protection Agency. Facts and figures about materials, wastes and recycling. Accessed March 6, 2023. https://www.epa.gov/facts-and-figures-about-materials-waste-and-recycling/national-overview-facts-and-figures-materials
3.
van Eijk  AM , Jayasinghe  N , Zulaika  G ,  et al.  Exploring menstrual products.   PLoS One. 2021;16(9):e0257610.PubMedGoogle Scholar
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Howard  C , Rose  CL , Trouton  K ,  et al.  FLOW (finding lasting options for women): multicentre randomized controlled trial comparing tampons with menstrual cups.   Can Fam Physician. 2011;57(6):e208-e215.PubMedGoogle Scholar
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Menstrual Cup Market by Product Type (Disposable and Reusable), Material (Medical Grade Silicone, Natural Rubber, and Thermoplastic Elastomer), and Distribution Channel. Allied Market Research; 2020.
6.
van Eijk  AM , Zulaika  G , Lenchner  M ,  et al.  Menstrual cup use, leakage, acceptability, safety, and availability.   Lancet Public Health. 2019;4(8):e376-e393.PubMedGoogle ScholarCrossref
7.
Stewart  K , Powell  M , Greer  R .  An alternative to conventional sanitary protection: would women use a menstrual cup?   J Obstet Gynaecol. 2009;29(1):49-52. doi:10.1080/01443610802628841PubMedGoogle ScholarCrossref
8.
Nonfoux  L , Chiaruzzi  M , Badiou  C ,  et al.  Impact of currently marketed tampons and menstrual cups on staphylococcus aureus growth and toxic shock syndrome toxin 1 production in vitro.   Appl Environ Microbiol. 2018;84(12):e00351-e18.PubMedGoogle ScholarCrossref
9.
Torondel  B , Sinha  S , Mohanty  JR ,  et al.  Association between unhygienic menstrual management practices and prevalence of lower reproductive tract infections.   BMC Infect Dis. 2018;18(1):473.PubMedGoogle ScholarCrossref
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Manley  H , Hunt  JA , Santos  L , Breedon  P .  Comparison between menstrual cups.   Womens Health (Lond). 2021;17:17455065211058553.PubMedGoogle Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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