menstrual cup

Are Menstrual Cups (Diva Cup, Pixie Cup, Etc) Safe to Use with Pelvic Floor Issues?

The women in my group were raving about these cups, so I had to give it a try. I was soooo excited for the convenience. It seemed awesome, but I wanted to take a closer look at the impact it had on my pelvic floor.

Here are my pros and cons:

Pros: You really have to relax your PF to get it in easily. A lot of women have trouble with relaxing their pelvic floor, so this was great practice! From the start, I was very excited to recommend it just for that step alone. Win #1!

It truly was convenient. We love to go hiking and climbing in the mountains all day. Changing a tampon in the woods… yeah… not that much fun. Same goes for the beach in the summer. This little cup made it all day! Win #2!!!

Now, let’s take a look at the cons.

It made my prolapse relapse. After the delivery of my second, I had a grade 2 prolapse. Most of the time, it stays at a grade half or less (even with heavy exercise and nursing) but using the menstrual cup made it relapse to a 1, so let’s talk about why that happened and how it can happen with other things as well. Maybe you don’t have prolapse, maybe your pelvic floor issue is leaking? What I describe below will cause leaks and if bad enough, painful sex as well.

The cup stays in place by placing pressure out on your vaginal wall.

Much like my daughter in this picture.

pelvic floor exercises

This acts like a stimulus to the pelvic floor, and mine responded by tightening, which is what happens to most women. The tightening was so slight it was almost imperceptible, but I could tell something was off because I couldn’t get in a really deep good breath. Basically, it shut down my deep breathing system by preventing my pelvic floor from going down (not the cup but the tension in my pelvic floor muscles).

Side Note: Your pelvic floor must fully relax down with every inhale. If it doesn’t, your body can’t get in a deep breath and this sends you into a pattern of shallow breathing.

A great analogy that came to mind was tight bra straps. Ever put on a bra where the shoulder straps are just a little too tight and then wore it all day? Bet you had neck and shoulder tension, and you just couldn’t wait to get that bra off at the end of the day. Well, that’s your neck and shoulders responding to the pressure from the strap. It’s responding with tension. The same thing happens to your pelvic floor if something is putting constant pressure on the sides: it’s going to tighten.

pelvic floor exercises

I thought I was relaxing my PF, but I wasn’t. Consciously, I wasn’t doing anything differently. I certainly wasn’t trying to hold it tight. It was an unconscious action, like the neck tightness you get from tight bra straps. It's not like you are consciously fighting the strap.

Now I know what it’s like for women that have tight pelvic floors without ever realizing it. Especially when patients tell me they aren’t holding their pelvic floors tight and I’m like, “Yeah, you are” (I really like to sugar coat things.). Think about it more as resting tension than an actual muscle contraction like a bicep curl.

This is what was going on with me from the menstrual cup. The effect on my pelvic floor? Instant worsening of my prolapse (not back to the original grade 2, but to a grade 1, nonetheless). This small amount of tightening stopped the normal, natural movement of my pelvic floor. Not letting it fully relax with each breath made it stop functioning correctly. The effect of something so small was huge!

Not only did it cause worsening pelvic floor symptoms but it caused neck, shoulder and jaw tightness. It increased the overall tension in my body. (I have two small children, one of whom just got his first tooth. I do not need tension from any other source!! LOL)

It’s taken several days and lots of conscious effort but I finally got my pelvic floor to relax. It feels good to be able to take deep breaths again! Within a day of getting my pelvic floor to relax, my prolapse went back to almost imperceptible. My body is in its happy place again!

I ran a strict study- for being an N=1 and no blinds of any kind. Hormones change your ligament laxity and a lot of women experience an increase in pelvic floor symptoms right before or during their period. I made sure to alternate periods and test it more than once to make sure I got a clear picture.

Is it worth it? Depends. I think I might try wearing it at night only and seeing what effect that has. Maybe it will be better if I’m not up and moving around.

What if I was trying to heal my prolapse or stop leaks, then I’d proceed with extreme caution because it could cause you a setback each month that could take weeks to overcome, if you overcome it at all. You might just think you have prolapse that won’t heal and wonder why it doesn’t get any better, when all it is is a set of stimuli that continuously make your pelvic floor unhappy.

There are so many factors that go into having an awesome pelvic floor, from your breathing, to posture, to arch strength. It’s literally head to toe! Fixing pelvic floor issues is not for the faint of heart. It takes work, time and dedication.

Update: After a couple of months of investigation, I can wear it at night without any issues of relapses or pelvic floor tightness. Yay!!! Now, I'm going to test a couple more months of wearing it for downtime and see how that goes. I will keep you posted!

If you are interested in investing some mental and physical effort in helping your pelvic floor, be sure to check out our pelvic floor programs. I’d love to help you on this journey of healing.

Update again: I can wear it one or two days during the day but not when I workout. If I use it through my whole period or during exercise, my pelvic floor tightens right back up.

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