Do menstrual cups increase risk of IUD expulsion? A survey of self-reported IUD and menstrual hygiene product use in the United States

Schnyer, Ariela; Jensen, Jeffrey T.; Edelman, Alison; Han, Leo

doi:10.1080/13625187.2019.1643836

Cited by 17 publications

(13 citation statements)

References 16 publications

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“…Wiebe et al concluded no significant association between concomitant menstrual cup and IUD use and increased risk of IUD expulsion [ 16 ]. Schnyer et al concluded significant positive association between concomitant menstrual cup and IUD use and IUD expulsion [ 18 ]. Long et al also concludes significant positive association, and 9 months after initial enrolment, the study protocol was altered to advise participants against use of menstrual cups with IUD in-situ due to the increased risk of expulsion [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Long et al conducted follow up during the first-year post insertion at 6 weeks, and 3, 6, and 12 months, however specific data regarding time to expulsion is not available [ 19 ]. 74.5% of Schnyer et al cohort reported expulsion occurring within the first year following IUD expulsion [ 18 ]. Time to expulsion ranged from under 1 week to 13 months in 7 cases reported by Seale et al, and 8 months up to 30 months in two cases reported by Ruddock-Ward et al [ 20 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…Schnyer et al had a larger sample of menstrual cup users despite not specifically recruiting menstrual cup users [ 18 ]. This may reflect a trend of increasing use of menstrual cups amongst Caucasian, younger, and highly educated individuals, as these characteristics were highly represented in survey responses [ 16 , 18 ]. As this survey relied on self-reporting, answers could not be verified and may be impacted by recall bias.…”

Section: Discussionmentioning

confidence: 99%

“…Time to expulsion in the reported case studies and the Schnyer et al cohort suggests a longer follow-up period is necessary to accurately assess correlation between menstrual cup use and IUD expulsion [ 18 , 20 , 21 ]. Long et al had a follow up period of minimum 12 months and reported increased risk of Cu-IUD expulsion with concomitant menstrual cup use [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Menstrual cup and risk of IUD expulsion – a systematic review

Bowman

Thwaites

2023

Contracept Reprod Med

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Background The menstrual cup is a safe, cost-effective, and environmentally friendly menstrual product which is increasing in usage, especially in younger women. The potential risk for concomitant menstrual cup use to increase IUD expulsion has been raised over the last 10 years, however, few studies assess this. This systematic review aims to identify, appraise and synthesize the current specific evidence on menstrual cup use and risk of partial or total IUD expulsion. Methods PubMed, and the Cochrane Library were searched for publications available in English, until February 20th, 2021. Quantitative and qualitative studies, systematic reviews and case series reports were included. Websites of menstrual cup manufacturers LenaCup®, DivaCup®, Lunette®, AllMatters® and Saalt® were searched for warnings relevant to IUD expulsion. Results Seven studies were included in this review, comprising 73 partial or total IUD expulsion events in patients with IUD contraception using menstrual cups. The case study reports included two individuals who each experienced two and three expulsions respectively. Of the seven publications, three reported expulsion rates of 3.7%, 17.3% and 18.6%. Time to expulsion ranged from less than one week to two and a half years. These three studies disagree on whether there is a statistically significant association between menstrual cup use and IUD expulsion. Conclusion There is a possible association between menstrual cup use and increased risk of IUD expulsion and this information should be shared with patients. However evidence is scarce and high-quality randomised controlled trials are needed to address this risk and the impact of factors such as age, menstrual cup removal technique, pelvic anatomy, IUD type, and measures such as cutting the IUD strings short or delaying menstrual cup use for a period post-insertion. This research gap is limiting patients’ ability to make informed choices regarding intrauterine contraception and menstrual management and must urgently be addressed in the context of rising IUD and menstrual cup use, particularly among a younger demographic who are seeking highly effective contraception.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Menstrual cup and risk of IUD expulsion – a systematic review

Bowman

Thwaites

2023

Contracept Reprod Med

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“…Wu, et al reported that the LNG-IUS placed in 3 monkeys, expulsion of device was found in one monkey [8]. In human women, the rate of postpartum IUD expulsion varies from 1.9% to 29.7% which depending on [9][10][11][12]. while removal rates are 3.6% to 19.3% due to associate side effects (bleeding, pain and discharge) [9,11].…”

Section: Discussionmentioning

confidence: 99%

Experiment of a novel four-spherical intrauterine contraceptive device with nickel-titanium

Yu¹,

Meihua²,

Yu³

et al. 2020

Clin J Obstet Gynecol

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The aim of this study was to develop a novel four-spherical intrauterine contraceptive device (4-SIUD) with nickel-titanium (Ni-Ti) for human, and to evaluate the contraceptive effect. The 4-SIUD composed of 4 mesh spheres and 5 support arms. The shape of 4-SIUD was like a “T”. The height (H), upper width (D) and thickness of the 4-SIUD for macaques were 0.8 cm, 0.5 cm and 0.3 cm, and for human were 4.5 cm, 4.0 cm and 0.8 cm, respectively. The 4-SIUD was inserted into 5 macaques and pregnancy was not observed at 12 months. Three women used the 4-SIUD for 12 months, uterine perforations, expulsion, pain, and pelvic inflammatory did not occur. The results suggested that the 4-SIUD is appropriate for rhesus macaques and human use, and has a good contraceptive effect.

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Benefits and limitations of nonhormonal contraception

Segerer,

Böttcher

2023

Gynäkologie

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ZusammenfassungNichthormonelle Kontrazeptiva sind in den letzten Jahren zunehmend gefragt. Spitzenreiter ist dabei das Kondom, welches zu den Barrieremethoden gehört. Auch Methoden der natürlichen Familienplanung, Intrauterinpessare und operative Methoden (Sterilisation, Vasektomie) gehören zur nichthormonellen Kontrazeption. Die Effektivität der Barrieremethoden und auch der Methoden der natürlichen Familienplanung hängt dabei stark von der konsistenten und korrekten Anwendung ab, während die Einlage von intrauterinen Pessaren oder operative Methoden unabhängig von der Anwendung sind und diese Methoden somit auch eine hohe kontrazeptive Effektivität besitzen. Wichtig ist eine individuelle Beratung vor Wahl der kontrazeptiven Methode, welche die aktuelle Lebenssituation der Anwender:innen, die kontrazeptive Effektivität, mögliche gesundheitliche Risiken und die Akzeptanz der Methode berücksichtigt.

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Do menstrual cups increase risk of IUD expulsion? A survey of self-reported IUD and menstrual hygiene product use in the United States

Cited by 17 publications

References 16 publications

Menstrual cup and risk of IUD expulsion – a systematic review

Menstrual cup and risk of IUD expulsion – a systematic review

Experiment of a novel four-spherical intrauterine contraceptive device with nickel-titanium

Benefits and limitations of nonhormonal contraception

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