Menstrual cups could reduce vaginal infections, trial shows

Researchers from Liverpool School of Tropical Medicine, in collaboration with researchers from Kenya and the US, investigated options for girls and young women in low-and-middle-income countries to manage menstruation with comfort and dignity and to improve health outcomes.

As part of the Cups or Cash for Girls (CCG) trial, they assessed the impact of the menstrual cup on girls’ incidence of herpes simplex virus type 2 (HSV-2).

Two new papers from the CCG trial provided evidence that the menstrual cup may provide beneficial results to menstruators’ reproductive health and could be an acceptable and long-lasting solution to manage menstruation.

One study, published in eClinicalMedicine, showed that girls provided with cups had a 33 per cent reduction in HSV-2 compared to the control group. HSV-2, the virus that causes genital herpes, can triple an individual’s risk of becoming infected with HIV.

The study involved 4,137 Kenyan schoolgirls between 16-18 across 96 secondary school in western Kenya.

Schools were allocated to four treatment groups: menstrual cup, conditional cash transfer, combination of cup and cash transfer, and usual menstrual practice (control). Girls were followed for three years or until they completed secondary school.

Dr Garazi Zulaika, post-doctoral research associate at LSTM and lead author on the paper said: “We were interested to know whether a long-lasting, sustainable, and hygienic menstrual solution would be used by girls and be effective in improving their schooling and sexual and reproductive health.

“Our results show that menstrual cups were well-accepted by girls’ as well as protective against infections, highlighting how they can be a great option for menstrual hygiene management while also having significant health impacts.”

A sub-study, published in PLoS Medicine, followed 436 girls and assessed whether menstrual cups reduced rates of bacterial vaginosis or changed the vaginal microbiome.

It found that girls given menstrual cups had a 24 per cent reduction in bacterial vaginosis compared with controls. Additionally, there was a 37 per cent relative increase in Lactobacillus crispatus, indicating cups could improve or maintain a healthy vaginal microbiome.

Elizabeth Nyothach, trial manager at the Kenya Medical Research Institute, who partnered with LSTM on the study, said: “Menstrual cups can be used for up to ten years, offer long term health benefits, reduce waste, and provide financial savings as there is no longer a need for menstruators to buy single use pads and tampons every month.”