Using a menstrual cup for the first time takes a little practice, but most people get comfortable with it within two or three cycles. The key steps are choosing the right size, folding the cup to make it small enough to insert, angling it correctly, and confirming it’s sealed. Here’s everything you need to know to get it right.
Find Your Size First
Menstrual cup sizes refer to the cup’s diameter. A small cup has a narrower opening, while a large cup is wider. Most brands offer two sizes, and the right one depends on your cervix height, your flow, and whether you’ve given birth vaginally.
Your cervix height is the length of your vaginal canal, and it changes throughout your cycle. To measure it, insert a clean finger during your period and note how far in you can reach before you touch your cervix (it feels like the tip of your nose). If you can insert your finger to the second knuckle or beyond, you have a medium to high cervix. If your finger barely gets past the first knuckle, your cervix sits low, and you’ll want a shorter cup.
This matters more than most people realize. A cup that’s too long will sit uncomfortably low or poke out. A cup that’s too short in someone with a high cervix can ride up and become hard to reach during removal.
Three Folds That Work for Beginners
Folding makes the rim small enough to insert comfortably. Try all three of these and use whichever feels easiest.
- C-fold: Pinch the rim flat between your fingers, then fold the cup in half lengthwise so the two edges meet. The rim forms the shape of the letter C. This is the simplest fold, though it creates the widest insertion point.
- Punch-down fold: Place your thumb on the rim and press one edge downward toward the base, creating a narrow V shape. Hold the base tightly to keep it compact. This makes the smallest tip of the three folds, which many first-time users prefer.
- 7-fold: Pinch the cup flat, then take the top right corner and fold it diagonally down to the opposite edge of the base, forming a 7 shape. Hold firmly near the folded edge. This is a good middle ground between the C-fold and punch-down.
How to Insert the Cup
Get into a comfortable position. Squatting, sitting on the toilet, or standing with one foot on the edge of the tub all work. Relax your pelvic muscles as much as you can. Tension is the most common reason insertion feels difficult on the first try.
Hold the folded cup with one hand, rim facing up. With the index and middle fingers of your free hand, gently hold your outer labia apart. Slide the folded cup in at roughly a 45-degree angle, aiming toward your tailbone rather than straight up. This follows the natural angle of your vaginal canal. Let the cup open once it’s fully inside.
The cup should sit low in the vaginal canal, not pushed up near the cervix. Inserting it too high is one of the most common mistakes, and it causes both leaks and difficult removal.
Check That the Seal Formed
Once the cup is in, you need to confirm it’s fully open and sealed against the vaginal walls. Give the stem a very gentle tug. You should feel slight resistance, which means suction has formed. If the cup slides down easily, it hasn’t sealed.
If the cup doesn’t feel fully open, try rotating it slightly by gripping the base and turning. Some people find that doing a few kegel squeezes helps the cup pop open and settle into place. You can also run a finger around the base of the cup to check for any dents or folds in the rim. A fully open cup feels round and smooth all the way around.
How Long You Can Wear It
Most manufacturers recommend emptying the cup every 4 to 12 hours depending on your flow. On heavy days, you may need to empty it every 4 to 6 hours. On lighter days, up to 12 hours is generally safe. Don’t exceed 12 hours.
Toxic shock syndrome (TSS) is the safety concern people hear about most with internal menstrual products. It’s caused by a toxin produced by certain strains of bacteria. Lab testing on menstrual cups shows they don’t promote the growth of TSS-causing bacteria or increase toxin production. In fact, cups produced significantly lower toxin levels in testing than tampons did. TSS remains extremely rare with any menstrual product, but staying within the 12-hour window is still the standard recommendation.
How to Remove It Safely
The most important rule: never yank the stem to pull the cup out. You need to break the suction seal first, or removal will be uncomfortable.
Sit on the toilet or squat, and bear down gently with your pelvic muscles to push the cup lower. Insert your thumb and index finger until you can feel the base of the cup. You can use the stem to guide your fingers to the base, but the stem alone isn’t meant to pull the cup out. Once you reach the base, pinch it firmly. You should feel or hear the seal release. Then slowly pull down while continuing to pinch, keeping the cup upright to avoid spills.
If you can’t reach the base, slide one finger alongside the cup and press it gently against your vaginal wall. This lets air in and breaks the seal. You can also hook your finger over the rim and slide the cup out at a slight angle. If the seal won’t budge, pinch the base for a few seconds and wait for the sound of air releasing before pulling down.
If the Cup Feels Stuck
A cup that’s ridden up high can feel unreachable, and the moment of panic makes your muscles tighten, which pushes it further away. First, stop and take a few slow breaths. Then squat low and bear down as if you’re having a bowel movement. This engages your abdominal and pelvic muscles to push the cup downward. You may need to repeat this a few times before the cup is low enough to reach.
The cup cannot get lost inside your body. The cervix blocks the top of the vaginal canal, so there’s nowhere for it to go. With patience and bearing down, it will come within reach.
Troubleshooting Leaks
Leaks during the first few uses are normal while you’re learning. The most common cause is incorrect positioning. Remember that the cup sits horizontally at the base of the vaginal canal, angled toward the tailbone. If you’ve pushed it too high, it may sit next to your cervix rather than below it, letting blood flow right past the rim.
If you’re inserting correctly and still leaking, the cup may be the wrong size. A cup that’s too small in diameter won’t seal against your vaginal walls. A cup that’s too large can’t fully open, leaving gaps. Weak pelvic floor muscles can also cause a cup to slide down or shift position. Kegel exercises over time can help the cup stay put.
Some light spotting during your first cycle with a cup is also just residual blood that was already below the cup when you inserted it. Wearing a panty liner as backup while you’re learning is a practical solution.
Cleaning Between Uses and Between Cycles
During your period, rinse the cup with warm water each time you empty it. You can use a mild, unscented soap if you want, but plain water is fine. Make sure the tiny suction holes near the rim are clear, since blocked holes prevent the cup from forming a proper seal.
At the end of your cycle, sterilize the cup by boiling it. Place it in a pot of boiling water for no more than 10 minutes. Don’t leave it unattended, because if the water boils off, the silicone can scorch. Some brands sell microwave-safe sterilizing containers that let you boil the cup in 3 to 4 minutes. Store the cup in a breathable cloth bag between cycles, not in an airtight container.
A Note on IUDs and Menstrual Cups
If you have an IUD, using a menstrual cup is possible but comes with some added risk. The suction created by the cup, or accidentally pulling on IUD strings during removal, could theoretically contribute to IUD displacement. A systematic review of the available research found expulsion rates between 3.7% and 18.6% among cup users with IUDs, though the studies were small. Cup manufacturers generally say use with an IUD is acceptable for most people, but recommend discussing it with your provider, especially if you’ve had a previous IUD expulsion. Breaking the seal completely before removing the cup is especially important if you have an IUD in place.