Can You Use a Menstrual Cup With an IUD? What You Need to Know

Have an IUD and wondering if you can use a menstrual cup? You're not alone. It's one of the questions we hear from people who love their Lena Cup but have recently had a coil fitted, or are considering getting one.

The good news is that many people successfully use menstrual cups with an IUD. The two can be used together, but there are a few things worth knowing, particularly when it comes to removing your cup.

You may have heard that menstrual cups can affect IUD strings or increase the chance of an IUD moving out of place. There is some research behind this concern, but it doesn't mean you have to give up your cup.

Here's what you need to know about using a menstrual cup with an IUD, how to remove it carefully and when to ask your healthcare provider for advice.

Can you use a menstrual cup with an IUD?

Yes, many people use menstrual cups with an IUD. Having a copper or hormonal IUD does not automatically mean you need to stop using your menstrual cup.

The important thing is understanding how the two work and taking care when removing your cup.

An IUD, also known as an intrauterine device or coil, sits inside your uterus. Two small strings extend through the cervix into the top of the vagina. These strings allow a healthcare professional to check the position of the device and remove it when needed.

A menstrual cup sits lower down in the vagina, where it collects menstrual fluid. It opens against the vaginal walls to create a seal that helps prevent leaks.

Because they sit in different places, a menstrual cup does not need to touch your IUD. However, the cup's seal and its removal can potentially cause a problem if you accidentally pull on the IUD strings.

The simple rule? Always release the seal before removing your menstrual cup.

If you have an IUD and are new to menstrual cups, or have recently had your IUD fitted, it's a good idea to discuss using a cup with your healthcare provider.

Does menstrual cup suction affect an IUD?

This is probably the biggest concern people have about using a menstrual cup with an IUD.

When a menstrual cup opens inside the vagina, it forms a seal against the vaginal walls. This helps keep the cup in place and prevent leaks.

Your IUD, however, sits inside the uterus, above the cervix. The cup does not attach directly to the IUD.

There is no definitive evidence that menstrual cup suction routinely pulls an IUD out of place. However, research has raised the possibility that suction, movement or accidental pulling on the IUD strings during removal could contribute to displacement or expulsion.

That's why breaking the seal before removing your cup is so important.

To do this, gently pinch the base of your cup between your fingers. You should feel the seal release. Once it has released, ease the cup down and out.

Never pull your cup out while it is still sealed in place.

Can a menstrual cup get caught on IUD strings?

It is possible, although it doesn't happen to everyone.

The IUD strings extend through the cervix into the vagina. Their length and position vary from person to person, and they may sit close to where your menstrual cup is positioned.

When removing your cup, you want to avoid catching or pulling on these strings.

If you're unsure where your strings sit, or you find that they seem to get in the way, speak with your doctor, gynaecologist or sexual health clinician.

They can check the position and length of your strings and discuss whether adjusting or trimming them would be appropriate. This isn't something to do yourself. The strings need to remain accessible for future checks and removal, and making them too short can sometimes make removal more difficult.

You don't need to assume that your strings are a problem just because you use a menstrual cup. It's simply worth asking if you're unsure.

How to remove a menstrual cup when you have an IUD

The most important part of using a menstrual cup with an IUD is knowing how to release the seal before removal.

If you're used to pulling your cup down by the stem, this is a good opportunity to get into a different habit.

Here's how:

1. Wash your hands

Wash your hands thoroughly with soap and water before handling your cup.

2. Relax

Find a comfortable position, such as sitting on the toilet or squatting. Relaxing your pelvic floor can make your cup easier to reach.

3. Locate the base of your cup

Reach for the base of the cup with your fingers. Avoid pulling down on the stem while the cup is still sealed.

4. Pinch to release the seal

Gently squeeze the base of the cup between your fingers. This breaks the seal against the vaginal walls.

5. Ease the cup out

Once the seal is released, gently move the cup down and out. Take your time and avoid sudden pulling movements.

6. Empty and clean

Empty the contents into the toilet and clean your cup according to the manufacturer's instructions before reinserting it.

If you feel resistance, stop and check that the seal has been released. Never force the cup out.

Does it matter whether you have a copper IUD or hormonal IUD?

There are two main types of IUD, and both can be used by people who choose menstrual cups.

Copper IUD

A copper IUD is hormone-free. It releases copper ions that affect sperm movement and function, helping prevent pregnancy. Some people experience heavier or longer periods, particularly in the first few months after insertion.

Hormonal IUD

A hormonal IUD releases a small amount of progestin, usually levonorgestrel. Depending on the type, it can make periods lighter, shorter or stop them altogether.

Does one type work better with a menstrual cup?

At the moment, there isn't enough evidence to say that copper or hormonal IUDs are generally safer to use with a menstrual cup.

One important study published in 2024 looked specifically at two types of copper IUD. It found a higher rate of expulsion among users of one of the IUD types who also used menstrual cups, but not the other. The researchers also reported cases of accidental removal during cup use.

The findings are interesting, but they don't establish that all IUDs carry the same risk or that everyone using a cup will experience a problem.

Whatever type of IUD you have, the practical advice remains the same: release the seal before removing your cup and avoid pulling on the strings.

What does the research say about menstrual cups and IUDs?

Research into menstrual cups and IUD displacement is still developing.

A 2023 systematic review looked at the available studies and found a possible association between menstrual cup use and increased IUD expulsion. However, the researchers also highlighted that the evidence was limited and more research was needed.

A 2024 study investigated menstrual cup use among people participating in a clinical trial involving copper IUDs. It found differences in expulsion rates depending on the type of IUD used. It also identified accidental self-removal as an issue worth considering.

What does this mean for you?

It means there is a potential risk to be aware of, but it does not mean menstrual cups and IUDs cannot be used together.

Many people use both successfully. The aim is to understand how to remove your cup properly, know what to look out for and get individual advice if you're unsure.

What should you know before using a menstrual cup after IUD insertion?

If you've recently had an IUD fitted, ask the clinician who inserted it when you can start using your menstrual cup again.

You may have heard that you must wait a certain number of weeks. Advice varies between clinics, and there isn't strong evidence establishing one universal waiting period for everyone.

Some clinicians recommend waiting for a few weeks, while others provide different advice depending on your circumstances and their aftercare guidance.

The FSRH clinical guideline notes that there is no clear evidence that the risk of IUD expulsion is higher specifically in the weeks immediately after insertion than at other times. It also notes that there is no clear evidence of an increased infection risk from menstrual cup use after insertion.

However, your own clinician's advice should take priority.

If you've recently had an IUD fitted, ask about:

• When you can comfortably resume using a menstrual cup.

• How and when to check your IUD strings.

• Whether your strings are a suitable length for using a cup.

• What to do if you notice a change in your strings or experience unusual symptoms.

There's no need to guess or rely on a general rule from the internet. Your healthcare provider can give you advice based on your IUD and your individual circumstances.

When should you speak to your doctor?

If you use a menstrual cup with an IUD, it's helpful to know what is normal for you.

Your healthcare provider can show you how to check your IUD strings and explain what changes to look out for.

Get in touch with your doctor or sexual health clinic if:

• You can no longer feel your IUD strings.

• Your strings feel noticeably longer or shorter than before.

• You can feel the hard plastic part of the IUD at your cervix or in your vagina.

• You experience new or unusual pelvic pain or cramping.

• Your bleeding pattern changes unexpectedly.

• You think your IUD may have moved or come out.

If you suspect your IUD has moved, don't try to push it back into place or remove it yourself. Use condoms or another form of contraception, or avoid sex, until you've received medical advice. You may also need advice about emergency contraception.

Seek urgent medical attention if you experience severe or worsening pelvic pain, fever, unusual or foul-smelling discharge, very heavy bleeding or a positive pregnancy test.

The bottom line: Using a Lena Cup with an IUD

Many people use menstrual cups and IUDs together without any problems. Having an IUD doesn't automatically mean you need to give up your Lena Cup.

The most important thing to remember is to break the seal before removing your cup. Pinch the base gently, make sure the seal has released and ease the cup out slowly.

If you're unsure about your IUD strings, ask your healthcare provider to check them. They can advise whether adjusting the string length would be helpful for you.

And if you've recently had an IUD fitted, check when your clinician recommends returning to menstrual cup use.

A little knowledge and the right removal technique can make managing your period much easier.

Frequently Asked Questions

Can you use a menstrual cup with an IUD?

Yes. Many people use menstrual cups with copper and hormonal IUDs. There is a possible increased risk of IUD displacement or expulsion, so it's important to understand how to remove your cup correctly. Always release the seal before removal and speak with your healthcare provider if you have concerns.

Does menstrual cup suction pull out an IUD?

There is no definitive evidence that menstrual cup suction routinely pulls an IUD out of place. However, suction and accidental pulling on the IUD strings have been raised as possible factors in displacement. Always pinch the base of your cup to release the seal before removing it.

Can a menstrual cup get caught on IUD strings?

It is possible to catch or pull on IUD strings when removing a menstrual cup. If you're unsure about the length or position of your strings, ask your healthcare provider to check them. They can advise whether trimming or adjusting the strings would be appropriate.

Should I have my IUD strings trimmed if I use a menstrual cup?

Not necessarily. Some people find that their strings sit comfortably and don't interfere with their cup. If you're concerned that the strings are getting in the way, ask your healthcare provider to check their length and position. They can discuss whether an adjustment is suitable. Never try to trim them yourself.

Is a menstrual cup safer with a copper or hormonal IUD?

There isn't enough evidence to say that one type is generally safer than the other. A 2024 study found differences in expulsion rates between two types of copper IUD, but more research is needed. The same careful removal technique applies to both copper and hormonal IUDs.

Can I use a menstrual cup with a Mirena?

Mirena is a hormonal IUD. Many people use menstrual cups with hormonal IUDs, but the same precautions apply. Release the cup's seal before removal and ask your healthcare provider if you're unsure about your strings or whether a cup is suitable for you.

How long should I wait to use a menstrual cup after getting an IUD?

There is no single waiting period that applies to everyone. Some clinics recommend waiting a few weeks, while others give different advice. Ask the clinician who fitted your IUD when you can resume using your cup.

Should I check my IUD strings after using a menstrual cup?

Follow the checking advice given by your healthcare provider. You may be advised to check your strings regularly, such as after your period. If you notice that they feel different or cannot find them, contact your healthcare provider. Don't pull on the strings or try to reposition the IUD yourself.

What happens if my IUD comes out while using a menstrual cup?

If you think your IUD has moved or come out, contact your healthcare provider. Don't try to reinsert it yourself. Use another form of contraception or avoid sex until you've received medical advice, as you may no longer be protected against pregnancy.

Can a menstrual cup cause an infection if I have an IUD?

There is no clear evidence that menstrual cup use increases the risk of infection after IUD insertion. Good hand hygiene and proper cup cleaning are important. Follow your clinician's aftercare advice and seek medical attention if you develop fever, pelvic pain or unusual discharge.