An alert has been issued by doctors about ill-fitting menstrual cups, which they warn could potentially lead to health concerns after the case of one woman who developed a rare case of temporary kidney problems.
CTV reports that in a BMJ case study, Danish doctors advised that there could be a rare, but serious consequence to using a menstrual cup –used to catch monthly blood flow – if it is not correctly positioned or is the wrong size.
In their case report, urologists Clara Maarup Prip and Lotte Kaasgaard Jakobsen from Aarhus University, Denmark, said menstrual cups are designed to fit at the edges of the vaginal wall, but if inserted incorrectly, they can compress the ureter, which could lead to a condition called “ureterohydronephrosis”.
In their report, a patient in her early 30s suffered from blood in her urine and pain in both her abdomen and her side for six months before her scans showed swelling in her kidney and ureter.
Imaging revealed a menstrual cup compressing the uterer’s opening at the juncture. After the cup was safely removed, there was a complete regression of symptoms and the ureterohydronephrosis, they said.
At her one-month follow up, the patient continued to improve and felt no pain, and six months later, the patient admitted that she did not use the menstrual cup anymore, except during instances like visits to a swimming pool due to the fear of complications.
“Menstrual cups present a sustainable alternative to single-use devices, but complication rates are still sparsely described,” the study said
What the evidence says
“A recent review of the literature on menstrual cup usage reported that possible complications include pain, vaginal wounds, allergic reactions, leakage, urinary incontinence, dislodgement of intrauterine devices, and infections,” according to the case report.
More serious complications found in other cases include toxic shock syndrome and effects on the upper urinary tract.
While there have been only a handful of case studies about menstrual cups causing pain in the ureter, and most incidents were reported to be easily managed, the sample size to test the theory that menstrual cups are indisputably safe is too small to conclude that.
There needs to be more awareness surrounding use of menstrual cups and choosing the right shape, size, and insertion method to side-step any complications, the author’s said.
“The increasing use of menstrual cups calls for more knowledge on complication rates to enlighten both users and clinicians.”
Study details
Ureterohydronephrosis due to a menstrual cup
Clara Maarup Prip and Lotte Kaasgaard Jakobsen.
Published in BMJ Case Reports
Abstract
Menstrual cups are increasingly used to control menstrual bleeding. Complication rates are sparsely described, but some serious complications have been reported. We present a rare case of ureterohydronephrosis due to a menstrual cup. A woman in her 30s presented with intermittent flank pain and occasional haematuria. CT urography showed a menstrual cup placed in the right side of the vagina in close proximity to the ureteral ostium together with ureterohydronephrosis. After removal of the menstrual cup, there was a complete regression of symptoms and ultrasonic regression of the ureterohydronephrosis. More awareness should be made, both among menstrual cup users and clinicians, about presenting symptoms and how to choose the correct shape, size, and insertion method to avoid complications.
BMJ article – Ureterohydronephrosis due to a menstrual cup (Creative Commons Licence)
CTV News – Doctors warn against ill-fitting menstrual cups (Open access)
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