I am a huge supporter of the use of menstrual cups. I have used a Diva Cup since 2008, and cannot imagine switching away from it. I talk about my foray into postnatal products here, as it is not safe to use insertable menstrual products after delivery, no matter the method of delivery.
The other day, one of my friends tagged me in a link to an article describing how cups are linked to increased bacteria. At first, I just brushed it off. ONE article does not concern me. But as I was thinking about what to write this week, I realized that I was biased. I should actually sit down and do the damn research myself.
And do you know what I found? Not much.
Not only is there next to no research done on the prevalence of bacteria found on cups, there doesn’t seem to be any plans of doing any research on this. Get on this, scientists!
Moving on…
Let’s examine what Toxic Shock Syndrome (TSS) actually is. If you’re like me about an hour ago, you would say, “oh, TSS has something to do with leaving tampons in for a long time.”
You’d be partially right, but mostly wrong.
Yeah, I was surprised too.
TSS is actually caused by bacteria (specifically Staph and Strep) getting into the bloodstream and releasing harmful toxins.
This means something super important: Toxic Shock Syndrome is NOT limited to tampon users.
What???
That was my reaction. Anybody can get TSS. Jim Henson died from TSS, and as far as I know, he did not use tampons.
Tampons are a pretty good breeding ground for bacteria, and in the 70’s, there was a chemical compound in the “super absorbent” tampons that really increased this. Once that compound was eliminated, the number of TSS cases reported dropped drastically. Removing tampons when directed helps, too.
Also, using a higher absorbency tampon than required can cause micro-abrasions inside the vagina, leading to a higher likelihood of the bad bacteria finding a way inside the bloodstream.
Okay. Now that we’ve cleared that up, what about bacteria on cups causing TSS?
According to my research (thanks Dorothy Ann), there has been one reported case of a person getting TSS while using a cup. It was in 2015, and it was reported that there was an abrasion inside the vagina at the time of use of the cup.
We already have Staph and Strep bacteria all over our bodies at all times. They’re mostly harmless. If they are allowed to grow as a colony, breed, and then slip into our bloodstream, there is STILL a pretty high likelihood that our white blood cells will fend them off. It’s once the bacteria release the poisonous toxins that there’s a problem, and scientists still don’t know what causes that!
Without any real hard scientific evidence to prove one way or another, we can’t say that Cups are better or worse than tampons at breeding bacteria. If you look at the original article I mention again, there’s a diagram showing the amount of bacteria found on tampons and cups, with the control being just a regular vagina. Look at how much Staph they found in a regular vagina, and compare it to the rest. There is almost as much or more Staph bacteria in a regular vagina as there is on a cup or tampon! Remember, this is NORMAL. The decreased amount of bacteria on the tampon is probably due to the change in pH of a vagina from the substances on the tampon. This is not necessarily a good thing. The pH of a vagina should be balanced. You WANT to find bacteria in there! (The good kind, obviously.)
This diagram is one of the reasons why I wanted to dismiss the article immediately. It doesn’t really show anything important.
But I’m glad I did the research, if only to realize how little research has actually been done. I’m surprised, even though vaginas are apparently a dirty word in research.
I will keep using my cup, washing it thoroughly with soap after every use. But honestly, I’m not too worried.
References
https://www.nhs.uk/conditions/Toxic-shock-syndrome/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556184/
https://www.popsci.com/toxic-shock-syndrome
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