menstrual cups

[thevargasgirl.livejournal.com]

DELRAY BEACH, FL. / April 22, 2003 -- Two public interest health groups have called on the US Food and Drug Administration (FDA) to stop the sale of menstrual cups (The Keeper® and Instead®). Associated Pharmacologists & Toxicologists (APT) and the Endometriosis Research Center (ERC) have submitted their Petition to the FDA, in which they cite research to demonstrate that blocking the release of menstrual debris, inherent to the use of menstrual cups, is likely to increase the incidence and severity of endometriosis.

so maybe therye not all good. i still feel more comfortable using insteads than i ever felt using tampons. what do you guys think?

-=t

Comments

[mactavish.livejournal.com]

I think that the group that released this press release (which I can't find in the news yet) doesn't cite any authoritative evidence supporting their claim. However, they *are* looking for people to participate in a study to gather evidence:
http://www.endocenter.org/menstrualcups.htm

I'll use Insteads until more evidence is in.

[thevargasgirl.livejournal.com]

yep as will i. and im still planning on investing in a keeper. i just cant stand tampons for one more month!!!
-=t

[isolt.livejournal.com]

Same here. I love my Keeper lots and lots.

I'll be *really* sad if they can convince the FDA to ban them. I'll have to buy a couple spare keepers or something.

[starzz.livejournal.com]

they said that the keeper does this : "block the release of menstrual debris." it does NOT do that, it collects the mestrual "debris" and lets you dispose of it ECOLOGICALLY! tards.

[thevargasgirl.livejournal.com]

yeah it just doesnt add up im my opinion.
-=t

[katlynel.livejournal.com]

I think the idea is that it causes a "backwash effect," allowing the flow to go back up into the uterus. I'm still not sure what I think of this, except that I'm personally not really worried about endometriosis and will continue to use my Keeper until further evidence emerges.

I really wonder whether this hypothetical link to endometriosis would occur at any greater rate than the link of tampons to TSS.

[starzz.livejournal.com]

well if you dont ever empty the keeper ;) but, I feel that tampons would cause more of a "backspash" anyways, tampons are work of the devil.

[defenestration.livejournal.com]

Unless you don't ever empty it, or stand on your head while using it, I don't see how that would work. :P

[katlynel.livejournal.com]

Well, when you're lying on your back, the cup is actually tilted downward toward your uterus. It's more or less horizontal if you're sitting down, especially if you're at all reclined back.

[defenestration.livejournal.com]

That makes more sense. I usually don't wear mine to bed, so yay.

[fairis.livejournal.com]

How do cups block the release of menstural debris anymore than tampons? I use Instead, and it doesn't block the release of blood at all. The blood flows out and into the cup.

[junni.livejournal.com]

I think the idea is this: tampons and pads absorb flow, and it cannot flow back into your uterus. The Keeper/Mooncup and Instead hold the menstrual debris, and therefore it could, theoretically, flow back into your uterus or other places where it doesn't belong. I don't know that anyone has proven this happens though, but it certainly is a plausible risk.

I'm an avid Instead user myself, lest anyone think I'm biased against.

[fairis.livejournal.com]

Hmm, I guess I didn't think about back-flow. But the hole in the cervix is pretty small, isn't it? And all the muscles are pushing everything the other way. I wish that the people who raised their concerns had more research (or if they have more research, that they would publish it.)

instead

[zellion.livejournal.com]

I read this post about the article and thought- awwww hell, I'm wearing an instead now.

Do you, in fact, live near the Cuyahoga river? I'm from round those parts.

Re: instead

[junni.livejournal.com]

I used to live in Cleveland, and, oddly enough, miss it terribly. :/

Re: instead

[americanbeauty.livejournal.com]

I'm from the Akron area and I asked junni pretty much the same question earlier in the summer!

[the-t-at-utk.livejournal.com]

I've got clots. They slip through tampons sometimes, and they never soak into the pads. And I rarely get a pad dirty at night anyway--it just pools up inside(I just bought a diva and haven't gotten to use it yet, so this experience is with disposables). As long as you empty the cup before bed, I don't see how it would make any difference.

And in response to some other comment about tampons(or sex) clogging it up, some study 'proved' that when applied during your period, they reduce the risk of cervical cancer. You can't have your cake and eat it too. *shrugs*

[junni.livejournal.com]

I found this on pubmed.gov. This article is in the press. Yes it is only a case report (about one person), but here it is in the peer reviewed literature in a respected journal. See abstract and reference below:

Gynecol Obstet Invest. 2003 [Epub ahead of print]. Epub 2003 Jul 14. Related Articles, Links


The Keeper((R)), a Menstrual Collection Device, as a Potential Cause of Endometriosis and Adenomyosis.

Spechler S, Nieman LK, Premkumar A, Stratton P.

Pediatric and Reproductive Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Md., USA.

Barrier contraceptive devices like the cervical cap and diaphragm and menstrual collecting devices may block menstrual flow, increase retrograde menstruation, and thus theoretically increase the likelihood of developing endometriosis or adenomyosis. We describe the case of a woman with a prior tubal ligation who after 4 years of regular use of the Keeper((R)), a menstrual collecting device, developed adenomyosis and endometriosis. Copyright 2003 S. Karger AG, Basel

[mactavish.livejournal.com]

I think the group sounding the alarm might have read this and assumed that correlation meant causation, and that one case indicates a real risk. I'm glad they're asking people to join their study, as they'll then find out how high the risk actually is.

[junni.livejournal.com]

*nods in agreement* The biologist in me can see a lot of sense in this though, as menstrual fluid contains living cells, and if living cells end up in the "wrong" place (i.e., cells from the lining of the uterus in the abdomen, or something), they can still grow, and in a nutshell, that's the theory behind endometriosis. I poked around in some of the other literature related to endometriosis, and I don't think anyone has yet figured out why some people get it and others don't, but that it can seem to run in families (which lends itself to a genetic component).

But yes, I get really annoyed when people jump from correlation to causation! I, for one, like my Insteads. :) (And I'm saving up for a Mooncup!)

Re: If you don't mind my asking...

[junni.livejournal.com]

It's like a Keeper in design, but made out of silicone instead of gum rubber. http://www.mooncup.co.uk

[junni.livejournal.com]

Oh, but, mind you, they are attempting to do a retrospective study, and they do not appear to be collecting controls (just those who used the cups and have endometriosis). A prospective one would be far better (although not always possible), as there would be less need to rely on participants' recall (recall bias) and less overall potential for bias in general.

[junni.livejournal.com]

Ooh, well... maybe they do want controls, if your link is the same as the poster's (I've not looked at all of this too closely). Phew. The idea of a "study" without controls just scares me!

[balmofgilead.livejournal.com]

i'm part of a yahoo listserv about the keeper (on groups.yahoo.com) and a few months ago there was some discussion about that group's motion to ban menstrual cups. the consensus was that the research done had not been very good, and at the time, the survey was somewhat unscientific--i.e. the questions on the survey were not aimed toward figuring out whether menstrual cups CAUSED endometriosis or menstrual problems. they only seemed to ask if current or past users had ever experienced certain problems, without regard to whether those problems had occurred before or after cup use.

although i'm somewhat skeptical of the interest groups and the veracity of their research and claims, i have one thought/concern:

there's lots of suction associated with the keeper. it's almost like a valve or plunger or whatnot, and i'm wondering if it could possibly force air or menstrual fluid back up into the uterus, with enough force to push it out of the uterus into other places (e.g. into the fallopian tubes or out into the abdomen). i'm not quite sure how to fully explain my concern...i guess the analogy to a toilet plunger --similarly, a rubber cup shaped thing, over a hole, that forces liquid through the hole-- is the best i can do.

it's not quite what the groups above describe, but it worries me...any thoughts, anyone?

[balmofgilead.livejournal.com]

i just wanted to add--i mean that the keeper/other cups may act sort of like a plunger when they're being put in or removed...which usually involves squeezing and pushing the cup quite a bit.

[appletrees.livejournal.com]

You compared the Keeper to a plunger. Don't plungers pull stuff out, though? If you're using a plunger on a toilet, for example, it doesn't push the clog back in, it pulls it out towards the plunger. Wouldn't a menstrual cup do the same thing? They do have suction, but I would think it would pull everything out towards the cup, rather than in the other direction, right?

[junni.livejournal.com]

"retrograde menstruation"--exactly what the case report I cited above theorizes. Of course, just like you said, it's a theory, and a plausible one, just no one has proven causation yet, only possible correlation.

[balmofgilead.livejournal.com]

right, i know about retrograde menstruation, and it's proposed connection to endometriosis. my concern, though, is that not only can keepers/similarly shaped menstrual cups "block" menstrual flow as suggested above (which seems like a somewhat weak case since they *do* provide a space for the blood to collect rather than just shutting it up in the uterus), but that they may actually push the blood back up in the other direction when they're being inserted or removed. i wouldn't be concerned if not for that.

[thevargasgirl.livejournal.com]

well then how would one explain insteads causing the same thing? instead have little to no suction.
-=t

[balmofgilead.livejournal.com]

personally i can't imagine instead having any effect...but then this is based on my concern and not the people-that-are-looking-into-this's concern. THEY don't seem to say anything about suction. i can't imagine, though, that just the cups themselves (minus the suction/plunging issues) could make endo problems...but i'm no doctor.

btw, though, i remember seeing something on mum.org from dr. phillip tierno (a microbiologist at NYU who has done significant independent research on TSS risks from assorted products)--he seemed concerned about instead since it's so close to the cervix...but then, diaphragms are that close, too...who knows? this whole thing is making me consider seeking out a sewing machine and making some cloth pads, hehe.

[nelsolidarida.livejournal.com]

The suction is the main problem i have with the Mooncup, it feels weird getting it out. This was unbearably painful the first time, but since getting tips from other women on how to break the seal before removal etc it has been less so. (also trying to relax and stay logical, ie not thinking my innards are being wrenched out)

Just realised while reading the thread: tampons may absorb the blood (and leak when they get saturated) but no way do they absorb tissue. Whereas at least a cup catches the tissue, even if it does then retain it until you empty it, so it gets taken out and disposed of rather than left in there as the exit is blocked again.

[true.livejournal.com]

my doc showed me some articals he has awhile back saying that both the cups and tampons are horrible for women with endometriosis and may even cause women to become a sufferer of endo.
Cups and tampons have been out for me since then. Seeing this, just reminds me of that. And I do have endo, so I take caution.

[snapdragon-666.livejournal.com]

I didn't know endometriosis could be caused by an outside factor. I thought it was where menses becomes attached to parts where it shouldn't? I must be thinking of something else :)

But anyway, i'm glad i've already got my keeper. Society seems bent on making women use disposable products. I know this isn't really the issue here, but the outcome will be the same. And the more women who use disposables, the more damage will be done to the environment.

Let's face it, most menstrual products (apart from cloth pads. So far...) apparently cause some sort of illness. Disposables have carcinogens in. And although endometriosis is a terrible thing to have, i'd rather have that than cancer.
xxx

[nelsolidarida.livejournal.com]

Does this research have any links to the tampon industry? (eg finance from tampon companies etc) This has been the case with several other health scares, so i'd need to be quite sure before ruling it out.

I wonder, too.

[ide-cyan.livejournal.com]

I think it's funny that the ONLY info on the web regarding the "Associated Pharmacologists & Toxicologists" is regarding the "study into a potential relationship between the use of Menstrual Cups and Endometriosis".

And that Dr. Armand Lione's last campaigns were about the dangers of aluminum and the importance of flossing.

I smell a smear campaign.

[starkewpie.livejournal.com]

It doesn't seem like it is a *huge* health risk (there hasn't been a giant upsurge of endometriosis, I've only heard good things about them... it's the only thing my mother and some of my girlfriends will use). It's our body, and it's just a silicone/rubber/plastic cup. Making a warning label makes much more sense than moving to ban them. The women who like them are going to continue using them even if they are banned. I refuse to use anything other than OB tampons, (they fit my body, I leak with everything else) and if they were outlawed I'd drive to Canada or Mexico and smuggle them over!

In that article there is the quote:
Armand Lione, Ph.D., President of Associated Pharmacologists & Toxicologists, Washington, DC, added: "Women who use these products as an alternative to tampons need to be warned that endometriosis is a real risk associated with the menstrual obstruction caused by the menstrual cups."

That would be a perfect FDA warning right there. On the side of the box, like the Toxic Shock warning on tampons.

Thanks for letting us know this - I will tell the women I know who use Instead & the Keeper as soon as I see them.

[thevargasgirl.livejournal.com]

it wasnt about letting you know, im skeptical. i dont think this is at all a valid reason to get scared or anything.
-=t

[ide-cyan.livejournal.com]

Let them prove the causal link in a statistically sound study. First things first. Bad scientists!

[inkster.livejournal.com]

Just a thought... not really sure how sound this is.

When I lay down when I have my period, it basically stops. Which means that the blood is likely pooling or not coming out at all. So why wouldn't sleeping laying down also be a cause of endometriosis, if it's the case that retrograde menstruation is a problem?

Usually I'm standing or sitting up, so there's very little chance of the blood flowing backwards when I've got my Keeper in. I can't think of a time I've stood on my head in the last several years either, which would be the most obvious cause of the blood flowing back into the uterus.

I can see the risk of it (because it could potentially do it), but I don't see why it would be any worse than wearing a pad or something. Or what about sex during your period -- couldn't that force it back too?

It's good information to have, since I think it's good to know what you're getting into, but I'm not ready to jump to conclusions and stop using my Keeper.

[mangojellytoast.livejournal.com]

I can't think of a time I've stood on my head in the last several years either, which would be the most obvious cause of the blood flowing back into the uterus.


Yeah, in Yoga all inverted poses (where the pelvis is over the head, like headstands and shoulderstands etc.) are contraindicated to menstruation, so I think it would follow that doing any kind of activity that puts you upside down during your period would be a bad idea.

...But if you're using the Keeper or something similar and you never invert yourself, how is the blood supposed to get back up?

[xemcats.livejournal.com]

If anything, they shouldn't BAN menstural cups altogether. I hope that if this stupid case does go through, they just put a warning on menstrual cups, like the TSS warning on tampons.

[raindropsie.livejournal.com]

I don't think they should put a ban on menstrual cups, tampons don't have a ban and they are associated with TSS. they should just have a warning label. I t would be interesting however, to see if a menstrual cup could be made so it doesn't let the flow flow back up, of course allowing you to empty it when you want... Hopefully the suction of the cup doesn't allow retrogade flow to occur tho.

[thevargasgirl.livejournal.com]

Well, this entry is OLD!
I got a keeper and I love it. Retrograde flow schmetrograde flow.

<3