Effect of menstrual cups on vaginal health, reproductive tract and urogenital infections: a systematic review and meta-analysis
Abstract
Background: The menstrual cup is a device inserted into the vagina during menstruation to collect blood. Evidence of its effect on the vaginal microbiome and associations with laboratory-confirmed infections is limited. We compiled existing information to assess associations between menstrual cups and reproductive tract infections (RTIs), sexually transmitted infections (STIs), and the vaginal microbiome.
Methods: We searched four databases (PubMed, CINAHL, Global Health, and Scopus, from inception to January 23, 2026) for trials or observational studies reporting on menstrual cup use and laboratory-confirmed RTIs, STIs and the vaginal microbiome. Study quality was assessed using the Cochrane Collaboration tool for trials and the Joanna Briggs Institute Critical Appraisal Checklist for Cohort Studies. Outcomes of interest between cup-users and users of alternative menstrual products (non-cup users) were compared using prevalence ratios (PR). Meta-analyses were conducted using fixed-effects models to generate pooled estimates. PROSPERO registration: CRD42024559595.
Findings: Eleven studies involving 10,268 participants were included. Only three studies were considered of good quality. In two randomised controlled studies in Kenya, menstrual cups reduced the risk of STIs relative to non-cup users (adjusted PR [aPR] 0.74, 95% CI 0.60-0.91, p = 0.037, n = 695, I2 = 0.0%). The association with bacterial vaginosis was 0.81 (aPR, 0.63-1.04, p = 0.0963, n = 695, I2 = 0.0%). When…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 10,268 participants or records.
Read the paper
Related studies
- Understanding the factors influencing fall armyworm (Spodoptera frugiperda J.E. Smith) damage in African smallholder maize fields and quantifying its impact on yield. A case study in Eastern Zimbabwe
- Alarming situation of emerging H5 and H7 avian influenza and effective control strategies
- Livestock and food security: vulnerability to population growth and climate change
- Atmosphere–ocean oxygen and productivity dynamics during early animal radiations
- Characterization of the global distribution and diversified plasmid reservoirs of the colistin resistance gene mcr-9
- The global seroprevalence of Toxoplasma gondii in pigs: A systematic review and meta-analysis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.