When it comes to managing menstruation and birth control, many people are combining modern solutions for convenience and comfort. One popular combo? Using a menstrual cup alongside an intrauterine device (IUD). While both are effective tools—menstrual cups for eco-friendly period care, and IUDs for long-term contraception—many wonder whether using them together is truly safe.
Specifically, does the type of IUD—hormone-based (like Mirena or Kyleena) versus copper-based (like ParaGard)—make a difference when using a menstrual cup? Could the suction from the cup accidentally dislodge or expel the IUD? Should you be more cautious with one type over the other?
Recommended: Is It True You’re Not Supposed to Use Menstrual Cups with IUDs?
In this article, we’ll dive into the science, safety concerns, and real-life tips to help you understand how menstrual cups interact with different IUDs and how to use them together without compromising your health or contraceptive protection.
Understanding Menstrual Cups and IUDs
A menstrual cup is a reusable, bell-shaped device made of medical-grade silicone, rubber, or elastomer. Unlike pads and tampons, it doesn’t absorb menstrual blood—it collects it. The cup is inserted into the vaginal canal, where it sits just below the cervix and creates a gentle suction seal against the vaginal walls to prevent leaks.
When inserted properly, menstrual cups can be worn for up to 12 hours, depending on the heaviness of your flow. Many users choose menstrual cups for their long-lasting wear, eco-friendliness, cost-effectiveness, and reduced risk of odor or irritation. However, that suction—while useful for preventing leaks—is a key reason why pairing it with an IUD needs extra attention.
What Is an IUD?
An intrauterine device (IUD) is a small, T-shaped contraceptive tool placed inside the uterus by a healthcare professional. It offers long-term, highly effective pregnancy prevention. There are two main types of IUDs:
- Hormonal IUDs, such as Mirena, Kyleena, and Skyla, release a hormone called progestin. This hormone thickens cervical mucus to block sperm, thins the uterine lining to discourage implantation, and may sometimes suppress ovulation. Hormonal IUDs can reduce menstrual flow significantly, and in some cases, periods stop altogether.
- Copper IUDs, like ParaGard, are hormone-free. They use copper wire to create an environment toxic to sperm, preventing fertilization. However, copper IUDs are often associated with heavier periods and more intense cramps, especially during the first few months after insertion.
Recommended: Is the Copper IUD Better for Heavy Periods?
Although a menstrual cup stays in the vaginal canal and an IUD sits within the uterus, they are closer than they may seem. IUDs have two small strings that extend from the uterus through the cervix and slightly into the upper vagina. These strings are meant to help healthcare providers (or sometimes the user) check the position of the IUD or remove it when necessary.
Because the menstrual cup sits in the same area where the strings hang, problems can occur if the cup is inserted too high or removed incorrectly. For example, if the suction seal isn’t broken before removing the cup, it may tug on the IUD strings. This can potentially shift the device or cause it to be expelled—especially during the first few months after insertion, when the risk of expulsion is already slightly higher.
Is It Safe to Use a Menstrual Cup with a Hormonal IUD?
Yes—many people safely use a menstrual cup with a hormonal IUD. However, it’s important to understand the potential risks and how to reduce them. A hormonal IUD, such as Mirena, Kyleena, Skyla, or Liletta, is placed inside the uterus and releases a small, steady dose of progestin to prevent pregnancy. Over time, this type of IUD typically causes lighter periods, and in some cases, periods may stop altogether.
Because of the reduced menstrual flow, some users find menstrual cups especially convenient. You might only need to empty the cup once or twice a day, making it a low-maintenance option. However, the concern arises not from the IUD’s hormones—but from the physical interaction between the menstrual cup and the IUD strings.
The strings of a hormonal IUD hang just below the cervix into the upper vagina, the same space where a menstrual cup sits. If the cup is placed too high, or if it’s removed without first breaking the suction seal, there’s a small chance it could pull on the IUD strings, possibly displacing or even expelling the IUD. While this risk is rare, it does exist—especially in the first few months after IUD insertion, when the device hasn’t fully settled in place yet.
Is It Safe to Use a Menstrual Cup with a Copper IUD?
Using a menstrual cup with a copper IUD, such as ParaGard, can also be safe—but just like with hormonal IUDs, there are a few important precautions to consider.
A copper IUD is a non-hormonal form of birth control that works by releasing copper ions into the uterus, creating a toxic environment for sperm. It’s highly effective and can last for up to 10–12 years. However, one of the key differences between copper and hormonal IUDs is how they affect your period.
Most people who use copper IUDs experience heavier bleeding, longer periods, and more intense cramps—especially during the first few months after insertion. Because of this, menstrual cups can be a great option for managing the increased menstrual flow that sometimes comes with a copper IUD. Cups hold more fluid than tampons, can be worn longer, and don’t contribute to dryness or irritation.
Recommended: How to Switch from the Pill to an IUD
That said, the same caution applies: the copper IUD has thin strings that hang through the cervix into the upper vagina, and menstrual cups sit in that same space. If the cup is placed too high or removed without releasing the suction seal, it may accidentally tug on those strings, risking IUD displacement or expulsion.
What makes copper IUDs a little more sensitive in this situation is the heavier bleeding, which can sometimes mask the signs of an early expulsion (like spotting, cramping, or a noticeable change in bleeding pattern). This makes it especially important to monitor your IUD placement and be mindful of any unusual symptoms.
As with hormonal IUDs, waiting several weeks after IUD insertion before using a menstrual cup is strongly recommended. During this initial period, your uterus is still adjusting to the device, and the risk of expulsion is slightly higher.
Potential Risks of Using Menstrual Cups with Any IUD
As with hormonal IUDs, waiting several weeks after IUD insertion before using a menstrual cup is strongly recommended. During this initial period, your uterus is still adjusting to the device, and the risk of expulsion is slightly higher.
1. IUD Expulsion
The biggest concern when using a menstrual cup with an IUD is the risk of IUD expulsion. This happens when the IUD partially or completely comes out of the uterus. Though uncommon (affecting about 2–10% of users), expulsion can happen spontaneously, but the use of a menstrual cup may slightly increase the risk—particularly if it’s removed incorrectly.
Recommended: Pros and Cons of Long-Acting Reversible Contraceptives (LARC
When you pull out a menstrual cup without breaking its suction seal first, the vacuum effect can tug on the cervix and, in turn, pull on the IUD strings. This may lead to the IUD shifting out of place or coming out entirely.
2. Displacement or Shifting of the IUD
Even if the IUD doesn’t fully expel, it can become misaligned. A displaced IUD may not function properly as a contraceptive and could also cause pain, cramping, or irregular bleeding. Misalignment can happen if the suction from the menstrual cup is too strong or if the strings are accidentally caught during cup removal.
3. Difficulty Checking IUD Strings
If you use a menstrual cup regularly, you might have a harder time checking your IUD strings on your own. Over time, the strings may soften, curl, or shift slightly out of reach. If you can’t feel them anymore, you may not notice if the IUD has moved—unless you experience symptoms or see a healthcare provider.
4. Delayed Recognition of Expulsion
Especially in users with copper IUDs, who may already experience heavier or irregular bleeding, it can be difficult to notice if the IUD has started to come out. Because menstrual cups collect blood, it’s possible to miss warning signs like spotting or unusual cramping—symptoms that might otherwise indicate early expulsion.
Recommended: How to Discuss Family Planning with Your Partner
Tips to Safely Use a Menstrual Cup with an IUD
If you want to enjoy the benefits of both a menstrual cup and an IUD, the good news is: you can—safely. It just takes a little knowledge, mindfulness, and proper technique. Here are some tips to help you avoid complications and make your cup-IUD combo work for you:
1. Wait After IUD Insertion
Give your body time to adjust before using a menstrual cup. Most healthcare providers recommend waiting at least 4 to 6 weeks after IUD insertion before using internal menstrual products. This allows the IUD to settle into position and lowers the risk of expulsion.
2. Learn to Break the Suction Properly
Before removing your menstrual cup, always break the suction. Don’t just pull the stem! Pinch the base of the cup gently or insert a finger along the side to release the seal. This prevents any downward pressure that could tug on your IUD strings or disturb the device’s placement.
3. Know the Position of Your Cervix
Everyone’s anatomy is a little different. During your period, your cervix might sit lower than usual. Knowing where your cervix is helps you insert the cup correctly without pushing it too high, which can increase the chance of touching or interfering with your IUD strings.
4. Check Your Strings—But Gently
Once your period is over, gently check that your IUD strings feel the same length and position as usual. If you can’t find them, feel a hard plastic edge, or experience pain, see your doctor to make sure your IUD hasn’t shifted.
Recommended: Can I Get Pregnant on Birth Control If I Miss One Pill?
5. Ask About Trimming Your Strings
If your strings are long and sit low in your vagina, they may be more likely to get caught by your cup. Ask your healthcare provider if they can trim your IUD strings slightly, but still leave enough length to remove the device safely in the future.
6. Choose the Right Cup for You
Menstrual cups come in different shapes, sizes, and firmness levels. A softer cup with a shorter length may sit lower and reduce suction strength—lowering the risk of IUD disruption. Some brands even make cups specifically designed for IUD users.
7. Be Extra Cautious in the First Few Months
The risk of IUD expulsion is highest within the first three months after insertion. During this time, be extra careful with cup placement and removal. If you’re worried, you can use external protection like pads until you’re more confident with your routine.
8. Listen to Your Body
If you ever feel a sharp pain during cup insertion or removal, experience unusual cramping, or your bleeding changes significantly, stop using the cup and contact your doctor. These can be signs of a shifted or expelled IUD.
9. Keep Everything Clean
Always wash your hands before inserting or removing your cup, and sanitize the cup between cycles. This helps prevent introducing bacteria that could cause infections, especially important for IUD users.
Conclusion
Using a menstrual cup alongside an IUD—whether hormonal or copper—is generally safe when done correctly. Both are powerful tools that offer long-term convenience, cost-effectiveness, and freedom in managing reproductive health. However, like any combination of medical devices, they require understanding, caution, and a little extra attention to detail.
The key is not in choosing between a menstrual cup or an IUD, but in learning how to use them together safely. This includes waiting after insertion, breaking suction properly, monitoring your IUD strings, and choosing a cup that fits your anatomy.
Ultimately, with guidance from your healthcare provider and a bit of practice, you can confidently enjoy the benefits of both—without sacrificing comfort, safety, or peace of mind. If you’re ever unsure, trust your instincts and don’t hesitate to speak with a professional.
Your body, your rules—just make sure you’re informed and gentle with both.