Menstrual Cups Can Cause Toxic Shock Syndrome. Here's How to Prevent That

Menstrual cups can reduce your green footprint during your time of the month. A menstrual cup is a bell-shaped container made of silicone, latex, or rubber that is inserted into the vagina. Instead of absorbing menstrual flow with cotton, the cup collects the flow in its receptacle, which stays in place around the cervix through suction.

The good news for menstrual cup users is that they seem to be a safe and effective alternative to other feminine hygiene products. According to an article published in July 2019 in The Lancet Public Health, menstrual cups weren't detrimental to the natural vaginal flora. But are they completely risk-free? Maybe not completely.

Researchers still aren't sure if menstrual cups are any better at preventing toxic shock syndrome than alternative period products. Toxic shock syndrome—or TSS—is a potentially deadly condition that occurs when a type of strep bacteria on the tampon emits toxins that overwhelm the body. But luckily, TSS is very rare.

"There's a possibility of developing toxic shock syndrome, but the risk of TSS is 1 in 100,000," said Leena Nathan, MD, an OB-GYN at the Ronald Reagan UCLA Medical Center in Los Angeles. "So it's rare even if the tampon is left in for a longer period of time."

While rare, TSS from a menstrual cup can happen: in a review of published studies, researchers identified five cases.

To avoid the risk of TSS, Christine Greves, MD, an OB-GYN with Orlando Health System in Florida, told Health that it's best to empty your menstrual cup every four to six hours, like you would change a tampon.

"That being said, it depends on a woman's cycle," said Dr. Greves. "A person with a heavier flow might need to empty it more frequently, but adhering to the four-to-six-hour schedule is a good rule of thumb."

Many menstrual cup brands also recommend washing the cup with a water-based soap or boiling it for five to 10 minutes to clean it in between periods.

Ultimately, menstrual cup users don't need to be worried about TSS if they adhere to the usage guidelines and avoid leaving it in for long periods of time.