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FLOW Multicentre randomized controlled trial comparing tampons with menstrual cups

A systematic review and meta-analysis

In this randomized control trial, 110 women were assigned to use tampons or a menstrual cup for three months. Individuals were then surveyed on their satisfaction with the product and kept online diaries during their menstrual cycle, where they documented any problems, changes, and overall observations. After the three months of using exclusively the test product, they were surveyed for their overall satisfaction, how convenient it was, and if they would recommend. It was found that those in the menstrual cup cohort were significantly more satisfied than those in the tampon group; furthermore, there was no difference in discomfort at the end of the trial period. 91% of those in the menstrual cup group would recommend menstrual cups as a method of menstrual care, and found the cups more convenient. The overall results of the study conclude that menstrual cups are an acceptable alternative to tampons; however, due to the small sample size (n-47 for each group) and the lack of participant diversity in the study, further research is recommended to increase the generalizability of the study.




Courtney Howard MD CCFP(EM), Caren Lee Rose MSc, Konia Trouton MD CCFP MPH, Holly Stamm MD CCFP, Danielle Marentette MD CCFP, Nicole Kirkpatrick MD CCFP(EM), Sanja Karalic MD CCFP MSc, Renee Fernandez MD CCFP, Julie Paget MD CCFP

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Howard, C., Rose, C. L., Trouton, K., Stamm, H., Marentette, D., Kirkpatrick, N., Karalic, S., Fernandez, R., & Paget, J. (2011). FLOW (finding lasting options for women): multicentre randomized controlled trial comparing tampons with menstrual cups. Canadian family physician Medecin de famille canadien, 57(6), e208–e215.

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Type of research

Randomized controlled trial




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