top of page

Menstrual cup use, leakage, acceptability, safety, and availability

A systematic review and meta-analysis

A systematic review and meta-analysis was conducted to summarise current knowledge about leakage, safety, acceptability, prices, availability, and environment costs of menstrual cups (MCs) and compare with other menstrual products, aggregating outcomes from 43 studies and 3319 participants from high-income, low-income, and middle-income countries. Findings: leakage was similar or less when using the MC than when using disposable pads and tampons. The adoption of a MC required a familiarisation phase and peer support seemed to be important for uptake in LMICs. Challenges regarding lack of sanitation, hygiene, and privacy did not stop women from using the MC. MCs were infrequently mentioned in online educational materials on puberty and menstruation for adolescent girls. 199 brands of MCs were identified in 99 countries with prices ranging US$0.72–46.72. Use of the MC showed no adverse effects on the vaginal flora and serious adverse events were not common. Purchase costs and waste from consistent use of a MC would be a small fraction of the purchase costs and waste of disposable pads or tampons. For example, comparing with using 12 disposable pads per period, the MC would comprise 5% of the purchase costs and 0.4% of the plastic waste, and comparing with 12 tampons per period, the MC would comprise 7% of the purchase costs and 6% of the plastic waste. Further studies are needed on cost-effectiveness and environmental impact comparing different menstrual products, and to examine facilitators for use of menstrual cups, with monitoring systems in place to document any adverse outcomes.




van Eijk, et al.

Relevant locations


Best suited for

Product maker,Quantitative researcher,Menstrual cycle researcher


Van Eijk, Zulaika, Lenchner, Mason, Sivakami, Nyothach, . . . Phillips-Howard. (2019). Menstrual cup use, leakage, acceptability, safety, and availability: A systematic review and meta-analysis. The Lancet Public Health, 4(8), E376-E393.

Open acess


Type of research

Systematic review,Meta-analysis




bottom of page