When APEX ran a story on menstrual cups last year, we found most of our readers hadn’t even heard about the little silicone bulbous objects that are inserted into the vagina to collect menstrual blood. There were only a handful of users. And it was pretty difficult to find stores selling them. But these ‘life-savers’ for working women have found many takers of late. Shristi Shakya, executive assistant at Putali Nepal that sells these cups, says in the past one year “both sales and awareness have increased.”

Most women who have started using menstrual cups seem pleased with the result. Compared with sanitary pads, menstrual cups are more comfortable, portable, odor-free and environmentally-friendly, they said. Devashree Niraula, 24, who started using menstrual cups this April, can now sleep better during her periods. Earlier, she used to wake up with uncomfortable leakages every few hours. Niraula “highly recommends” menstrual cups.

These cups are available at various prices. PeeSafe has been selling them at Rs 799 apiece, which makes it among the cheapest in Nepal. According to PeeSafe importer Rajat Sarawgi, these India-made products are cheap “despite being made of 100 percent medical grade silicone and manufactured in a germ-free facility”. There are more expensive versions available too. The UK-made PeeSafe sells for Rs 2,500 apiece. At first blush the prices might seem a touch high. Yet in the long run these reusable cups that last up to five years are cheaper than pads.

Not everyone is sold on them though. Dr Aruna Upreti, a reproductive health expert, is uncomfortable with the idea of women inserting foreign objects into their body. “Using menstrual cups incorrectly may even lead to infertility,” she cautions. And she doubts rural women who are ill-informed about reproductive health will be able to use them effectively and hygienically.

But can’t sanitary pads also cause problems if used incorrectly, menstrual cup backers retort?
It bears keeping in mind that although menstrual cups are still relatively new in Nepal, Leona Chalmers, an American actress, invented them way back in the 1930s. They have as such been “extensively researched” and if you follow proper guidelines there is nothing to fear, says Shakya of Putali Nepal.

Both Shakya and Niraula suggest that before using the cups, it is better to visit a store, inspect the cups, and find one that is right for you. This is a long-term investment. Take your time, they add, but make the best pick.
 

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Why urban women are taking to menstrual cups

Shristi Shakya, who has been using menstrual cups since 2015, says Dr Aruna Upreti’s concern about the risks
 of improper usage is valid. But she argues any sanitary product can cause problems if used incorrectly

For two years, Devashree Niraula had been thinking about using menstrual cups but she did not have anyone to talk to about it, and was a little scared of the idea of inserting a cup into her body. This April, after much online research on menstrual cups, she finally bought one. “It’s been a life saver. Finally I can sleep peacefully for eight hours during periods,” she says.

Earlier Niraula used pads, which she found uncomfortable while sleeping. “I always had the problems of leakage and odor. These problems persist even with the cup, but to a lesser degree. And sometimes the cup does not fit well,” she says. But as it had taken her two to three years to get somewhat used to pads, “I’m being patient with the cups as well.”

When Niraula shared her experience of adopting this ‘environmentally-friendly’ option on Facebook, she started getting lots of questions. “People seem curious. I’m sure many will switch to menstrual cups. I hope they do,” she says.

Cost and comfort

I had done a story on menstrual cups for APEX in September last year. Back then, it was difficult to get information as there were few sellers and users of menstrual cups, even in Kathmandu. For this story, I again spoke to Shristi Shakya, executive assistant at Putali Nepal. (I had talked to her for the previous story as well.) Shakya confirms that the number of users and sellers of menstrual cups has increased over the past year. Putali Nepal itself sells between 15 to 20 cups a month, at Rs 2,500 apiece.

“Many traders have started selling menstrual cups,” says Shakya. “Not all are high-quality though.” So how do we identify the good ones? “They come from a reputable manufacturer, are made of 100 percent medical grade silicone and have a usage brochure,” she replies.

PeeSafe, a seller on Daraz, an online shopping site, has been selling menstrual cups for Rs 799 apiece, one of the most affordable rates in Nepal. Rajat Sarawgi, CEO of Brand Bucket, the importer of PeeSafe products in Nepal, assures that “it is made of 100 percent medical grade silicone and manufactured in a germ-free facility.”

PeeSafe sold over 50 menstrual cups last month, most of them online. Sarawgi says retail sales have not been good; he reckons people do not want to buy the cups in stores. “Some of the pharmacies we approached were not even aware about the product,” he adds.

Menstrual cups are PeeSafe’s best-selling product on Daraz. It also sells tampons and bio-degradable pads, but Sarawgi says menstrual cups are the real deal. “They last five years, and are both comfortable and economical,” he says.

As there are many sellers of menstrual products now, Sarawgi stresses the importance of looking at reviews before making purchases. “One should also research the appropriate size, and be cautious about knock-offs,” he advises.

Cup concerns

I asked Shakya why there is such a big difference between the price of their product and PeeSafe’s. She says there can be many reasons, such as the country from which the products are imported. While PeeSafe imports its menstrual cups from India, Putali Nepal does so from the UK. Just that? Shakya replies that higher production cost and better material could be other factors behind the higher retail price of the menstrual cups Putali Nepal sells.

With the increase in interest in menstrual cups, Shakya fears misinformation about them might circulate, potentially harming the industry. “Many brands of menstrual cups are sold online. One of them, which is sold on Daraz, has incorrect information on how to clean a menstrual cup once a period cycle is complete. It says the user has to soak the cup in hot water and dry it off in the sun. Actually, the cups have to be boiled in water and dried,” she says.

Putali Nepal, therefore, does not sell menstrual cups in bulk. It also gives training and brochures to  its users (and other potential users). “Although menstrual cups are safe, effective and tested, users can still get infected if they do not follow certain guidelines,” says Shakya.

Dr Aruna Upreti, who has studied reproductive health, is against the use of such cups. Her main concern has to do with inserting foreign objects into the body. She questions if women who cannot tell between the urethra opening and the vaginal opening can properly insert a menstrual cup in their body. She thinks menstrual cups have been introduced for commercial gain without due concern to the health risks. “Using menstrual cups incorrectly may even lead to infertility. And if the cups are given to rural women, they may not use it in a hygienic way, which can easily lead to infection,” says Upreti.

“New does not necessarily mean better,” she cautions. “Just because this idea worked in Europe and the US does not mean it will work in a developing country like ours.” Upreti instead recommends bio-degradable sanitary pads, which are also an environmentally-friendly option.

Shakya, who has been using menstrual cups since 2015, says Dr Upreti’s concerns are valid. But she argues any sanitary product can cause problems if used incorrectly.

Insert with care

Niraula says inserting menstrual cups for the first time can hurt and may even require lubricant. When she has period cramps, she does not feel like going through the hassle of inserting a cup as she is not completely used to it yet. She would also not recommend teenagers to use it as “they may not have explored their body yet.”

Bidhya Maharjan, 22, shares a similar experience. Before she used a cup for the first time three years ago, she had no experience inserting anything into her vagina. It was painful and she thought she could not do it every month. Many of her friends now use menstrual cups and share their good experience with her.

“But I had a friend whose menstrual cup was stuck in her vagina and she could not pull it out,” says Maharjan. Initially, she also had some difficulty adjusting to the cup. There was the problem of leakage, for example. “But now I am very comfortable using the cups and would recommend them to others as well,” she says.