'It gets easier with practice' A Randomized Cross-over Trial comparing the Menstrual Cup to Tampons or Sanitary Pads in a low resource setting.
ESC Congress Library. Beksinska M. 05/04/16; 127051; A-226
Dr. Mags Beksinska
Dr. Mags Beksinska
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Abstract
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Objectives: To assess the ability of women in a public-sector setting in South Africa to successfully fit and learn to use the menstrual cup and to evaluate changes in ease-of-use and reported problems over three menstrual cycles of use.
Methods
The study from which these data are derived was a randomized, crossover study among 110 women in Durban, South Africa, Participants aged 18-45 years with regular menstrual cycles, - had water from the municipal system as their primary water source and had no sexually transmitted infections were eligible for inclusion. Participants used the menstrual cup over three menstrual cycles and were interviewed at baseline and monthly follow-up visits.
Results
Of 124 women assessed, 110 were eligible and randomly assigned to selected menstrual products. 105 women completed all follow-up visits. By comparison to pads/tampons (usual product used), the MC was rated significantly better for comfort, quality, menstrual blood volume collection, appearance, and preference. Both these comparative outcome measures, and likelihood of continued use, recommending the product, and future purchase increased for the MC over time. The data shows clearly that experience of use of the MC across the three use cycles resulted in improvements in use with ease of insertion increasing from 38% of women at visit 1 to 96% at visit 3. At visit 1, over half (58%) of women reported that initial difficulties with insertion became easier with use. Similarly, ease of removal changed from visit 1 to visit 3 with 96% of women saying the MC was very easy to remove at visit 3 compared to two-thirds (67%) at visit 1. Problems related to discomfort with the MC at time of insertion also reduced.
Conclusion: In a population of novice users, initial concerns and user problems were overcome by almost all women over a three-cycles of use. Acceptance of the MC in this population, many with limited experience with tampons, indicates that there is a pool of potential MC users in low resource settings.

Objectives: To assess the ability of women in a public-sector setting in South Africa to successfully fit and learn to use the menstrual cup and to evaluate changes in ease-of-use and reported problems over three menstrual cycles of use.
Methods
The study from which these data are derived was a randomized, crossover study among 110 women in Durban, South Africa, Participants aged 18-45 years with regular menstrual cycles, - had water from the municipal system as their primary water source and had no sexually transmitted infections were eligible for inclusion. Participants used the menstrual cup over three menstrual cycles and were interviewed at baseline and monthly follow-up visits.
Results
Of 124 women assessed, 110 were eligible and randomly assigned to selected menstrual products. 105 women completed all follow-up visits. By comparison to pads/tampons (usual product used), the MC was rated significantly better for comfort, quality, menstrual blood volume collection, appearance, and preference. Both these comparative outcome measures, and likelihood of continued use, recommending the product, and future purchase increased for the MC over time. The data shows clearly that experience of use of the MC across the three use cycles resulted in improvements in use with ease of insertion increasing from 38% of women at visit 1 to 96% at visit 3. At visit 1, over half (58%) of women reported that initial difficulties with insertion became easier with use. Similarly, ease of removal changed from visit 1 to visit 3 with 96% of women saying the MC was very easy to remove at visit 3 compared to two-thirds (67%) at visit 1. Problems related to discomfort with the MC at time of insertion also reduced.
Conclusion: In a population of novice users, initial concerns and user problems were overcome by almost all women over a three-cycles of use. Acceptance of the MC in this population, many with limited experience with tampons, indicates that there is a pool of potential MC users in low resource settings.

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