Does Wrong Placement of Menstrual Cups Lead to Kidney Problems?

Nowadays, menstrual cups are widely used to manage menstrual bleeding. However, the complications of using menstrual cups are rarely discussed. Every woman should be aware of how improper positioning of menstrual cups can lead to serious health problems.

Recently, the British Medical Journal reported a case of a woman with uterohydronephrosis—a swollen kidney caused by blocked urine flow into the bladder.

A woman in her 30s presented with occasional blood in her urine (hematuria) and intermittent right-sided flank and pelvic pain that had lasted for around six months. Her medical history revealed the removal of a 9mm kidney stone three years earlier. She also mentioned using a copper coil for contraception and a menstrual cup on the one or two days of heaviest blood flow each month, which she emptied every 2–3 hours. ^[2]

She experienced intermittent flank and lower abdominal pain for around six months. The pain was mild in intensity but occurred 2–5 times a week, lasting about an hour and often accompanied by an urge sensation. Upon examination, she had no other lower urinary tract symptoms. Her blood test showed normal serum creatinine levels, while urine analysis revealed the presence of blood and proteins. ^[1]

The doctor asked her to undergo a CT urography. The scan showed no history of kidney stones but revealed a swollen kidney and ureter. The scan report also noted a well-placed intrauterine device and a menstrual cup positioned on the right side of the vagina, in close proximity to the opening of the ureter into the bladder.

The woman was advised not to use the menstrual cup during her next period and to return for a follow-up scan after a month. On her next visit, her symptoms had completely resolved as she followed the doctor's instructions. The journal report concluded that the position of the cup had blocked the flow of urine from the right ureter.

This was not the only case reported. A few similar cases had been documented previously. In all reported cases, patients presented with flank or abdominal pain and had uterohydronephrosis on a CT scan. Symptoms completely regressed after the removal of the cup. In three cases, women resumed using menstrual cups, and none experienced a recurrence of symptoms. One also opted for a smaller-sized cup. ^[3]

Although rare, women should be aware of symptoms such as flank pain, abdominal pain, and hematuria, which require urgent medical attention. Choosing the correct cup shape and size and inserting it properly can help avoid complications.

Correct placement, along with selecting the appropriate shape and size, is crucial to preventing negative effects on the upper urinary tract. The terminal part of the ureter is near the vagina as it passes into the bladder, which can affect urine drainage. ^[1]

While menstrual cups are a convenient and eco-friendly option for managing periods, proper usage is essential to avoid rare but serious complications. Awareness of correct positioning, appropriate sizing, and potential symptoms can help women make informed choices and seek timely medical attention if needed.

References:

1. MJ Case Reports. "A Case of Menstrual Cup-Induced Urological Complications." BMJ Case Reports 18, no. 2 (2025): e262035. Accessed February 19, 2025. https://casereports.bmj.com/content/18/2/e262035.

2. BMJ Group. "Position Menstrual Cups Carefully to Avoid Possible Kidney Problems, Doctors Urge." BMJ Group, n.d. Accessed February 19, 2025. https://bmjgroup.com/position-menstrual-cups-carefully-to-avoid-possible-kidney-problems-doctors-urge.

3. Bruneau, L., et al. "Is the Menstrual Cup Harmless? A Case Report of an Unusual Cause of Renal Colic." International Journal of Surgery Case Reports 46 (2018): 28–30. doi:10.1016/j.ijscr.2018.04.002.

(Input from various sources)

(Rehash/Dr. Ansila S/MSM)