Part 3: Menstruation

Periods are enough of a pain in the ass, but when tampons start falling out, something has to be done. Women who are more intact than me may not have any problems with tampons, and women who have worse damage may find this doesn’t work, but I couldn’t really face life with the stickiness of pads if I didn’t have to. As miraculous as Thinx sound in the adverts, I don’t see how they can prevent the stickiness…

I wanted something that would give the support of a pessary and catch the blood. I had read on forums that some women were using super plus tampons as pessaries (which sounds painful to me given how often you have to change them and how dry they’d be). Other women were turning menstrual cups inside out and using them as pessaries that way.

If you can afford to go to a gynecologist for a pessary, do it. There are a bunch of shapes and all different sizes. I’m sure you can find something more comfortable and less risky than either of these options.

But back to menstruation. I didn’t want to use super-plus tampons the whole way through my period, so I never tried them. (I am paranoid about TSS, more on this later.) Also, by now, I had been taking my pessary in and out for more than a year and I decided I was ready to get past the yuck factor with menstrual cups.

There is a whole world of menstrual cups. Luckily, enterprising women have put together charts of brands, sizes offered, and stiffness of materials. That’s how I came across one brand that actually had sizes for short vaginas, which a lot of us prolapsed women have.

I messaged my postpartum gynecologist’s office to see if they had any advice, but none of their patients had talked to them about this. Still, they reckoned I should go for the widest, stiffest cup I could find.

So, some free advertising: As far as I could tell, this was the Meluna Sport XL Shorty. I was a little nervous about the XL because they recommend it for tall women and I’m an unimpressive 5’3”. But my pessary was 70mm across and the cup was about 40mm, so it was definitely going to fit.

And it did. It stays in much better than a tampon and is much more comfortable to wear. It can ride down but it doesn’t fall out. (We’ll see if this is still true after I have this second child). It’s comfortable, and I really like that I only have to empty it once or twice a day (using pads at night because I’m paranoid about TSS).

The drawbacks are, of course, the messiness but also the fact that your TSS risk is really in your own hands. I scrub the cup with a toothbrush every time I empty it and use the little brush for the holes. I only sanitize once per cycle (as directed). Because I’m paranoid, I boil it right before I put it in at the beginning of my period, since the bleeding conveniently starts in the morning most often.

Now, technique. When I was doing my research, I read about cups getting suctioned on to women’s cervixes. Ouch. I can confirm that this can happen, and it was pretty freaky to feel my uterus pulled that far down as I struggled to break the suction, but no harm done — it went back up.

That said, women with prolapse really do not want to be encouraging their organs to fall out of place anymore than they already do, am I right? But there are steps you can take to prevent the suction. For me, it was happening because my loose vagina (haha?) was folding around the cup, preventing air from getting in when it opened. This vacuum was pulling my cervix in. Ugh.
But it doesn’t have to be that way. This what worked for me.

1. When you put the folded cup in, lean forward (or whatever direction will get the loose tissue out of the way).
2. Open the cup near the entrance of your vagina (I mean, there’s plenty of space now, right?). Keep a finger in there to make sure air gets in.
3. Push the cup up into place. Any excess air should escape through the holes, and if your cervix falls in, there shouldn’t be any vacuum holding it in place.

Then, several hours later, you’ve got to get it back out again.

1. Your cup probably has something to hang onto to pull it out. Ignore that (or cut it off to accommodate your shortened vagina). Squeeze the sides just a little to cause the air to push up against your cervix (if it has fallen in there). Don’t relax the squeeze, or you might create the vacuum you were trying to avoid!
2. Twist side to side gently, pulling down. I tend to rock it down a little to get an edge out, making sure air can get in.
3. Voila! Empty the cup and flush sooner rather than later — blood is heavy, sticky stuff.

If your cervix does get stuck, I’m sorry I don’t have a bulletproof solution. I just had to pull the cup down until I could reach a finger into the cup and break the suction. Then, slightly panicked, I pushed my uterus back up. No need to panic — it was fine.

Some women say they can use menstrual cups without getting blood on their hands. Nice for them.

Posts in this series:

Prologue
Part 1: Is this normal?
Part 2: Sometimes you won’t get better
Part 3: Menstruation
Part 4: Pregnant with prolapse
Birth plans and prevention