LSTM led review finds menstrual cups linked to improved vaginal health and lower infection risk
- News
12 August 2026
The first systematic review and meta-analysis examining the relationship between menstrual cup use, vaginal health and laboratory-confirmed infections has found that menstrual cups are associated with a healthier vaginal microbiome and lower rates of some infections.
Published in eBioMedicine, the study was led by researchers from LSTM and RUSH University, USA, analysed data from 11 studies involving 10,268 women and girls in the USA, Denmark, Tanzania, and Kenya.
The review found that menstrual cup users had lower rates of bacterial vaginosis (BV), the most common vaginal infection globally, compared with people using other menstrual products. Across five studies, menstrual cup users had a 21% lower prevalence of bacterial vaginosis than non-cup users.
Researchers also found evidence that menstrual cup use was associated with a healthier vaginal microbiome. Compared with users of other menstrual products, menstrual cup users were significantly more likely to have a vaginal bacterial community dominated by Lactobacillus crispatus, a protective bacterium known to reduce the risk of vaginal dysbiosis and sexually transmitted infections (STIs). This association was observed across studies in Kenya and several European countries.
The review also identified evidence from two randomised studies in Kenya showing that menstrual cup users experienced a 26% lower risk of sexually transmitted infections compared with non-cup users. No increased risk of any laboratory-confirmed infection examined in the review was found among menstrual cup users.
Professor Penelope Phillips-Howard, Professor of Epidemiology and Public Health at LSTM and joint senior author of the study, said: “Despite the fact that 1.8 billion women globally are of menstruating age, spending on average 65 days a year dealing with menstrual blood flow, few good quality studies exist that compare sanitary products. In this review, we focussed on laboratory-confirmed infections and summarised current knowledge on the effect of the menstrual cup on infections and vaginal health compared to other products.”
Menstrual health remains a significant global challenge. Period poverty and limited access to safe menstrual products can affect girls’ education and women’s participation in work, while the use of poor-quality materials may increase the risk of urogenital infections. In some settings, a lack of access to menstrual products can also increase vulnerability to exploitation and coercion.
The researchers deliberately focused on studies using laboratory-confirmed measures of reproductive tract infections, sexually transmitted infections and vaginal microbiome composition to provide the strongest available evidence. However, they note that the overall evidence base remains limited, with only three of the included studies considered high quality, highlighting the need for further research in a wider range of settings and populations.
First author Dr Annemieke van Eijk, researcher at LSTM, said: “The menstrual cup can be considered a multipurpose tool. In our previous work we showed that it was acceptable, effective and cost-effective. Now we show that menstrual cups support menstrual care while promoting a healthy vaginal microbiome and improving sexual and reproductive health.”
The authors conclude that menstrual cups offer a low-cost, sustainable and scalable menstrual health solution that may provide advantages beyond menstrual management. They may support a healthier vaginal microbiome and help reduce the prevalence of bacterial vaginosis and some sexually transmitted infections. However, the authors note that more studies with high-quality data are needed to confirm these benefits across different populations.
