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Pelvic Floor-Related and Genitourinary Outcomes Associated with Menstrual Cup Use: A Scoping Review
María Ángeles Sirvent-Pinar1, Eleuterio A Sánchez-Romero2,3,4,5, Arturo Garcia-Garcia6,7
1Faculty of Health Sciences, Department of Physiotherapy, Nutrition and Sports Sciences, Universidad Europea de Valencia, Paseo de la Alameda 7, 46010, Valencia, Spain. mariaangeles.sirvent@universidadeuropea.es.
Introduction And Hypothesis:
Menstrual cups are increasingly used as sustainable and cost-effective menstrual hygiene products, but their effects on pelvic floor function and genitourinary health remain unclear. We aimed to map evidence on pelvic floor-related symptoms and clinically relevant genitourinary outcomes associated with menstrual cup use.
Methods:
We conducted a scoping review following PRISMA-ScR and Joanna Briggs Institute guidance. Six databases were searched from inception to March 2026. Eligible studies included women or menstruating individuals using menstrual cups who reported pelvic floor-related symptoms or clinically relevant genitourinary outcomes. Two reviewers independently screened studies, extracted data, and assessed methodological quality.
Results:
Ten studies were included: one randomized controlled trial, one cross-sectional study, one prospective case series, and seven case reports. Evidence was synthesized into two conceptually distinct domains: functional pelvic floor and lower urinary tract outcomes and structural genitourinary complications. Reported functional outcomes included pain-related symptoms, initial vaginal discomfort, pelvic floor symptom burden, and exploratory changes in pelvic floor muscle parameters. The evidence was heterogeneous and insufficient to establish causality or clinically meaningful pelvic floor dysfunction. Rare structural complications consisted mainly of reversible ureteral obstruction or hydronephrosis reported in isolated cases, with resolution after cup removal.
Conclusions:
Current evidence does not support clinically established pelvic floor dysfunction attributable to menstrual cup use. The literature primarily identifies rare reversible mechanical complications and important knowledge gaps. Well-designed prospective studies using standardized objective pelvic floor assessments are needed.
