For whatever it's worth: cleanliness is always important, obviously, but women who are susceptible to UTIs will probably have a hard time with menstrual cups in general. It's not really an issue of cleanliness, either. The slight pressure that the cup places on the urethra can keep the bladder from emptying completely, leaving a friendly breeding pool for nasty little bacteria. I learned this the hard way many years ago when I was using a diaphragm--it was something no one warned me about. Cups are obviously a lot smaller than diaphragms, but they're big enough to exacerbate a UTI if one is brewing anyway, or to cause problems for women who get frequent UTIs.

All that said, I've used the (unfortunately-named) Diva Cup for years and I love it, and I'm always evangelizing about it. Thanks for the reviews!

So I'm on Loestrin 24 and have been for years, and I don't need any of this stuff anymore. And my doctor says there's nothing wrong with me! So I consider myself fairly environmentally friendly in this department. Now, I wonder how damage is caused from producing those lovely little pills...

...like a plungers >.>

Sorry, couldn't help it... that was my first thought on seeing the keeper lol

I've tried sea sponges and found that by squeezing certain muscles you can push them to within reach.  But maybe I didn't have enough up there, as I did have leakage.  Your description doesn't describe how many to use at a time, I was kind of winging it when I tried them.

Also, to abigoogle, sorry to tell you this, but any time we take a pharmaceutical - even birth control - we pee out the part of it we don't use, it goes into the wastewater, and because pharma products are not regulated in the water quality standards (this will probably change) it gets discharged to rivers or the ocean.  Scientists for years have observed feminized fish and frogs at these points of discharge, caused by this waste, as well as other problems from the other chemicals. Birth control pills result in concentrations of estrogen in the waste-stream.

I have used both the keeper and the Diva cup. I didn't see mention of how to clean... The diva cup can be boiled. The keeper can not be boiled.

I do get a little more leakage with the Diva cup on my super heavy days.  

I backpacked and camped a lot this summer, seemingly it always corresponded with my special monthly time. Especially on the backpacking trip I was so grateful for it. No waste and so easy. Just make sure to do your secret buisness near where you can discreetly wash your hands.

Thanks for undertaking the harrowing work of product comparisons on our behalf, Ladies!

Although no longer "surfing the crimson wave" myself, I have a 10-year-old who'll soon be paddling out there.  The School Lecture on this topic admonished the girls to avoid any product that had "insert" in the directions--in part because of their smaller bodies; did any of the products reviewed address age/body size beyond "before- and after-childbirth"?  

Has anyone out there had experience (direct or indirect) of first-timers using one of The Cups?

If you decide to take the advice of using dental floss to create a string for your sea sponges, be sure to never, ever use mint floss!

I have tried so many products that I ended up being allergic to or didn't work right such as the Instead softcup and the sea sponges as well as regular tampons and liners. I have a Divacup and the lunapads teeny panty liners and they are awesome!!!  

The Diva cup fits well with no leaks ( I only use the liners for catching the little bits after reinserting the cup)and I use the liners even on days I am not on my cycle for the everyday discharge.  They are so comfortable I forget I am even wearing them!  I no longer have allergy problems that were creating rashes and infections and it is great for the environment and saves a lot of money!  I love Lunapads and will never switch to anything else!

Thanks Lunapads Team for EVERYTHING!!

It's important to note that menstrual cups do not work for all women. Look for a good return policy - I know the Keeper has one. I tried it a few years ago and had nothing but pain and discomfort with inserting, removing and wearing. I gave it four months even though the company only has a 3 month guarantee but they still took it back anyway. I was very grateful at the time since I was rather broke. I believe the company has an 80-90% satisfaction rate. I am one of those 10%.

Some of us are built much smaller than others regardless of our age (I'm 31). The experience was so awful I'm afraid to try another brand. If there are any other ladies out there with the same problem, let me know if you've found a menstrual cup that works!

A frequent and not so fun side effect of natural childbirth is stress urinary incontinence, or SUI. There are devices out there for SOMEWHAT managing SUI but they don't really work so well and do nothing for your period. SUI sufferers end up using 1-2 pads a day or more, a major downer for enviro-conscious gals! Can anyone out there comment on whether cups like Diva or Keeper could be used every day and mitigate SUI?

Have used all three cups at one time or another.  While I have not had any leakage with any of them, the Diva cup's much shorter stem made for difficult retrieval.  It also had the very unfortunate side effect of poking and rubbing in a very sensitive location, making it downright painful.  I much prefer the longer stems of the moon cup and the keeper.

Thanks, Grist, for having this discussion!!

To greenma: unfortunately it's not likely that any of these products will help with SUI, but you may wish to see a urogynecologist who can assess if physical therapy and/or a pessary may help. (If those fail or you're not a candidate for those, there are multiple medications that may help, or some women are candidates for surgery-- depending on how inconvenient or debilitating their symptoms are.)

To abigooogle and jishica (and everyone except mgiles who writes she's no longer 'riding the crimson wave'): although it is certainly true that many medications we take are present in our urine and also found in our water, the significant benefit from oral contraceptives and progesterone-based long acting contraceptives like the Mirena IUD and Implanon implants are that they result in lighter periods and -most importantly- fewer unintended pregnancies. I'm sure we all agree that doing this is in all of our best interests, for many reasons!

Although the actual measurements of different brands of cups vary by only tiny amounts, I found one brand (Diva) uncomfortable to the point of being unusuable, while another brand (the Mooncup) works fine for me.  Slight differences in shape can make all the difference in usability, so I encourage people not to give up if one doesn't fit.

About the birth control pill issue--please check out a book called "The Estrogen Effect."  The superfluous amounts of estrogens being excreted into waterways are not only responsible for the feminization of amphibians, fish and reptiles but their sterility, which is threatening a lot of these species. It's also getting into our drinking water and affecting US (namely infant boys). I am all for keeping unintended pregnancies low as possible, but there are other ways to do this, which include a need to become well-acquainted with one's body, and without disrupting human or animal health and ecosystems. On a primal level, I also think it's just not natural or healthy to just not menstruate for months or years at a time, to take pills to trick your body into thinking it's perpetually pregnant. But maybe I am also bitter because I had a fair share of physical issues on different types of the pill, including a possible clot, despite being "a good contender" (thin, low blood pressure, low cholesterol, non-smoker). My period wasn't any lighter either.

Speaking of which, I have advanced endometriosis--insertable menstrual control devices are linked to exacerbation of endometriosis (and I definitely have noticed when I've tried to use them that my cramps are much worse). They have been suspected of instigating the disease if used early on in adolescence, so I would suggest women who have or suspect they have endometriosis to minimize (or even abstain from) using cups and tampons, and that adolescents should hold off the first few years of puberty.

It seems a bit odd that the "Grist pick": the Keeper, is made from a material that a lot of women are allergic to. Why would you recommend the only product (of the products that you reviewed)  containing a known allergen to your readers? Also latex is a porous material that can not be truly sterilized (can't be boiled)and will break down over time, much faster than silicone will. Many sex toy manufacturers recommend that latex toys be replaced after a year or so but the makers of the Keeper claim that their cup lasts as long as its silicone competitors. Seems a bit strange no?