Increased risk of fungal infection detection in women using menstrual cups vs. tampons: a cross-sectional study

Objective To determine if the use of menstrual cups rather than tampons is associated with more or less health risk. Design Analysing biological, demographic, and behavioural data in a cohort of women who reported using mostly tampons ( n = 81) or menstrual cups ( n = 22). Setting A cross-sectional analysis using the inclusion data of a single centre longitudinal study. Population 149 women from 18 to 25 years old living in the area of Montpellier (France) who reported having at least one new sexual partner over the last year. Methods Statistical modelling (mainly binomial regression models and factor analyses of mixed data). Main Outcome Measures Self-reported data from questionnaires (fungal infection, urinary tract infection, stress level) and biological data (HPV screening, vaginal microbiota profiling, circulating antibodies titration, and local cytokine concentrations). Results We identify an increased risk of reporting fungal infections for women using menstrual cups over tampons. We do not detect significant differences in terms of vaginal microbiota composition or local cytokines expression profile but find that women fall into two different clusters in a factor analysis of mixed data depending on the type of menstrual product they use more (cups or tampons). Conclusions These results point to potential health risks in the use of menstrual cups and differences in local vaginal environments. In-depth studies are needed to better understand potential associations between menstrual product use and women’s health. Funding European Research Council (EVOLPROOF, grant 648963) Ethics The PAPCLEAR study ClinicalTrials.gov identifier is NCT02946346 . Tweetable abstract A cross-sectional study finds a significant association between menstrual cup use and fungal infection risk.