Heavy Periods? Yeah, You Can Change That

I received a couple of questions in response to my post about Menstrual Cups for the Sensitive  relating to heavy menstrual flow and cup capacity. It is true that the heavier your flow, the more often you will need to empty your cup, and/or go with a larger sized cup - defeating the comfort of a smaller cup. While I myself have always had a four day period of light-to-medium flow, I completely understand the heavy flow problem. Let me explain.

I had always been accustomed to pretty regular periods, never lasting longer than four days, and fairly cramp-free. In fact, the only real symptoms I experienced were boob swelling and salty cravings. I always opted for OB Regular, or better yet, Slender Junior if I could find them, and a thin liner. I have never had any need for those crazy-absorbent super 'overnight' pads or tampons. Before menstrual cups became widely available, I used to use an old, small (size 65) diaphragm left over from the late-'80s when I suddenly became unable to tolerate the pill. When I moved to the UK and got the far better cervical cap, I ditched it immediately. But I hung onto it for years because it worked beautifully for use at night during periods. (Cervical caps don't work for that because they are so awesomely teeny.)

Just for fun, here's a cervical cap (hello, old friend!) & a diaphragm, pic courtesy of the awesome British National Health Service (NHS) where you can go to a Family Planning Centre and get free contraceptive care (at least you could c.1991):


I remember this period fondly, before I found the Copper-T IUD, which lasts 12 years, is 99+% effective and is oddly unknown in the US. They were my BFF's for 20 years; I can't believe I ever put up with the Pill's side effects in my 20s. That was before I had met Iudia. (just like menstrual products, we are ridiculously far behind)
 
When the SoftCup came out, I thought: Great! Because that's basically all it is: a disposable diaphragm for period use. Yeah, not great. Not at all. The thing is basically shaped like a huge clunky diaphragm - much bigger than I would ever have been able to use - and worst of all, it has a thick, clunky square-edged(!) hard plastic rim. Not the soft, rounded spring of a diaphragm. Again: you might as well just put in your special order for a UTI. 

Here's an idea of different sizes; the SoftCup resembles that frisbee-sized option in the back:
 


I digress. (Anyone who reads this blog will not be surprised by that.) Anyhoo. After 25 years of having easily predictable and manageable periods, a year ago my period didn't come. Since I'm 51, I thought: this is it! Menopause is here. Yeah, no. Perimenopause was here. When my period returned, after a 3-month hiatus, it did so with a vengeance. Lasting for 20 days, 10 of which were heavy bleeding. 

Yeah. That's what I thought: W....T....F?! Although my B.S. is in Women's Studies (now called Gender Studies, but whatevs) and my specific area of emphasis was women's reproductive health [irony alert] that means I knew a great deal about contraceptive options...and precious little about perimenopause. Because, I dunno, I figured I'd get to that later, you know, when it applied to me. So. I was shocked by the level of blood loss, which amounted to 7 times my usual amount. (I actually got a test for anemia afterward). Worst of all, I had to get up in the middle of the night because even the medium menstrual cup, normally enough for a full 8 hours, could not cope with the amount of flow. I instantly had So.Much.Empathy for my heavy flow friends. 

I very quickly did a huge amount of research into this whole issue of heavy flow. In my case, it's called 'flooding' and many women will have at least one episode of it when they reach perimenopause, and it tends to worsen. Or, it can just be a onetime thing. I was hoping it was that. I came across so many desperate women online who were at the point of surgical intervention. I tend to be a little crunchy, but also very pragmatic. I research naturopathic and conventional approaches, then take the best and leave the rest. While I hoped that 20 day apocalyptic adventure was a one-off, because I tend to be a pessimist, I immediately ordered two herbal supplements (in liquid extract form) on Amazon:

• Lady's Mantle and Shepherd's Purse

These are time-honored plants for reducing blood flow, both menstruation and post-partum; they are usually used in tandem, with Shepherd's Purse being the stronger and faster-acting. There is lots of fascinating history. For example, Lady's Mantle is so-named for it's resemblance to the cloak worn by medieval women, which fell in graceful pleats; the leaves are fuzzy and hold dewdrops, which then catch refracted light and sparkle like jewels, hence its other name, Dewcup. I happen to have an English-style cottage garden and Lady's Mantle was used to edge the borders. So I made my own tincture by soaking the dried leaves in vodka, but while I waited the month for this to be ready, I bought some on Amazon. 

 

Shepherd's Purse is aimed more toward reducing blood loss quickly, and it tastes pretty astringent. So named because the shape is reminiscent of the bags traditionally carried by shepherds.


 
Good thing too, because just 3 weeks later, the same thing happened. This time I used the Lady's Mantle and Shepherd's Purse, multiple doses a day, and after 5 days the bleeding reduced and slowed, finally ending after 10 days. OK, so they cut the flow by 1/3, and the duration in half - 10 days is better than 20 days - but still, not acceptable. 

Also, while I usually prefer liquid tinctures, in this case, the amount required is a lot, and the cost would become higher. So I found a capsule formula that worked even better and is more cost effective. I took 2 capsules, twice a day for the first couple of days. You can take much higher doses if you're really trying to get the bleeding under control. It has the uninspiring name of Menstrual Reg. The first two ingredients are Lady's Mantle and Shepherd's Purse. There's also Yarrow, Chasteberry, and False Unicorn, all herbs with a long, honorable history as remedies for women.
 
I did more research. And learned two very simple, and inexpensive, options:

• Ibuprofen. For reals. Several studies have been done showing that this alone can reduce your flow by 30-50%. That's huge. It appears you're likely to get the best results if you start taking it right when your period begins, or better yet, a day or two before it starts. And if you take the Rx level dose of 600-800mg a couple times a day, which is 3 or 4 Advil, or 1 or 2 Aleve. The 2nd article describes just taking the low OTC dose of 200mg, and a resulting reduction of 25%. So, you can try either. (Usual disclaimers of "I'm not a health professional, do your own research, use common sense, & make your own decisions, yadda yadda" apply.) 

Specifics here
And here

Personally, I found this did work to reduce flow by about 25%, however I only used the low dose because I have one kidney and NSAIDs are one of the few things I need to use very conservatively; otherwise, I would have opted for the higher dose. But in the end, I decided to simply address the root reason that my flow was so heavy in the first place, with:

• Progesterone cream. For me, this completely resolved the heavy flow, restoring my normal, light 4-day period, within just one cycle. 

Basically, when flow is heavy it very often means there is an imbalance in the hormone ratio, with estrogen being high, and progesterone low. Not that either of those hormone levels are too high/low in & of themselves, but rather that their ratio to one another is out of balance. 

In real (as opposed to highly scientific)  terms, here's how it plays out: estrogen is what encourages the uterine lining to grow rich and fluffy, but fragile. Progesterone is what turns off the switch and says 'OK, lining, you're fluffy enough: stop and stabilize'. But when estrogen steamrolls over progesterone, the lining gets pretty over-the-top (like a house of cards, the bigger it gets, the more unstable) and then there's no smoothing out, no gradual easing into the shedding process. Result: lining releases chaotically, and because it grew needlessly fluffy, its got a lot to release. Hello, heavy, long period. But if you can steady that teeter-totter between estrogen and progesterone....Yahtzee! You can restore moderate, efficient bleeding.

Other good indicators that your estrogen level is too high in relation to your progesterone? You're approaching perimenopause (ages 35-50) or you've had issues with PCOS, or you know you have a short post-luteal phase (often concurrent with PCOS). That means that the time between ovulation and menstruation is too short. So, if the average period is 28 days, then ovulation is usually around day 14. But if your post-luteal phase is short, that means ovulation is happening around day 18 or 20, with you period starting 8-10 days later, due to that shortage in progresterone. Restoring that balance does all kinds of other good things for PMS, fertility, mood swings, etc, but that's all beyond our scope, here. This post is already in danger of becoming a novel.

So how did I use the progesterone cream? I just applied around a 1/4 - 1/2 tsp alternating areas with thinner skin (insides of wrists, belly, tops of feet) every day for 10 days out of the month, specifically that post-luteal phase above, so day 15-25. It sounds complicated, but it really isn't. I was pretty lackadaisical about it; I didn't measure exactly, just glopped some out and eyeballed it. And I wasn't too exact about the days either, just aiming for 1/2way into my cycle. 

Didn't matter. The results were fast and everything I'd hoped for. The first cycle I did this, my period was normal. And has been every month since. I occasionally still use Lady's Mantle tincture or some Advil on the first day of my period, if it seems to be on heavy side, but most often, I don't even need that. It's pretty incredible that a $15 cream so effectively stopped the escalating pattern of heavy periods coming every 3 weeks and lasting 10-20 days.

The brand of cream isn't as important as that it contains actual progesterone (not just yams). I've used a few different brands I've had good results with, and they are not the most spendy, either.

NOW products have always been reliable for me, and very reasonably priced. 
Smoky Mountain Naturals is also a decent choice. LifeFlo, too. The best is probably Ona's Naturals. More spendy, but also 30% more concentrated. Plus I like supporting small, woman-owned companies.
(No, there are no affiliate links; this is just what I use myself.)  

So, this was the result of all my desperate research, and what worked for me.  The important thing is that you don't have to put up with needlessly heavy bleeding that disrupts your life. I've never minded my periods, and as I've grown older -without getting too feminist goddess-worshippy here- I've come to kind of, not exactly enjoy them, but to appreciate them. 

Bottom line: It always feels great to realize that you can gather knowledge, consider all of the choices, and then take control of your own health.

Menstrual Cups & Soft Tampons For the Sensitive Skin Win

Updated at the end with some Q&A and how-to's

So this post has nothing to do with bras, but it has a lot to do with sensitive skin. Also, by virtue of the topic, there could be some TMI, but to be of any help here, the info needs to be specific. 

Cups are, quite simply, amazing. They really transform the whole period experience. Much of the time, I actually forget my period is happening. They are so far superior in comfort and function to tampons and pads, there is no comparison.

Let me give some background here: I have a great deal of experience with menstrual cups, or, moon cups, as I call them, which sounds so much nicer. Prior to that, I used the contraceptive cap for years; it's a little known option in the U.S., but easily obtained in the UK. And before I found the perfect cup for me, I used OB tampons, the brand with no applicator. In other words, I know this particular internal terrain very well.

OK, because this blog is not monetized I can tell a lot of blunt truths. So let me just say here that if you tried the most easily available brand in the U.S., the DivaCup, and it was a horrible experience, I am not at all surprised, but do not give up. 

 

Look at the size of that beast. I shudder to remember the one and only time I tried a "small" (hah!) DivaCup, and almost gave up on the whole concept entirely. It remains the worst cup I've ever tried. Why? It's gigantic, for one thing. And it's harsh and rigid. Call it the Panache of cups. And that stem? Also rough and harsh and it dug in painfully. Note: even when you manage to get a cup like this inserted, getting it out again can be far more painful. Cups should never cause you any pain. 

And if UTI's are a problem for you, note that cups that are this large and rigid can compress and irritate the sensitive tissue of the urethra, which is basically a recipe for a UTI. Conversely, if this brand happens to suit your specific anatomy, and you're happy with it, that's great. But if not, then it may help to realize this is not a universal cup shape or style, and it does not suit a huge segment of women. It's a shame that many women come away with the idea that this is what all menstrual cups are.

I've tried other brands, including Lunette (less rigid and huge, but still leaning that way), Sckoon (thick and clunky, but softer), and others, none of which even merit a mention. The result: I found only one brand that works for me, that is comfy and a match for my shape. And because they offer so many combinations of size & shape, you'll very likely find a match for you, too. It is very rare for me to be so brand loyal, but this company deserves that loyalty.

MeLuna

MeLuna (my moon) is a German brand and they do have a U.S. online storefront, but the link above is to their European online store. That's because there are far more choices there, for reasons I'll get into below. 

Why does MeLuna blow other brands out of the water? Behold the vast landscape of choice. Choice of softness level. Choice of color. Choice of shape. Even choice of stem style....Choices.

Here again, MeLuna demonstrates that they just get it. Along with 4 sizes: Small to X-Large, they offer 3 - three! - different levels of firmness. That is just an unheard of level of customization. It's the equivalent of a bra brand offering sizes 26A to 54J, all in both FOT and FOB options. It's hard to imagine that someone couldn't find the right fit. 

There are some great blogs with cup reviews, and plenty of YouTube reviews as well, so you can find a great deal of info. Here is a really comprehensive one:
Menstrual Cup Reviews

As with any review, they are all going to be weighted somewhat toward what is important to the reviewer. In my case, that's comfort and sensitive skin issues. Most reviews I have read focus on cup capacity (not very important to me) and how easily they pop open upon insertion (also not as important to me, since I'm an experienced cup user).

How Do You Figure Out Which Style Is Right For You?

In my experience, the biggest factor that determines this is your own shape. Much like full-on-top vs. full-on-bottom. In this case, it's high cervix vs. low. (Cervix = that firm, doughnut-shaped ring that is the opening to the uterus) How do you know which you have? Time for some TMI. 

Tampons. If you've used the more common applicator style, how did that go for you? If, when the plunger was pushed, you felt a bump of discomfort, or, if the tampon was not far enough in and sitting uncomfortably, that's a strong indication that you have a low cervix, i.e., it sits naturally lower in your body, giving you less vertical room in that area. Alternatively, if your problem is that you sometimes have trouble reaching the string to remove the tampon, your cervix is likely quite high.

Sex. If you routinely find certain positions painful, like something is being bumped, and there just isn't enough vertical room in there for what you're trying to accomplish, you almost certainly have a low cervix. Likewise, if ride 'em cowgirl is your go-to, you likely have a high cervix. 

OK, now that we've all got those visuals in our heads, what does it mean for cup selection? It means that if you have a low cervix, your cup choices are greatly reduced. Just like bras for full-on-tops. But the good news here is that MeLuna actually makes a cup especially for you. It's called the Shorty. Nice, right? (In the pic above, the Shorties are in the front, with the Regulars behind them. And if you google it, you can find So.Much.Info. with pics and video, so I won't repeat all that here.)

It is more than just the Shorty's reduced length, however.  It is also shaped differently: wider at the top, and much more tapered at the bottom. That last part is really important; the lack of the bulbous tip means that it won't compress or chafe against the tissue of the urethra or bladder, and that you should never be able to feel it when you are sitting. Ever. You are going to lose some capacity, which is perfectly fine as a trade-off for comfort and health. 

In real terms, this means that on my heaviest day (which is not super-heavy, but probably on the heavy end of average for most) I would need to empty my size Small Shorty every 4 hours. In the Medium, I could go 6 hours. Whereas on all the other days of my period, I could go a full 8 or 9 hours.

By comparison, the Regular is more narrow at the top, but longer and bell-shaped, rather than pyramid-shaped. I can wear this style in a Soft, but it is not the right shape for me. (Another hint: if you notice reduced flow on your trips to the Ladies', that means the cup is pressing on your urethra, and interfering with your bladder's ability to fully empty and you are moving into UTI risk territory.)

Figured Out the Shape, What About Size & Firmness?

The size is a bit more tricky than the shape. Your cup size has virtually no correlation to your body or clothing size. Your best gauge here will be the tampons/sex litmus tests. For e.g., I have never used a super-sized tampon in my life. Likewise, the Medium Shorty is the largest cup that would ever be appropriate for me. If you have any issues with sensitivity or UTI's, my advice is to go smaller and softer. The drawbacks are that you may have to empty your cup more often, and there is a learning curve to getting a softer cup to pop open once inserted. I suspect this is the main reason that the U.S. storefront does not even offer the soft cups. American women don't have much experience with them, as they haven't been available here as long, and the firmer cups will  indeed pop open easily - which also makes them more uncomfortable to remove. 

I find that the Soft Shorties pop open more easily than the Soft Regulars due to the wider top. The Regular firmness pops open easily in either style. There is a 3rd firmness option, called Sport, and I have never tried it as it would be way too rigid for me. But it's a nice option if you have non-sensitive skin and really strong pelvic muscle tone, which would make using a Soft version impossible, since it couldn't open. The Sport version make leaks very unlikely because of the rigidity. 

The Soft really can't be topped for comfort. It's often recommended for those who have less muscle tone, due to multiple childbirth, or other issues; the reason being, that stronger muscle tone would overpower the cup, keeping it collapsed. I can't really speak to that, as I'm child-free and don't have an issue with muscle tone, but that means it does take a bit more work to get the soft cups to pop open for me, but it is so, so worth it. There are techniques to do this, such as letting the cup unfold earlier in the insertion process, waiting a few seconds, then twisting at the end. Occasionally, such as on very light days, these techniques don't work, and then I simply use the Regular firmness Shorty in size Small. You can read about the many folding techniques for cups, kind of like menstrual origami, but for myself, I find the C-fold works best for me with softer cups, and the 7-fold for larger cups.

Basically, I think the Regular firmness will work well for most women, so if you are not an experienced cup user, it makes sense to start there. It's still far less rigid than the dreadful DivaCup and I can use it comfortably most of the time. But the Soft Shorty in size Small is what I choose 80% of the time. 

Your final option is which stem to choose. Again, how great is that. All of the stems are pretty soft and unobtrusive, but the ball stem is the most popular, apparently. And I get why: it's quite soft and doesn't dig in any way, and they improved it a few years ago to make it flattened on two sides and easier to grip. On the Regular shape, you can opt for no stem at all, which I do, as I can't spare the extra room, and have no trouble reaching it, ever. However, if you have a high cervix, you have the awesome option of going for the sturdiest choice, the ring stem, and, if you still have trouble reaching the cup to remove it (I'll admit, I can't even imagine having this issue, but I know it exists) you can even buy a handy little tool that you use to hook the ring and remove it. 

Your final, final option: Colors. Why would you settle for a dingy yellowy-clear cup when you don't (and shouldn't) have to? In addition to their usual rainbow of options, MeLuna comes out with 'limited edition' colors, like this fabulous Fairy Dust (violet glitter) that I acquired:




But my love affair with this brand does not stop there. Oh no, because they offer several other things that we, as American women, are unfairly deprived of. Namely, Soft Tampons. These are pure genius - and can be very difficult to find (at reasonable prices) on Amazon or eBay. 

I love the tagline. That's right: these are perfect for tennis, sauna, and sex. They are nothing like the 'sea sponges' which I've also tried, and which I don't find to be soft at all, but do find to be leak-prone. But these are completely different: VERY soft synthetic foam. They are meant to be tossed after one use, so would get a little spendy if you used them exclusively, but if you have serious sensitivity issues, I imagine that would be completely worth it to you.

The beauty of these is that they are so soft and comfy, they can be used even if your skin is having a moment where it is irritated by everything else. They are heart-shaped darts and come in regular and mini. The mini especially are perfect for use during sex. They are completely undetectable and a partner would be unable to tell your period was even part of the equation. There is also a round version that I like equally well and provides slightly more coverage.

Finally, they have an awesome little gizmo that costs around $4 (that they appear to be out of now) that you can pop onto a water bottle and create a mini-bidet. I mean, why do we not have these awesome, low tech, inexpensive, life improving things on U.S. shelves? Oh, and that's the cherry on top of my love for MeLuna: they are incredibly reasonably priced, have regular specials, and cheerfully ship to the U.S. And they waive the high Euro tax, which is something like 17%.

If you've tried a cup and failed, and need some 'tech support' but don't want to ask your question publicly, feel free to submit a comment and include your email. I won't publish it and will instead respond to you directly. 

Q:  How Do I Know When To Empty My Cup?
A:  It's usually pretty easy to tell. I get kind of a 'bubbly' sensation, and the cup will also begin to shift around a bit. Because, usually, you cannot feel the cup at all, that is noticeable. After that - for me, it's 1/2 hour or so later - you will start to see spotting. It's not a drastic overflow event, more like what happens with a tampon. 

Q:  I Love the Softer Cups, But I Can't Get Them to Pop Open.
A:   Yeah, this is a good/bad news thing. The stronger your pelvic muscles, the harder it will be to get a soft cup to spring open after you insert it. 
     The biggest thing is to be sure the inside of your cup is not wet. This applies to all cups, soft or not. So after you rinse it out, be sure to dry the inside only; it's fine to leave the outside wet to help it glide better. But if the inside is wet it will stick together and create suction - in the wrong direction. 
     Next most important: insert it maybe 1/3 of the way, then let it open. The opposite of what you would do with a huge, rigid Diva-style cup. Count to 3, then nudge it the rest of the way along. This lets it fill with a little air and begin to open more. 
     Last step: when the cup is where you want it, and if it is still partially, or even fully, collapsed into a flat shape, grasp the ball (or stem, whatever you chose) and twist, so that the cup rotates a quarter or 1/2 turn. It should open at least partially at this point; if so, and it feels comfy, you can be fairly confident it is going to slowly open the rest of the way in a few minutes if you just go about your business. If it doesn't open at all after you rotated it, then give up; it's not going to happen, for whatever reason. 
     Depending on that reason, I move on to my next option. If my flow is very light or intermittent, then I will choose my small cup in regular firmness. Or, if my skin feels tender, or if the position of my cervix feels lower than usual (FYI: that changes throughout the cycle) then I go straight to those awesome soft tampons. For light flow, they last the entire 8-10 hour day. For medium-heavy days, they'll be more like a regular tampon and go 4-6 hours.

Q:  What Are Those 'OB' tampons you talked about?
A:  This brand has been around awhile and was designed by a woman. And you can tell. This is the only brand of tampon I would ever choose. They have no applicator, and look like small cotton bullets:

How do you insert them? That's the beauty of these. You can guide them to exactly the angle and depth you want. (An applicator will decide that for you - no thanks.) You just wiggle the string a bit to widen the base, making the perfect spot for your finger, then glide it where you want it to be.

Note: there is another version, called SilkTouch or Pro, which I don't care for. But you might, if you have a high cervix. It's shaped to be thinner and longer. 

Q: I'm Worried About Removing Those Soft Tampons.
A: Yeah, they have no applicator and no string. This is a great benefit of getting familiar with your internal landscape. You will no longer be intimidated by those things. If you have trouble reaching it from a sitting position, don't panic. Try relaxing, then pushing down with those muscles. If that's not enough to help you reach to edges of the sponge, then your next move is to get into a squat position and try again. If that doesn't work, then just go about your business and try again in 1/2 an hour or so. This is likely to be the case after sex, when to enable the fun, your cervix will lift higher in your body, to uh, make more room. You literally just need to wait for it to settle back down to its usual position.

Menstrual Cups & Soft Tampons For the Sensitive Skin Win

Updated at the end with some Q&A and how-to's

So this post has nothing to do with bras, but it has a lot to do with sensitive skin. Also, by virtue of the topic, there could be some TMI, but to be of any help here, the info needs to be specific. 

Cups are, quite simply, amazing. They really transform the whole period experience. Much of the time, I actually forget my period is happening. They are so far superior in comfort and function to tampons and pads, there is no comparison.

Let me give some background here: I have a great deal of experience with menstrual cups, or, moon cups, as I call them, which sounds so much nicer. Prior to that, I used the contraceptive cap for years; it's a little known option in the U.S., but easily obtained in the UK. And before I found the perfect cup for me, I used OB tampons, the brand with no applicator. In other words, I know this particular internal terrain very well.

OK, because this blog is not monetized I can tell a lot of blunt truths. So let me just say here that if you tried the most easily available brand in the U.S., the DivaCup, and it was a horrible experience, I am not at all surprised, but do not give up. 

 

Look at the size of that beast. I shudder to remember the one and only time I tried a "small" (hah!) DivaCup, and almost gave up on the whole concept entirely. It remains the worst cup I've ever tried. Why? It's gigantic, for one thing. And it's harsh and rigid. Call it the Panache of cups. And that stem? Also rough and harsh and it dug in painfully. Note: even when you manage to get a cup like this inserted, getting it out again can be far more painful. Cups should never cause you any pain. 

And if UTI's are a problem for you, note that cups that are this large and rigid can compress and irritate the sensitive tissue of the urethra, which is basically a recipe for a UTI. Conversely, if this brand happens to suit your specific anatomy, and you're happy with it, that's great. But if not, then it may help to realize this is not a universal cup shape or style, and it does not suit a huge segment of women. It's a shame that many women come away with the idea that this is what all menstrual cups are.

I've tried other brands, including Lunette (less rigid and huge, but still leaning that way), Sckoon (thick and clunky, but softer), and others, none of which even merit a mention. The result: I found only one brand that works for me, that is comfy and a match for my shape. And because they offer so many combinations of size & shape, you'll very likely find a match for you, too. It is very rare for me to be so brand loyal, but this company deserves that loyalty.

MeLuna

MeLuna (my moon) is a German brand and they do have a U.S. online storefront, but the link above is to their European online store. That's because there are far more choices there, for reasons I'll get into below. 

Why does MeLuna blow other brands out of the water? Behold the vast landscape of choice. Choice of softness level. Choice of color. Choice of shape. Even choice of stem style....Choices.

Here again, MeLuna demonstrates that they just get it. Along with 4 sizes: Small to X-Large, they offer 3 - three! - different levels of firmness. That is just an unheard of level of customization. It's the equivalent of a bra brand offering sizes 26A to 54J, all in both FOT and FOB options. It's hard to imagine that someone couldn't find the right fit. 

There are some great blogs with cup reviews, and plenty of YouTube reviews as well, so you can find a great deal of info. Here is a really comprehensive one:
Menstrual Cup Reviews

As with any review, they are all going to be weighted somewhat toward what is important to the reviewer. In my case, that's comfort and sensitive skin issues. Most reviews I have read focus on cup capacity (not very important to me) and how easily they pop open upon insertion (also not as important to me, since I'm an experienced cup user).

How Do You Figure Out Which Style Is Right For You?

In my experience, the biggest factor that determines this is your own shape. Much like full-on-top vs. full-on-bottom. In this case, it's high cervix vs. low. (Cervix = that firm, doughnut-shaped ring that is the opening to the uterus) How do you know which you have? Time for some TMI. 

Tampons. If you've used the more common applicator style, how did that go for you? If, when the plunger was pushed, you felt a bump of discomfort, or, if the tampon was not far enough in and sitting uncomfortably, that's a strong indication that you have a low cervix, i.e., it sits naturally lower in your body, giving you less vertical room in that area. Alternatively, if your problem is that you sometimes have trouble reaching the string to remove the tampon, your cervix is likely quite high.

Sex. If you routinely find certain positions painful, like something is being bumped, and there just isn't enough vertical room in there for what you're trying to accomplish, you almost certainly have a low cervix. Likewise, if ride 'em cowgirl is your go-to, you likely have a high cervix. 

OK, now that we've all got those visuals in our heads, what does it mean for cup selection? It means that if you have a low cervix, your cup choices are greatly reduced. Just like bras for full-on-tops. But the good news here is that MeLuna actually makes a cup especially for you. It's called the Shorty. Nice, right? (In the pic above, the Shorties are in the front, with the Regulars behind them. And if you google it, you can find So.Much.Info. with pics and video, so I won't repeat all that here.)

It is more than just the Shorty's reduced length, however.  It is also shaped differently: wider at the top, and much more tapered at the bottom. That last part is really important; the lack of the bulbous tip means that it won't compress or chafe against the tissue of the urethra or bladder, and that you should never be able to feel it when you are sitting. Ever. You are going to lose some capacity, which is perfectly fine as a trade-off for comfort and health. 

In real terms, this means that on my heaviest day (which is not super-heavy, but probably on the heavy end of average for most) I would need to empty my size Small Shorty every 4 hours. In the Medium, I could go 6 hours. Whereas on all the other days of my period, I could go a full 8 or 9 hours.

By comparison, the Regular is more narrow at the top, but longer and bell-shaped, rather than pyramid-shaped. I can wear this style in a Soft, but it is not the right shape for me. (Another hint: if you notice reduced flow on your trips to the Ladies', that means the cup is pressing on your urethra, and interfering with your bladder's ability to fully empty and you are moving into UTI risk territory.)

Figured Out the Shape, What About Size & Firmness?

The size is a bit more tricky than the shape. Your cup size has virtually no correlation to your body or clothing size. Your best gauge here will be the tampons/sex litmus tests. For e.g., I have never used a super-sized tampon in my life. Likewise, the Medium Shorty is the largest cup that would ever be appropriate for me. If you have any issues with sensitivity or UTI's, my advice is to go smaller and softer. The drawbacks are that you may have to empty your cup more often, and there is a learning curve to getting a softer cup to pop open once inserted. I suspect this is the main reason that the U.S. storefront does not even offer the soft cups. American women don't have much experience with them, as they haven't been available here as long, and the firmer cups will  indeed pop open easily - which also makes them more uncomfortable to remove. 

I find that the Soft Shorties pop open more easily than the Soft Regulars due to the wider top. The Regular firmness pops open easily in either style. There is a 3rd firmness option, called Sport, and I have never tried it as it would be way too rigid for me. But it's a nice option if you have non-sensitive skin and really strong pelvic muscle tone, which would make using a Soft version impossible, since it couldn't open. The Sport version make leaks very unlikely because of the rigidity. 

The Soft really can't be topped for comfort. It's often recommended for those who have less muscle tone, due to multiple childbirth, or other issues; the reason being, that stronger muscle tone would overpower the cup, keeping it collapsed. I can't really speak to that, as I'm child-free and don't have an issue with muscle tone, but that means it does take a bit more work to get the soft cups to pop open for me, but it is so, so worth it. There are techniques to do this, such as letting the cup unfold earlier in the insertion process, waiting a few seconds, then twisting at the end. Occasionally, such as on very light days, these techniques don't work, and then I simply use the Regular firmness Shorty in size Small. You can read about the many folding techniques for cups, kind of like menstrual origami, but for myself, I find the C-fold works best for me with softer cups, and the 7-fold for larger cups.

Basically, I think the Regular firmness will work well for most women, so if you are not an experienced cup user, it makes sense to start there. It's still far less rigid than the dreadful DivaCup and I can use it comfortably most of the time. But the Soft Shorty in size Small is what I choose 80% of the time. 

Your final option is which stem to choose. Again, how great is that. All of the stems are pretty soft and unobtrusive, but the ball stem is the most popular, apparently. And I get why: it's quite soft and doesn't dig in any way, and they improved it a few years ago to make it flattened on two sides and easier to grip. On the Regular shape, you can opt for no stem at all, which I do, as I can't spare the extra room, and have no trouble reaching it, ever. However, if you have a high cervix, you have the awesome option of going for the sturdiest choice, the ring stem, and, if you still have trouble reaching the cup to remove it (I'll admit, I can't even imagine having this issue, but I know it exists) you can even buy a handy little tool that you use to hook the ring and remove it. 

Your final, final option: Colors. Why would you settle for a dingy yellowy-clear cup when you don't (and shouldn't) have to? In addition to their usual rainbow of options, MeLuna comes out with 'limited edition' colors, like this fabulous Fairy Dust (violet glitter) that I acquired:




But my love affair with this brand does not stop there. Oh no, because they offer several other things that we, as American women, are unfairly deprived of. Namely, Soft Tampons. These are pure genius - and can be very difficult to find (at reasonable prices) on Amazon or eBay. 

I love the tagline. That's right: these are perfect for tennis, sauna, and sex. They are nothing like the 'sea sponges' which I've also tried, and which I don't find to be soft at all, but do find to be leak-prone. But these are completely different: VERY soft synthetic foam. They are meant to be tossed after one use, so would get a little spendy if you used them exclusively, but if you have serious sensitivity issues, I imagine that would be completely worth it to you.

The beauty of these is that they are so soft and comfy, they can be used even if your skin is having a moment where it is irritated by everything else. They are heart-shaped darts and come in regular and mini. The mini especially are perfect for use during sex. They are completely undetectable and a partner would be unable to tell your period was even part of the equation. There is also a round version that I like equally well and provides slightly more coverage.

Finally, they have an awesome little gizmo that costs around $4 (that they appear to be out of now) that you can pop onto a water bottle and create a mini-bidet. I mean, why do we not have these awesome, low tech, inexpensive, life improving things on U.S. shelves? Oh, and that's the cherry on top of my love for MeLuna: they are incredibly reasonably priced, have regular specials, and cheerfully ship to the U.S. And they waive the high Euro tax, which is something like 17%.

If you've tried a cup and failed, and need some 'tech support' but don't want to ask your question publicly, feel free to submit a comment and include your email. I won't publish it and will instead respond to you directly. 

Q:  How Do I Know When To Empty My Cup?
A:  It's usually pretty easy to tell. I get kind of a 'bubbly' sensation, and the cup will also begin to shift around a bit. Because, usually, you cannot feel the cup at all, that is noticeable. After that - for me, it's 1/2 hour or so later - you will start to see spotting. It's not a drastic overflow event, more like what happens with a tampon. 

Q:  I Love the Softer Cups, But I Can't Get Them to Pop Open.
A:   Yeah, this is a good/bad news thing. The stronger your pelvic muscles, the harder it will be to get a soft cup to spring open after you insert it. 
     The biggest thing is to be sure the inside of your cup is not wet. This applies to all cups, soft or not. So after you rinse it out, be sure to dry the inside only; it's fine to leave the outside wet to help it glide better. But if the inside is wet it will stick together and create suction - in the wrong direction. 
     Next most important: insert it maybe 1/3 of the way, then let it open. The opposite of what you would do with a huge, rigid Diva-style cup. Count to 3, then nudge it the rest of the way along. This lets it fill with a little air and begin to open more. 
     Last step: when the cup is where you want it, and if it is still partially, or even fully, collapsed into a flat shape, grasp the ball (or stem, whatever you chose) and twist, so that the cup rotates a quarter or 1/2 turn. It should open at least partially at this point; if so, and it feels comfy, you can be fairly confident it is going to slowly open the rest of the way in a few minutes if you just go about your business. If it doesn't open at all after you rotated it, then give up; it's not going to happen, for whatever reason. 
     Depending on that reason, I move on to my next option. If my flow is very light or intermittent, then I will choose my small cup in regular firmness. Or, if my skin feels tender, or if the position of my cervix feels lower than usual (FYI: that changes throughout the cycle) then I go straight to those awesome soft tampons. For light flow, they last the entire 8-10 hour day. For medium-heavy days, they'll be more like a regular tampon and go 4-6 hours.

Q:  What Are Those 'OB' tampons you talked about?
A:  This brand has been around awhile and was designed by a woman. And you can tell. This is the only brand of tampon I would ever choose. They have no applicator, and look like small cotton bullets:

How do you insert them? That's the beauty of these. You can guide them to exactly the angle and depth you want. (An applicator will decide that for you - no thanks.) You just wiggle the string a bit to widen the base, making the perfect spot for your finger, then glide it where you want it to be.

Note: there is another version, called SilkTouch or Pro, which I don't care for. But you might, if you have a high cervix. It's shaped to be thinner and longer. 

Q: I'm Worried About Removing Those Soft Tampons.
A: Yeah, they have no applicator and no string. This is a great benefit of getting familiar with your internal landscape. You will no longer be intimidated by those things. If you have trouble reaching it from a sitting position, don't panic. Try relaxing, then pushing down with those muscles. If that's not enough to help you reach to edges of the sponge, then your next move is to get into a squat position and try again. If that doesn't work, then just go about your business and try again in 1/2 an hour or so. This is likely to be the case after sex, when to enable the fun, your cervix will lift higher in your body, to uh, make more room. You literally just need to wait for it to settle back down to its usual position.

Review: Glamorise Cami Wonderwire Bra

I am always on the lookout for a comfy large cup size cami-bra. Because:

1)  I am both full-on-top and fairly high-set. Result: cleavage is always a factor for me. I have no philosophical issue with cleavage as such, but I simply prefer not to display more than a minimal amount at work. 

2)  I seriously dislike wearing layers of clothing. Indoors. Because dry, overheated air is a huge pet peeve of mine. I define overheated as above 70F. Frankly, I think 68F is plenty, and my own home is kept at 65F. For some reason, gov't buildings here are always 72-75F degrees, which is ridiculous. Especially given that there are constant bulletins about 'fiscal austerity'. So what we have are moratoriums on buying pens and paper, while the heating oil bills don't merit any review. 

Digress much? Don't mind if I do. But my point is that even a camisole is just another layer I do not want to pile on. 

Beauty

Very pretty. The lace is substantial and semi-opaque, so gives very good coverage. For reference, although the cami portion appears to come up quite high, my cleavage begins juuust below that top strip of lace. If you look closely, you can see the faint tell-tale shadow.

Black is hard to photograph and the details are not showing especially well, but the colors are more muted in person:

 Comfort

When I put this on in the morning, I really expected to be writing a rave review later that day. However.....

Wires.  These are wonderful. They are medium-narrow and cushioned with a thin layer of foam which makes them very comfy indeed. This is the 'wonderwire' in the name. They tack fully. There is an additional side sling that adds a bit more padding to the side wire and shapes very nicely.

Cups.  One vertical seam, resulting in a very rounded shape, which is not wide thanks to the narrow wires and side slings. The fabric is smooth and very supportive. I had zero jiggle. In terms of capacity, they run true to size and have moderate stretch. This is a real plus. Both full-on-top and full-on-bottom shapes are easily accommodated in this style.

Shape.  The best I've seen from Glamorise, which, as a more old-school brand, tends to favor a more pointy shape. It is a far better shape than I get from my other go-to cami-bra,N by Natori Truly Soft Bra. As an aside, this pic gives a very clear example of what a full-on-top shape is.

Here is how it looks under my favorite 'cut-way-too-low-for-anything-above-a-B-cup' top.  

    Compromises

Sides & Band. The band is very tall and the sides come up quite high, which is never a plus for me. And unfortunately, the elastic edging the top of the band and armholes is not soft and caused chafing by lunchtime. I really considered taking it off at that point. The only positive here is that there are no side stays. That also means, however, that there is nothing I can do to improve the comfort. 

I don't think this is a matter of softening through washing, either. The irritation it causes is similar to what I get from 'comfort' bras like the Ahh Bra, where the sides are just cut too high for comfort. The fabric is simply covering too much skin area so that even normal motion causes chafing of sensitive skin. If you do not have sensitive skin, and are not high-waisted, this may not even present any difficulties for you. 

When Do I Wear It?

When I want to wear a blouse that, when combined with my cup size, would otherwise risk making me look like I was on my break from working the pole. So, for going out with friends on weekends, when I'll be wearing it for 4 hours or less. If you don't mind tall bands and high sides, this is a very well-made bra, that is both practical and pretty, at a decent price. 

Size: 42F  Remember that Glamorise sizing is old-school US, i.e. the bands run tight, and you must add +4". This fits me like a 38GG (UK) or a 38I (US/Euro)