What should you know about menstrual cups and toxic shock?

Toxic shock syndrome is a rare, serious illness caused by toxins made by certain bacteria. It has been associated with menstrual products, including internal products, although a cup is not the only possible source. Symptoms can develop quickly and may include a sudden high temperature, vomiting or diarrhoea, dizziness, faintness, muscle aches, headache, confusion, or a widespread rash.

A cup may irritate tissue if inserted roughly, left in longer than the product instructions allow, or used without clean hands. The risk cannot be removed entirely by hygiene, so knowing the warning signs matters.

Wash your hands before insertion and removal, clean the cup exactly as the manufacturer directs, and follow the stated wear time. Empty it as advised rather than extending use, and inspect it for damage. Use a cup that fits comfortably; stop if it causes persistent pain, sores, unusual discharge, or difficulty removing it.

Do not share a menstrual cup. If you have recently given birth, had pelvic surgery, or have an infection or wound, ask a clinician when internal products are suitable. Keep a backup external product available if the cup becomes uncomfortable.

Remove the cup and seek urgent medical care immediately if you develop sudden fever with vomiting, diarrhoea, dizziness, faintness, confusion, severe weakness, muscle aches, or a spreading rash. Tell the clinician that you were using a menstrual cup. Do not wait for symptoms to settle or restart the cup while unwell.

Ask whether a cup is suitable with your medical history, how soon you can use internal products after a procedure or birth, and what symptoms could indicate infection or irritation. Ask how to clean and replace your particular product if the instructions are unclear.