Menstrual cups have become the gold standard for sustainable period care, saving money, reducing waste, and eliminating the chemicals found in tampons, while also promoting better menstrual health. But with more women making the switch, a new concern has surfaced: Can menstrual cups cause prolapse of the pelvic organs?

This article goes beyond speculation. We’re looking at expert opinions, real risks, and safer alternatives for those who want to protect their pelvic health while managing their cycle.

 

Understanding Pelvic Organ Prolapse (POP)

Pelvic organ prolapse (POP) is a real condition that affects millions of women, often without them realizing it. It happens when the muscles and connective tissues that hold your pelvic organs in place become weak or overstretched, allowing your uterus, bladder, rectum, or urethra to shift downward into the vaginal canal.

It can impact everything from bladder control to bowel movements to sexual function. And once prolapse starts, it doesn’t just fix itself, it requires active care and awareness to prevent worsening symptoms.

Types of Pelvic Organ Prolapse

• Uterine Prolapse - The uterus drops into or even protrudes from the vaginal canal. This can create a feeling of heaviness or pressure in the pelvis, sometimes with a visible bulge.

• Cystocele (Bladder Prolapse) - The bladder falls forward into the vaginal wall, leading to frequent urination, incontinence, and difficulty fully emptying the bladder.

• Rectocele (Rectum Prolapse) - The rectum pushes into the back wall of the vagina, making bowel movements more difficult and causing sensations of pressure or incomplete emptying.

• Urethrocele (Urethral Prolapse) - The urethra sags downward, leading to leaking urine with activities like coughing, sneezing, or jumping.

 

Causes of Pelvic Organ Prolapse

1. Childbirth Trauma and Vaginal Deliveries

Vaginal birth is one of the biggest contributing factors to POP. The intense stretching and pressure placed on the pelvic floor during labor, especially with forceps or vacuum-assisted deliveries, can damage muscles and connective tissue. Dr. Jocelyn Fitzgerald, a urogynecologist at the University of Pittsburgh, emphasizes that such deliveries can weaken pelvic support structures, increasing the risk of POP.

Even an “easy” vaginal birth can lead to micro-tears in the pelvic floor that weaken support structures over time. For some women, the effects show up right away (a feeling of heaviness, incontinence). For others, menopause or a second pregnancy is what brings hidden damage to the surface.

2. Hormonal Changes During Menopause

Estrogen is critical for keeping connective tissues strong and elastic. When estrogen levels drop during menopause, the pelvic floor loses its natural resilience.

Postmenopausal women experience a higher rate of prolapse progression, as declining estrogen makes tissues thinner, weaker, and less able to hold organs in place. Hormonal changes during menstruation can also make prolapse worse, particularly when estrogen levels drop.

Hormone replacement therapy (HRT) may help slow down this process, but for women avoiding synthetic hormones, pelvic floor exercises and tools to strengthen the pelvic muscles are crucial.

3. Chronic Constipation and Straining

You might not think twice about how you poop, but bearing down hard and frequently can weaken your pelvic floor over time.

Every time you strain, you’re creating the same downward force that contributes to prolapse. Chronic constipation puts ongoing pressure on the pelvic floor, stretching muscles and making it harder for them to rebound.

The Cleveland Clinic emphasizes that long-term constipation is a leading, yet overlooked, cause of pelvic floor disorders. Women who struggle with poor gut health, low fiber intake, or IBS are at higher risk of developing POP due to repeated straining.

4. Obesity and Excess Abdominal Pressure

Carrying extra weight places constant pressure on the pelvic floor, making it harder to keep organs in place. Obese women are at higher risk for prolapse because of the increased intra-abdominal pressure pushing downward on pelvic structures.

Even a moderate weight loss (5-10% of body weight) can reduce prolapse symptoms and improve pelvic function.

5. High-Impact Activities (Weightlifting, Running, HIIT Workouts)

Exercise is essential for overall health, but certain movements put excessive strain on the pelvic floor. High-impact activities like long-distance running, jumping, and heavy weightlifting create repeated downward force on pelvic organs.

Many women unknowingly worsen early-stage prolapse by performing high-intensity workouts without proper pelvic engagement. Exhaling during heavy lifts can alleviate pressure on both the abdominal muscles and the pelvic floor.

6. Aging and Genetic Predisposition

Aging naturally leads to muscle loss and tissue weakening, but some women are genetically predisposed to weak connective tissue, making them more prone to prolapse.

Genetic factors play a role in POP risk, particularly among women with a family history of prolapse or incontinence.

If your mother, grandmother, or aunts struggled with pelvic floor disorders, being proactive with strengthening exercises, proper posture, and body awareness is essential.

7. History of Pelvic Surgery (Hysterectomy, C-Section, Other Pelvic Procedures)

Any surgery that removes or alters pelvic support structures can increase the risk of prolapse. The National Institute of Health states that hysterectomy (removal of the uterus) is a major risk factor for prolapse because it eliminates one of the pelvic floor’s central support points.

Similarly, C-sections and other pelvic surgeries can lead to scar tissue and weakened muscle tone, making it harder for the pelvic floor to function properly.

Prolapse Symptoms: How to Know If You Have It

• A heavy, dragging sensation in the vagina - One of the first red flags. Some women describe it as feeling like something is “sitting” inside them.

• A bulging sensation or visible bulge at the vaginal opening - In more advanced stages, prolapse may become visible or palpable.

• Urinary urgency, leakage, or difficulty emptying the bladder - Bladder prolapse (cystocele) makes urination difficult or causes leakage when laughing, coughing, or exercising.

• Constipation, straining, or incomplete bowel movements - If you feel like you can’t fully empty your bowels, rectal prolapse (rectocele) could be at play.

• Pain or discomfort during sex - Many women with POP experience reduced sensation or pain during intercourse because of shifted organs.

• Lower back pain - Pelvic misalignment due to prolapse can contribute to chronic, unexplainable lower back pain.

 

Potential Menstrual Cup Risks to Pelvic Health

While menstrual cups are generally safe, certain practices may pose risks to pelvic health:

• Suction Force Concerns: If the suction seal isn’t properly released before removal, the resulting downward pressure can strain the pelvic floor muscles, potentially contributing to prolapse over time. Physiotherapist Kate Lough highlights that improper removal techniques, such as not breaking the seal, can increase the risk of damage to vaginal and pelvic tissues.

• Incorrect Insertion Technique: Inserting the cup too high can exert undue pressure on the cervix or vaginal walls, leading to discomfort or potential pelvic issues.

• Impact on Weakened Pelvic Floors: Individuals with existing pelvic floor weaknesses or prolapse may experience increased discomfort or exacerbation of their condition when using a menstrual cup. Pelvic health specialist Keri Martin Vrbanac advises that those with a 2nd or 3rd-degree uterine prolapse should avoid using menstrual cups.

• Menstrual Cup Size and Firmness Considerations: Choosing the appropriate size and firmness is vital. Firmer cups may apply more pressure to the vaginal walls, while softer cups might require stronger pelvic floor engagement to maintain proper positioning. Finding the best menstrual cup for your needs can help manage symptoms effectively and reduce risks.

 

Yoni Eggs & Pelvic Floor Strengthening - Holistic Prevention & Healing

Yoni eggs teach neuromuscular control, the ability to contract and release muscles with intention rather than clenching out of habit. Many women unknowingly over-tighten their pelvic floor, creating tension that contributes to prolapse rather than preventing it. A yoni egg helps retrain the muscles so they function in harmony with the rest of your body.

Yoni eggs increase circulation and resilience. Blood flow is everything when it comes to healing tissues, especially after childbirth, menopause, or hormonal changes that weaken the vaginal walls. Using an egg gently activates the deep pelvic muscles, encouraging circulation and restoring lost elasticity.

Most importantly, yoni eggs help with prolapse prevention by teaching controlled engagement. When you grip a yoni egg correctly, you train your body to lift and support rather than push down and strain. This is the missing link for so many women—pelvic strength should feel effortless and aligned, not forced.

When NOT to Use a Yoni Egg

There are times when a yoni egg isn’t the right choice. If you have advanced prolapse (stage 3 or 4), active pelvic pain, or unaddressed muscle tightness, inserting an egg could cause more harm than good. Always listen to your body and, if unsure, work with a pelvic floor therapist to determine if yoni eggs are a good fit for you.

 

Free Bleeding: A Gentle, Zero-Risk Alternative

If you want to completely eliminate internal pressure, suction, or risk to your pelvic floor, free bleeding is the answer. Unlike tampons or cups, free bleeding allows the uterus to release blood naturally, without resistance.

For centuries, women bled without obstruction, letting the body’s natural process unfold without interference. Free bleeding removes any risk of vaginal pressure, misalignment, or downward strain.

 

How Free Bleeding Benefits Your Pelvic Health

Most women assume internal products are the only option for managing periods, but menstrual cups and tampons change the way the vaginal canal functions during menstruation. Free bleeding removes any interference, allowing the cervix to open and release blood at its own natural rhythm.

Zero Pressure, Zero Suction

Menstrual cups create a seal around the cervix, which can pull on vaginal walls during removal. Free bleeding removes this entirely, reducing the risk of any unnecessary strain on the pelvic floor.

A Natural Connection to Your Cycle

When you let your blood flow freely, you become more aware of its patterns, textures, and colors. This isn’t just a spiritual practice, it’s a way to monitor reproductive health in real-time. Changes in flow, consistency, or clotting can indicate hormonal imbalances, inflammation, or nutritional deficiencies.

Full-Body Awareness & Comfort

Many women who practice free bleeding report less cramping and bloating, likely because the uterus isn’t fighting against tampons or a suctioned cup. By allowing the blood to exit naturally, your body works with your cycle, not against it.

For those concerned about comfort and practicality, using a designated Free Bleed® blanket offers an easy, stress-free way to embrace this practice.

 

Conclusion

Menstrual cups are not inherently dangerous, but improper use, especially failing to break the suction before removal, can strain the pelvic floor. If your pelvic floor is already weakened due to childbirth, menopause, or chronic straining, you need to be extra mindful of how you insert and remove your cup. Pelvic organ prolapse is multifactorial, menstrual cup use alone won’t cause it, but for women at risk, small changes in habits make a big difference. If something feels off in your body, trust that instinct and adjust.

The most important takeaway? You have options. If menstrual cups don’t feel right for your body, or if you’re experiencing discomfort, listen to those signals. There are safer, body-honoring alternatives that protect and even strengthen your pelvic health.

 

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