Do Menstrual Cups Raise Infection Risk? What a 2026 Review Found

"Is it hygienic to keep blood inside?" is one of the most common questions I hear from patients thinking about a cup. This year we got a better answer.

What the review looked at

A systematic review and meta-analysis published in eBioMedicine in 2026 pulled together every trial and observational study it could find (searched through January 23, 2026) that compared menstrual cup users with people using other products, and measured laboratory-confirmed infections or the vaginal microbiome. That is an important detail: it counted infections confirmed by a test, not just self-reported symptoms.

It included 11 studies and 10,268 participants from Africa, Europe, and the Americas.

What it found

No increased infection risk was seen among cup users for any of the infections the authors evaluated.
Bacterial vaginosis (BV): when observational and randomized studies were combined, cup users had about a 21% lower prevalence of BV (prevalence ratio 0.79).
Sexually transmitted infections: in two randomized studies in Kenya, cup users had a 26% lower risk of STIs than non-cup users.
Microbiome: cup users were more likely to have a vaginal microbiome dominated by Lactobacillus crispatus, the profile we generally associate with a healthy, protective vaginal environment.

What it does not prove

I want to be careful here. Only 3 of the 11 studies were rated good quality, and the STI finding comes from one country. "Associated with" is not the same as "causes." A cup is not a treatment for BV, and it does not replace condoms or STI testing.

What the review does do is answer the worry many people have: when used as directed, cups did not show higher infection rates than other products in these studies.

How to keep your risk low

The review is reassuring, but hygiene still matters. The FDA's guidance for menstrual cups is simple:

Toxic shock syndrome with cups is rare, but cases have been reported. Follow wear-time and cleaning instructions, and do not use a cup if you have had TSS.

Wash your hands before and after handling the cup.
Empty and rinse it according to the instructions for use. The FDA notes cups are typically emptied every 8 to 12 hours; empty sooner on heavy days.
Between periods, wash it and boil it for one to two minutes (or follow your cup's instructions).
Stop and call your clinician if you have itching, rash, pain, swelling, or unusual discharge.

Sources

Disclosure: Dr. Elena Dolgan is an OB-GYN and the creator of the Leia Menstrual Cup. This article is educational and is not a diagnosis or a substitute for individualized medical advice. If you have symptoms of infection, see your clinician.

van Eijk et al. Effect of menstrual cups on vaginal health, reproductive tract and urogenital infections: a systematic review and meta-analysis. eBioMedicine, 2026. Read the study00189-1/fulltext)
Liverpool School of Tropical Medicine. LSTM led review finds menstrual cups linked to improved vaginal health and lower infection risk. 12 August 2026. LSTM news
U.S. Food and Drug Administration. Menstrual Cups. FDA

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