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Introduction: Menstrual toxic shock syndrome (mTSS) is a rare but serious complication associated with the prolonged use of intra-vaginal menstrual products. Significant research has been aimed at reducing incidence of mTSS that has resulted in proven sanitary practices. Reusable menstrual products have become increasingly appealing to consumers due to cost savings as well as the feel-good notion that comes with reducing waste. It is unclear if hygiene recommendations for menstrual cups are as efficacious at preventing the incidence of menstrual toxic shock syndrome when compared to that of tampons. Methods: A database search was conducted using PubMed, Medline, and Embase to review literature published after 1978. Specifications outlined in existing publications relating to menstrual cups and mTSS that have been found to reduce incidence of mTSS were chosen and analyzed for consistency in instructions for use of the top 5 most popular menstrual cup brands. Results: Of the five brands analyzed according to recommendations aimed at reducing mTSS in women using menstrual cups, only one brand met 3/5 recommendations. Discussion: MC hygiene protocols should be updated based on the suggestions presented in the reviewed literature in order to further prevent incidence of mTSS. Popular MC brands fall short of these recommendations most frequently in sizing, insertional instruction, and cleansing. Conclusion: The CDC guidelines lack clear guidance on hygiene measures for menstrual cups and need to be updated with specific information gleaned from research. Further studies should continue to examine the relationship between MCs, tampons, and mTSS.
Gingerich et al. (Thu,) studied this question.