Ah, the magnificent vaginal canal. While many may not use the word magnificent to describe the vagina, we at Diva know how important the vagina is to a women’s health, reproduction, and overall daily comfort. Whether just learning about puberty, or a woman well-versed in all things vagina (and period), there is still lots we can learn from the experts.

Keri Martin Vrbanac is an expert pelvic health specialist who is on a mission to help women find support for their pelvic region (and with the DivaCup). We sat down with Keri, bringing her some case studies that our Consumer Support Team often see from women who are finding some challenges with using a menstrual cup. For some new users, and also some long-time Divas, finding continued success with the cup can take some time as the vaginal muscles (the muscles that hold the DivaCup in place) may require additional support.

The below are just snapshots of the many ways pelvic health physiotherapy can help women find better success with the DivaCup and in turn, better vaginal and pelvic health!

Scenario 1:

I’m a runner and a yoga enthusiast. At 19, I wanted to change my period care routine to a better option so I invested in the DivaCup. I purchased the Model 1 as I am under 30 years old and have not had children. Unfortunately, my experience thus far has not been great. I’m having a really hard time with insertion and rotation. It almost feels as if the cup is too big for me. Please help!

Keri: It is possible that your pelvic floor muscles are hypertonic, or in other words, too tight. Some women with hypertonic pelvic floor muscles may experience pain when using any internal menstrual products or may have pain with intercourse. The only way to know the status of your pelvic floor muscles for sure is to visit a pelvic health physiotherapist in order to have an assessment completed. If it turns out that the floor is too tight, your therapist will educate you on how you can remedy the problem and perhaps return to comfortable use of the DivaCup.

Scenario 2:

I used the DivaCup for six years before I became pregnant. Fast forward a year and a half and my period has returned. I’m using the Model 2, I am 33 years old and my cup just doesn’t seem to stay in place very well. I am also experiencing leaking; something I have never had an issue with before! I used the Model 1 for a number of years and then switched to the 2 when I turned 30. Could it be that I need the smaller size again?

Keri: There is a possibility that your pelvic floor muscles have become weak following your pregnancy/delivery and are no longer strong enough to hold your cup in place. It is possible for you to strengthen those muscles through proper exercise, but before you begin any form of pelvic floor muscle exercises, you should visit a pelvic health therapist to determine if your pelvic floor is tight or weak, or both. Kegels are not for everyone and in some cases can actually cause more harm than good so consulting with a specialist before incorporating these kinds of exercises is important.

Scenario 3: 

I am 38, don’t have kids and am using the DivaCup model 2. The cup is easy to insert and rotate, but after a few hours, it begins to move up. Around this same time, the cup also starts to leak. I’m sure I am inserting the cup correctly, but when it moves up it makes it difficult to remove. Any advice would be greatly appreciated.

Keri: Your pelvic floor muscles may be hypertonic or too tight. Trying the smaller sized cup may help, but as there is a small difference in the size (Model 1 is 1/8″ (~0.3 cm) smaller), it may be that your muscles need to be elongated or relaxed. Sometimes a smaller pelvis can also affect the tone of the musculature but not always. The only way to know the status of your pelvic floor muscles for sure is to visit a pelvic health physiotherapist to have an assessment completed.

Scenario 4:

I’m 26. I do no have kids and have been using the DivaCup model 1. The cup is amazing. As a nurse I can go an entire shift without worrying about leaks… until I go to bed. While sleeping it seems as though the cup moves lower and begins to leak. Do I need the bigger size? Why is it that it fits fine during the day, even on my painful heavy days, and not at night?

Keri: Just like the rest of the muscles in our body, the pelvic floor muscles will relax when we are resting. Our pelvic floor muscles do not have to work as hard when we are sleeping because we do not require as much support. Position changes throughout the night may cause a shift in the position of the cup as well. Supported sleeping with a pillow between your knees may help maintain a more restful position and prevent frequent position changes.

Guest Post: Your Pelvic Floor and The DivaCup

Scenario 5:

My period has returned after having my fourth child. I’m 39 years old and using the DivaCup model 2. The cup doesn’t seem to want to stay in me. It falls so low that it is essentially falling out. I am really frustrated that I’m not finding success with the cup. All my friends rave about it.

Keri: It is possible that you have a bladder or uterine prolapse which means that one or both of these organs have lowered into the vaginal canal. With less space available, The DivaCup may be pushed downwards. A pelvic health physiotherapist can diagnose a prolapse and work with you to decrease its impact on your life.

Scenario 6:

As a gym enthusiast I love lifting weights, I also love the DivaCup, except when it leaks. I find that when I go through my weight routine, the cup begins to move out of place and leak, almost as if the seal has been broken. Could my muscles tense so much that they are breaking the seal?

Keri: Yes, your pelvic floor muscles could be tight OR they could actually be weak. With weight lifting, we increase our intra-abdominal pressure and this in turn causes a downward pressure on our pelvic floor muscles. A pelvic floor physiotherapist can determine the status of your floor and tailor your program to address this issue as well as provide tips for safe exercise and maintaining your pelvic health.

Keri Martin Vrbanac

Guest Post: Your Pelvic Floor and The DivaCup

Keri is a Pelvic Health Physiotherapist and the owner of A Body In Motion Rehabilitation in ON, Canada. Keri has been practising physiotherapy since 1997 where she graduated with distinction with her Bachelor of Science in Physical Therapy from the University of Toronto. Keri’s career as a physiotherapist has brought her to Australia, the United States of America and back to Canada where she has settled in Conestogo with her husband and her two amazing little girls! Keri’s passion for pelvic health is contagious and she continues with ongoing education to fuel her passion and remain current. Keri is a member of the Canadian Physiotherapy Association, The Ontario Physiotherapy Association, The International Pelvic Pain Association, The National Vulvodynia Association, and The Association for Continence. You can contact Keri at abodyinmotion@theboardwalkmedical.com.