The ins and outs of the best tampon alternatives

An upside down menstrual cup sits next to a tampon on a pink table.

As someone who's passionate about reducing waste, one area I’ve found myself lacking is in my use of tampons. But reducing waste isn't the only reason to make the switch to tampon alternatives: A reusable period product like menstrual cups, menstrual discs, reusable pads, and period underwear can also save you a ton of money in the long run. A single reusable disc or cup, for instance, only costs $30 to $40 to start and can last up to 10 years, which ends up way cheaper than buying new tampons and pads each month.

Various menstrual items including cups, discs, and period underwear laid out on a gray background.
Discs, cups, underwear, and pads Credit: Anne Loreto Cruz

Since the pandemic has me working from home, I figured it was the perfect time to try more than a dozen menstrual products without having to worry about bleeding through my pants during a 40-minute commute on the subway. Here's what I found out.

Menstrual cups, $20-40

One of the most common alternatives to tampons and pads are menstrual cups, which collect blood from inside the vaginal canal for up to 12 hours at a time. I’d been wanting to switch over to a more reusable product like a cup for a while, but I'd felt too overwhelmed by the wide variety of options of styles, sizes, and shapes to make a choice.

Here's what I learned in writing this story: The general shape of a cup is typically the same between different brands, but some are longer than others to account for higher or lower cervixes. (You can easily measure your cervix height with a finger if you’re not sure.) Another factor to consider is diameter. Many brands suggest slim or small options for someone like me (under 30, hasn’t carried a full-term pregnancy), but those are just suggestions. There are quizzes you can take to see what products potentially match well with your body and lifestyle, but each person’s vagina is different, so you may need to experiment to find the best fit.

Kim Rosas, menstrual product expert and founder of Period Nirvana, a site that helps people better understand and shop for menstrual products, noted that even a perfectly sized cup will take a few cycles to work out the kinks. Don't get discouraged if it doesn’t seal perfectly or feel comfortable right away.

Three different menstrual cups laid next to each other on a gray background.
All kinds of cups Credit: Anne Loreto Cruz

“Knowing what cup is going to work for you definitely cuts down on some of the mishaps that could potentially happen,” she said. “But certainly even with an amazing cup, the perfect cup for you, it still takes some time.”

I ordered three cups likely to work for my body type: the Flex cup, an ergonomically shaped Kind cup, and the Saalt Soft cup, which Rosas said has a good chance at fitting an “average” vagina (Disclosure: As a former team member of Put a Cup In It, a menstrual product blog, Rosas collaborated with Saalt to develop their Soft cup in 2019.)

A flex menstrual cup next to its packaging.
Credit: courtesy flex

The Kind cup was an initial favorite. It was easy to insert and felt more comfortable than using a tampon. Since it has an asymmetrical design, I was slightly worried that if I twisted it during insertion it wouldn’t sit as well, but I didn’t experience any leaks or discomfort while wearing it, and other than that, using the Kind cup was a breeze. Another cool feature is its extra long stem, which helps you find the cup with your fingers for removal and can be trimmed for comfort.

As with most cups, the stem is merely used to find the base of the cup when it’s time to take it out after 12 hours or when full. While the design of a cup's stem is reminiscent of a tampon, you definitely shouldn't pull it out the same way. Always release the cup’s suction before pulling it out; you do this by pinching the cup’s base to break the seal.

The best way to clean a cup in between uses is to dump its contents in the toilet, then rinse it clean in a sink before reinserting it, but you can wipe it down with toilet paper or disposable wipes if you don’t have access to a sink. Removing and dumping the contents of a cup is definitely a bit more hands-on than pulling out a tampon, but once you get the hang of pulling a cup out, most of the blood stays in the cup rather than getting all over your hands.

A pair of hands stretches out a black menstrual cup.
Credit: Flex

A note of warning: Menstrual cups might not be the best option if you use an intrauterine device, said June Gupta, a Maryland-based women’s health nurse practitioner and the director of Medical Standards at Planned Parenthood Federation of America. “The suction from removing the cup can cause your IUD to move out of place, making it less effective at preventing pregnancy,” Gupta explained in an email.

Since I have an IUD myself, I proceeded with utmost caution while trying out the other cup options. The Flex cup had a cool pull tab design that unseals the cup so you don’t have to pinch the cup’s base, but overall I’d still be too spooked about the risks to my IUD to use these regularly. And while I really wanted to like the Saalt Soft cup, I found it too difficult to remove compared to the other two cups I tried.

Menstrual discs, $13-40

Another tampon alternative that Rosas recommends are reusable menstrual discs. Discs are tucked between the vaginal fornix and the pubic bone instead of sitting in the vaginal canal like cups. To insert, you squeeze the disc to form a narrow shape and insert it into your vagina like you would a tampon, then lightly push the front edge of the disc up behind your pubic bone to set it in place.

One selling point for discs is that you can have penetrative sex while wearing them. Rosas also said that since discs don’t sit in the vaginal canal, they fit more universally and require less guesswork than cups. “Cups can sometimes slide down or be forced out, because they're held with muscle tone,” Rosas said. “But discs are far less finicky in that department.”

Since they don't require a seal or suction within the vaginal walls to stay in place, they're also a possible alternative to cups for people with IUDs.

I first tried Ziggy, a reusable menstrual disc by the brand Intimina, as well as disposable discs from Flex and Softdisc. Inserting the Ziggy felt so easy compared to wrestling with menstrual cups that it felt too easy.

A pair of hands holds two hot pink menstrual discs.
Credit: Ziggy by Intimina

The Ziggy felt more comfortable to me than the disposable discs I tried, since its rim is made with super soft silicone rather than firm plastic. I also tried another reusable disc, Nixit, and found it easy to insert and comfortable to wear.

However, all of the discs involved a bit of hassle to remove. To take out a disc, you need to catch the rim of the disc with a finger, then pull it down to untuck it from behind the pubic bone. Since the area where blood collects is a shallow dish that doesn’t really hold its shape, it acts somewhat like a piece of paper underneath a glass of water: Once removed, blood kinda gets everywhere no matter what. Rosas recommended taking discs out in the shower until you get the hang of it, then you can try removing them over the toilet and somewhat aim the mess into the toilet (I have not gotten there yet).

With disposable discs, you simply throw them away after a single use. With reusable discs, you can rinse them clean just like you would a menstrual cup, then sanitize them by boiling for five minutes at the end of your cycle.

A pink and clear menstrual disc sits next to its packaging.
Credit: Softdisc

Being able to have mess-free period sex was also a neat feature, although it’s a bit of a misnomer. It’s “mess-free” for the person not wearing the disc, as there’s plenty of mess once the disc has to come out. I barely felt the discs during sex, though my partner reported that certain positions were less comfortable for him while I was wearing it. I didn’t love the disposable discs (the rim was more firm and noticeable once inserted, and the crinkly plastic was off-putting) or the waste they create, but since discs can be worn for up to 12 hours at a time, they still create less waste than tampons.

Reusable pads, $10-22

If internal menstrual products aren’t appealing to you, reusable pads are a great option to reduce waste with a minimal learning curve. They function essentially the same as disposable pads, except they use snaps instead of adhesive to stay in place.

I tried a pack of reusable pads from Simfamily, which comes with six pads and a carrying case. For folks more used to pads, these were nearly the same, except that the lack of adhesive causes the pad to shift and need adjustment throughout the day. You can wear these for up to eight hours, but how frequently you change them out will depend on how heavy your flow is, just like with a disposable pad.

I also tried reusable pads from Aisle, which has been making reusable period products since the early ‘90s. The pads from Aisle felt much less bulky than the ones from Simfamily, and they didn’t tend to slide around as much either.

Reusable patterned pads resting on an orange and red backdrop.
Credit: Aisle

To clean these after each use, you can rinse or pre-soak the pads, then toss them into the washer.

As someone more accustomed to internal period products like tampons, the pads weren’t my favorite. Between the two brands I tried, the Simfamily pads left me feeling slightly sweaty and uncomfortable after long periods of sitting at my desk, but they’re still a good choice for someone looking to get into reusable pads on a budget. If you’re willing to invest for more comfort (and cute muted styles), the Aisle pads were my favorite in this category.

I also tried interlabial pads, small petals of cloth you tuck into your labia rather than insert into the vagina, but they were definitely the most uncomfortable option I tried. Rosas agreed, describing the feeling of the petals as like “a constant wedgie.” Without a dedicated laundering bag, these were also a pain to wash, and got lost in the nooks and crannies of my dryer.

Period underwear, $15-50

Rosas said period underwear can serve as an excellent backup for cups or discs so you can get the hang of things without worrying about leaks. They’re also great for full-time use for lighter days or for those looking for a sustainable option who don’t want to use internal menstrual products. There’s no set interval at which you have to swap out your period underwear, but after a few hours bacteria begins forming and they’ll start to smell pretty gross, so it’s a good idea to change them out regularly.

When you change out period underwear will also depend on the underwear’s absorbency and your flow. My period is pretty light, so I never fully saturated any pairs with blood, but someone with a heavier flow will want to either reach for higher absorbency pairs or plan to change them out regularly to prevent leaks.

Three diverse people sit together on an orange sofa.
Credit: Aisle

Some of the different brands I tried felt like wearing an awkward built-in pad; others felt remarkably similar to my regular underwear. Overall, I found period underwear to be a great option for when I’m staying home, but I could see changing pairs in the middle of the day being an issue if I were working in an office.

My favorite pairs were the Knix dream short, which felt super comfy and cute while also promising great overnight absorption, and the Innersy 3-pack of underwear, which would be good for lighter days and was the most affordable period underwear I tried. Aisle’s boxer briefs were also super comfy to wear and can be a great option trans or nonbinary people who menstruate.

To best clean period underwear, most companies recommend pre-soaking or rinsing with cold water before tossing into the wash. It’s not a ton of work, but I do think my roommate would be somewhat surprised to see my blood tinged underwear drip-drying in the tub.

And ... sea sponges?

Of all of the products I asked Rosas about, there was only one she hadn’t tried: menstrual sea sponges. (Disclosure: I didn't try them, either.)

“I am going to fully admit that I'm not brave enough to try that product,” she said. “And I've put a lot of sketchy looking things in there to try in the name of testing products.”

Rosas said that the unregulated nature of products like sea sponges and homemade tampons gives her pause. When I looked into menstrual sponges for myself, I found that the FDA also classifies menstrual sponges as “significant risk devices,” which can pose serious potential risks to the health and welfare of the user. In comparison, products like menstrual cups and discs are made with medical-grade materials, and must be cleared for sale in the U.S. by the FDA.

June Gupta agreed with Rosas’ concern for untested period products, saying that not all tampon alternatives are good ones. As with anything else you might put in your body, it's always a good idea to do your own research or consult with your doctor before making major changes to your period routine.

“Crocheted or cloth tampons are untested, unregulated, and can potentially cause dangerous problems including toxic shock syndrome, which is what happens when there is an overgrowth of staph bacteria in the vagina causing your body to go into shock,” Gupta said. And no one wants that.

This story was published in 2021 and updated in June 2022.

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