Dear Lorna,

Thank you for your comments.

Early in our project, I wrote to many menstrual cup companies, asking for donated cups for the indigenous women here, and none stepped up to offer any. I did not write to Mooncup, but other companies only offered discount prices down to US $ 7 or 10 depending on quantities. Mooncup sells each cup for 30 English pounds and I found no indication on their website that donate any cups, but only offer "subsidized" prices.

With the high-quality Chinese cups that I have tracked down (which are also registered with the US FDA), we do not have to beg anyone for charity and these low-income indigenous women themselves can afford all the real costs, without any smoke or mirrors. Mooncups are made in Britain, but most brand names are likely made in these same factories (and none of the factories will tell you who their clients are, to respect these trade secrets).

Some people talk about cheap, Chinese cups smelling terribly of chemicals, but these have no noticeable chemical smell, especially after the 24 hours of soaking in water and 10 minutes boiling that I recommend our users to do before starting to use new cups.

At some point, I may publish here the name of the Chinese factory that I buy from, but I am concerned that if they get too famous they may raise the price or slack off on quality. For now, I would like to personally introduce interested persons to the saleslady, so that she knows that people are getting to her via me, thus contributing to keeping the price they charge me low,

Being a man, I have no first-hand experience using these cups, but it seems the difficulty of the training period depends largely on the quality of information women receive in the initial training. From reading all the info I could find and conversations with various users, we have arrived at the following key suggestions:
--The "Push-down Fold" seems to be the best for insertion, since the whole cup and especially the tip get very small.
--It is not recommended to practice insertion during non-menstruation days, since lubrications, etc., are not the same.
--The first insertion is most problematic and it is best to do this on the second day of a menstruation, when lubrication is roughly greatest.
--Once released inside the vagina, the cup should be spun, squeezed from different angles, pushed a bit and pulled a bit, plus she should feel that that the cup is round and symetrical, all to insure that the cup has opened completely and has sealed to the walls of the vagina.

More info and instructions are found on this page in Spanish (which I can translate at some point):
omaere.wordpress.com/2017/04/03/copas-me...-mujeres-amazonicas/
The instructions are focussed on conditions out in isolated communities in the Amazon. One innovative suggestion is that, if safe, clean water is not available, women can rinse cups with their own fresh urine, which is sterile, warm, readily available, and even antiseptic.

Best wishes,
Chris Canaday

Hi Chris and everyone,

I recently went to a talk in London on MHM and Mooncup were part of the discussion. They spoke about their charity partnership scheme so it may be worth applying for this Chris?

They support charities with free mooncups and are quite involved in the process to monitor the impact.
www.mooncup.co.uk/why-mooncup/charity-support/

Mooncup recently conducted a research piece on MHM mooncup vs pad interventions in 30 schools in western Kenya, in collaboration with Liverpool school of tropical hygiene and other partners.

Their baseline survey showed 1 in 10 girls younger than 15 without menstrual hygiene support admitted they would have sex with males to obtain pads.

Findings showed that it took training and 3 cycles to get used to the cups. (from personal experience I would agree with this, Mooncup also offer an advice line in the UK which gets a lot of traffic from women learning to use them initially) Girls in Kenya don't typically use tampons so were unused to inserting something into the vagina. Some women may be confident immediately but I would say this is quite unlikely in many cases and it takes time to get to grips with how to use the cup.

After 9 months, girls with mooncups or sanitary towels had lower prevalence of sexually transmitted infections.

Girls with mooncups had lower prevalence of bacterial vaginosis (BV) which could reduce HIV/STI transmission, infertility, maternal risks.

Full research report - bmjopen.bmj.com/content/bmjopen/6/11/e013229.full.pdf

Mooncup have found (in a different project they support) that they can effectively equip women who have given birth with mooncups, by first training health care practictioners/ midwives/ traditional birth attendants to use the cups.

9 months later, once the health care professionals/ or local community equivalent, are confident in using them themselves (again, if they want to) they then become advocates and teachers to the mothers that they visit. The mothers learn over a period of visits and can ask questions to them in confidence. Mothers then teach their daughters/ other women, once they feel confident themselves.

Nerf International are working on Cup distribution to women in Nepal so it may be worth contacting them to look at their model and learn from their experience.

www.nerfinternational.org/who-are-we/

All the best with your work.

Lorna

Hi everyone,

Quick update on our project.

The first shipment of 100 Chinese cups arrived in July, plus 3 German-made MeLuna cups.

The Chinese cups are very good quality. I have shown them to numerous visitors to our ethnobotanical park (including many menstrual cup users) and none have said that they were of inferior quality. They are of similar quality to the German cups and (of a small sample of women) most prefer the Chinese cups. This despite the German cups costing 20 euros each in a shop in Belgium and the Chinese cups costing US $1.28 each including shipping to Belgium.

The indigenous women here are gradually learning about and using these cups. My adopted daughter (who is indigenous) is very happy with her cup and had no trouble using it from the first time. Some indigenous women have started bringing handicrafts to trade for cups.

I can share the contact information for this Chinese factory via email.

Best wishes,
Chris Canaday

Hi Elisabeth,

To find these inexpensive menstrual cups, all you have to do is search eBay, AliExpress or Alibaba. I like Alibaba, because you actually know which factory the cups come from, while on the others you only see some random anonymous vendor. The disadvantages are that you have to negociate the whole deal and one is left with doubts on quality until receiving the first shipment..

I have been asking them for email addresses of satisfied Western customers, but they do not want to give me any, which I interpret as potentially a trade secret of the brand-name menstrual cup companies. Also, many of the factories offer customized colors, designs, and logos.

We should not be suprised that this manufacturing happens in China, since they do so much of the world's manufacturing in general.

I would not post this info on Wikipedia, but once we have confirmed good suppliers, we can share the contacts with interested parties. If we post the info publicly, those factories might might not be so careful about quality or greatly increase their prices.

Best wishes,
Chris Canaday

I just wanted to clarify one fact:
Carol said: "Someone told me that near-boiling water will not damage them."

In fact, the recommendation is to boil the menstrual cup for around 20 minutes at the end of the menstrual cycle in order to disinfect it. After that, it is stored in a little cotton bag, ready for action again 28 days later. So boiling on the stove top (or in the microwave) is a good thing.

Not sure what you meant with "They can get very organic".

Chris: how did you find all this out about the very cheap Chinese menstrual cups (copies of brand names?). Is that information easily available? Should it be added to the Wikipedia article?
In China itself, tampons are apparently rarely used and probably menstrual cups not either. So it's interesting that they produce lots for women outside of China?

Regards,
Elisabeth

In reply to questions: I have experience in North America, India, and Mexico.
Personally, in my circle of women, menstrual cups are embraced by some but tried and rejected by others. You will see the same experience with diaphragms. The cups can be bulky and also not always easy to remove. They can get very organic and do well to be soaked in vinegar or peroxide now and then. Someone told me that near-boiling water will not damage them.
Women all over have variously used pessaries and rags in their under garments.
Some cultures and sub-cultures do not like to insert anything vaginally such as tampons, etc.
And now some programs are introducing pads filled with coconut coir, etc.
There are books about menstrual practice and lore.
Good luck.

Hi Carol and Elisabeth,

Thanks for your input.

Carol, I am surprised to hear about lemon peels used as menstrual cups. Please share links or bibliography about this.

I would also be very surprised if women in developed countries would ever put random rags in their underwear, except in an emergency. Washable, cloth pads would be a different story ... but a lot more work than emptying and rinsing cups ... and not so great if you get caught out in a rain storm.

Elisabeth, apparently many of the brand-name cups are made in these same Chinese factories and the detail of which is a trade secret. The final "developed world" price is presumably due to marketing, name, supply and demand, and the fact that people can justify buying it instead of so many disposable products. Most of these factories have certificates of complying to FDA and other standards (even though these certificates were not emitted by FDA, etc, but instead some Chinese laboratory). I am also planning on washing and soaking these cups extensively, to make sure that any chemicals that may be leaching out finish doing so before the cups are given to anyone.

I am certain that most of the indigenous women here do not simply let their menstrual blood drain directly, as I have spent a lot of time in the communities and this is never seen. One exception may be the women of the Secoya People, who traditionally live in small huts out in the woods during the 3 or so days of menstruation.

The inexpensive cups are not disposable and are reported to last over 10 years.

Best wishes,
Chris Canaday

Hi Carol and all,
I've never heard of scoped-out half lemons as a type of menstrual cup. Do you have more information (and references) on that?

Yes, suppliers of menstrual cups usually offer two sizes: one for women who haven't given birth yet and one for women who have. I don't see that as a problem though because the price of one (e.g. 20 USD) for the duration you can use it for (5 years or more) really makes it a very cheap solution - even if you have to buy a new one after giving birth.

What did you mean by "The silicone cups can be very uncomfortable"? As with most things there are personal preferences: some women like them and some don't. From my personal experience with friends is that most people in Germany (and Australia) had still to this day never heard of this option. Those that were game to try a cup liked it about 8 times out of 10 (I mean out of 10 people who tried it out, about 8 continued and 2 abandoned them). My rough guess, would be good to read more studies on that.

For anyone who's interested: we have a pretty good Wikipedia article about menstrual cups, see here:
en.wikipedia.org/wiki/Menstrual_cup

Chris, I wish you good luck with your project of menstrual cups for Amazonian women!
Like Susannah, I also wondered what your target group currently uses. If they are "Amazonian indigenous women who live in villages far out in the forest, away from cities" then I wonder if the practice is perhaps to simply let it run down your legs (which was apparently also common in Europe in the middle ages or before?). Wearing underwear wasn't always the norm for women (hard to imagine nowadays, isn't it).

Oh by the way, I agree with Carol: If you have - on occasions - no water available, you would just empty the cup and re-insert it without rinsing it. I wouldn't want to pee on it, but I suppose you could (getting the timing right might not be easy). Re-inserting would require fingers that are as clean as possible.

And I didn't realise they can now be bought for just 1 US$!? You said:
There are many, many cups offered on eBay, Aliexpress, and Alibaba for even under $1

Are they supposed to be disposable or reusable? I would have my doubts if they are so cheap... (but that's just a gut feeling because I am used to that higher price of 20 US$ or more). See also here: en.wikipedia.org/wiki/Menstrual_cup#Costs

Regards,
Elisabeth

Women have used their own versions of menstrual cups for a long time. That includes scooped-out half lemons and limes.
The silicone cups can be very uncomfortable, and different sizes might be needed for women before giving birth and after giving birth.
Using cloths is very common for even women in the developing world.
Blood can be poured from the cup and reinserted. Rinsing is good but not absolutely needed.

Hi Susannah,

Thanks for the encouragement.

No one wants to talk very openly about this, but apparently Amazonian indigenous women who live in villages far out in the forest, away from cities, mainly just use rags packed into their underwear (which must be very uncomfortable ). They later have to wash and try to dry these despite all the rain. So I think Menstrual Cups have a good possibility to become popular gradually as the women find out about this, get affordable access to cups, and spread the word.

Is there anyone out there who can help me with my various questions? (See initial post.)

Some of the Chinese manufacturers on Alibaba offer a "free sample", but then want to charge $55 for its freight.

New question. If a woman is out in the woods when she has to empty her cup, and does not have a bottle of clean water with her, what would you think of her rinsing her cup with fresh urine coming straight from her body and then reinserting it?

Thanks.

Best wishes,
Chris Canaday

I'm always interested in your great posts, Chris.
I lived in Ecuador myself, many years ago. I travelled on foot and by boat through the region around Puyo and to the coast. I now regret never having enquired how other women, especially those who were indigenous to the jungle, managed their periods. How I'd love to go back now and ask!
What do the women themselves say? Do they find the constant drenching problematic, and how do they overcome any problems? Their answers may be useful for other people.
If they wear rags, how do they hold them in place?
Re: spreading the idea and getting acceptance: open discussions like this are also good opportunities for people to critique their own current practice and pick up new ideas, see if they work for themselves - maybe better than just telling people "this is better than what you currently use". After all, they might have some very good ideas of their own that deserve to be heard and spread..

Hi everyone,

At our Omaere Ethnobotanical Park in Puyo, Pastaza, Ecuador (omaere.wordpress.com), we would like to start a project to promote and distribute Menstrual Cups among the local women who may be interested, especially the indigenous women who live in villages far our in the forest. These communities are mostly only accessible via 15-60-minute flights in small planes, days and days walking, or days in motorized canoes. Disposable products are mostly not available there and it is difficult to dispose of them without contaminating the environment. Apparently most of these women currently use rags that they have to wash and try to dry despite all the rain, plus, in their daily lives they often get soaked in the rain, have to cross streams, or get wet washing clothes. In contrast, menstrual cups are washable and reuseable for over 10 years, a woman can even go swimming or horseback riding with it in, they do not contaminate the environment, and, once a women acquires one and learns how to use it, she is set for a long time.

More info here (so far, only in Spanish ... do see the videos at the end)
omaere.wordpress.com/2017/04/03/copas-me...-mujeres-amazonicas/

Several points for this Forum:

(1) We have tried to access donated cups, from various companies, but have had no success. If any Forum members can help us with those contacts, we would be very grateful.

(2) We would like to put out a call for interested persons to bring new or used cups to Ecuador, when they come on vacation and give them to us when they visit Omaere. (The idea of used cups sounds unhygienic , but they can be soaked for weeks and then sterilized via boiling). How could we best put out that call?

(3) We would like to explore the option of buying good-quality, inexpensive cups over the internet and give them to the women at cost (hopefully under $5). There are many, many cups offered on eBay, Aliexpress, and Alibaba for even under $1, but it is hard to know which one to try. Remember that many of the fancy name-brands are also made in China.

(3a) Any suggestions on where to get good-quality, inexpensive cups?
(3b) Any tips for dealing with those websites?
(3c) Any Chinese speakers who would like to help us negociate a deal with a Chinese factory? (Would you have time and interest, Scott Chen?)

(4) Any suggestions on how to best socialize the idea among the women?

Thanks for your help.

Best wishes,
Chris Canaday