second child? Mariki was still hesitating. She never had to decide, either: The menstrual cup did it for her.
A job, a car in front of the door, and a nice house with enough bedrooms. On paper, there was no reason for Marieke Dean Engels, 37, in 2018 not to have a second child. However, she had her doubts. “I had a bad pregnancy. My three-year-old was fussy and sleeping poorly. I found motherhood difficult. Would I want this again? A year ago, she replaced her Mirena coil with a copper one to get rid of hormones for a while. Since then she has been Her periods are heavier. A reason for Marieki to start with a menstrual cup – the floppy cup that was a little familiar to the general public at the time. When she was working with it, she immediately checked if she could still feel her IUD threads. Not that it was there No reason for that. Just as a precaution. I could always find the sutures with my fingers. Until I lost them one day. She got so mad. It wasn’t right with her, so Marieke went to the doctor.” He looked with a duckbill, but saw nothing strange An ultrasound isn’t necessary, he said. “I remember thinking that was great, but I didn’t worry too much about it. I thought he should know.
After 2 months, my period did not come. I was barely late, but I didn’t have a good feeling about it. My husband didn’t understand why I was so worried, but I had to take a pregnancy test right away. By chance I found an old copy at home. She took the test and there was no disputing the result: it was—in contrast to Marecki’s reaction—clearly positive. “First thing I thought: This IUD should come out now.” Once at the gynecologist, it turned out to be a piece of cake. “He saw the IUD hanging in the cervix with the naked eye,” says Marieke. And she suddenly understood what hard thing she had felt with her fingers before. How did the spiral get there? All possible scenarios raced through her head. So is the menstrual cup. This thing has tremendous suction power. I thought he might have dragged my rolls with him. But Mariki could not count on support. The midwife replied with a little laugh. The cup that pulls the IUD out of the uterus? No, you couldn’t imagine it.
A bit tricky
It now appears that Marieke’s train of thought was not so crazy. Several studies suggest a link between menstrual cup use and IUD expulsion, also known as expulsion. In December 2021, the Dutch Journal of Obstetrics and Gynecology (NTOG) published the first results of an ongoing US study tracking more than a thousand women after fitting a copper IUD. In 17 percent of women who also used a menstrual cup, the IUD expelled within two years. Among non-Cup users, this was five percent. Two other US studies from 2019 published by NTOG also point to this risk.
But how could the IUD fall out all of a sudden? The likely reason is that the cup is sometimes still suctioned when it is removed from the vagina, pulling the IUD with it. It is also possible for the IUD threads to become wedged during cup removal. This way you can accidentally take the snail with you, explains gynecologist Winch Clerks. It is very difficult for a woman not to feel fired at all. So you can lose your IUD unnoticed and have unprotected sex. “Many women are not aware of this danger.”
Therefore, Marieke is not the only woman in the Netherlands who has suffered from this. In less than three years, the Implant Side Effects Reporting and Expertise Center (MEBI) received 24 reports from cup users who experienced sagging or (partial) expulsion of the copper IUD. Eight of them became pregnant. The majority of those who reported that the file was no longer in place did not notice. The number of reports about the copper IUD is much higher than the number of reports about its sister, the hormone IUD. The LARP Side Effects Center has recorded five cases in the latter category since 2017. As far as is known, the copper IUD does not fail faster than variants with hormones. However, according to gynecologist Klerkx, it can be explained that there are more reports of the copper IUD. “Women who use hormonal IUDs have much lighter bleeding or even no periods, while copper IUD users lose extra blood.” So they obviously get to the trophy more quickly, as Mareke did.
The world upside down
While more research is needed to draw firm conclusions about cup use, Clerks says it’s important to raise awareness of the topic.
You can read in the whole story how she does it, how to use the menstrual cup as safely as possible and how Marieke and her baby are doing now.