Urinary and bowel perceptions during menstrual cup use among healthy women: Implications for menstrual health counseling and user guidance.

OBJECTIVE: The aim of this study was to investigate self-reported urinary and bowel emptying perceptions during menstrual cup use among healthy women and to explore factors associated with reporting these perceptions. METHODS: A cross-sectional online survey was conducted among menstrual cup users in Spain. Participants without diagnosed pelvic floor pathology reported urinary and bowel emptying perceptions during and outside menstrual cup use and provided demographic and use-related data. These self-reports were based on perception-derived measures within a non-diagnostic framework. Group comparisons and an exploratory descriptive pattern-recognition analysis based on Multiple Correspondence Analysis (MCA) and Hierarchical Clustering on Principal Components (HCPC) were performed. RESULTS: A total of 1221 women were included. During menstrual cup use, urinary emptying perceptions were reported by 26.0% and bowel emptying perceptions by 14.6%, compared with 9.0% and 6.2%, respectively, when the cup was not in use. Reporting perceptions during cup use was associated with age at initiation (urination: p = 0.005; defecation: p < 0.001), with additional exploratory associations observed for age and duration of use. Associations outside menstrual cup use were weaker. CONCLUSION: In healthy women without diagnosed pelvic floor conditions, self-reported urinary and bowel emptying perceptions were more frequently reported during menstrual cup use and less frequently reported outside menstrual cup use in this sample. These findings suggest that these perceptions may reflect situational, perception-based experiences rather than underlying dysfunction; however, this interpretation should be made cautiously given the self-reported, non-clinical nature of the data.