Lived Experiences of Menstrual Cup Adoption among Reproductive-age Women: A Qualitative Study Exploring Perspectives of Menstrual Cup Users, Non-Users, and Dropouts from Eastern India

Background Menstrual health and hygiene (MHH) is a fundamental component of women’s reproductive health and human rights. Although menstrual cups (MCs) offer a sustainable, cost-effective, and hygienic alternative to conventional menstrual absorbents, their uptake remains limited in low- and middle-income countries (LMICs). This study aimed to explore the lived experiences of MC users, non-users, and dropouts to identify enablers and barriers influencing menstrual cup uptake and sustained use. Methods An inductive qualitative study was conducted among women aged 18–45 years. Purposive, maximum-variation sampling was employed to recruit current MC users, former users (i.e., dropouts), and non-users. In-depth interviews were conducted in participants’ preferred language (Odia, Hindi, or English) using a semi-structured guide. Interviews were audio-recorded, transcribed verbatim, and translated into English. Data were analysed using inductive thematic analysis following Braun and Clarke’s six-phase framework. Ethical approval and written informed consent were obtained prior to the commencement of data collection. Results Four broad themes emerged: (1) menstrual hygiene management and menstrual flow concerns, (2) physical comfort, (3) awareness and social influence, and (4) long-term and sustainable use of menstrual cups. Key enablers included dissatisfaction with sanitary pads due to leakage, skin irritation, frequent changing, and disposal challenges; improved awareness and monitoring of menstrual flow with MC use; enhanced physical comfort enabling uninterrupted work, sports, and daily activities; supportive peer and family influence; and perceived long-term cost-effectiveness and environmental benefits. Major barriers included inertia to change and long-standing familiarity with pads; limited local availability and higher one-time cost of menstrual cups; inadequate anatomical knowledge of reproductive tract and lack of hands-on training for insertion and removal; fears of complications such as infection or the cup becoming stuck; cultural taboos and virginity-related myths; and practical challenges related to sterilization, storage, carrying, and emptying the cup-particularly in public, workplace, or during travel with limited sanitation and privacy. Conclusion Menstrual cup adoption and sustained use are shaped by a complex interaction of knowledge, social networks, physical infrastructure, and prevailing cultural norms, rather than by individual preference alone. Interventions should extend beyond awareness creation to include hands-on training, early-cycle support, culturally sensitive community engagement involving family influencers, improved supply and affordability mechanisms, and strengthened water, sanitation, and hygiene (WASH) infrastructure.