Knowledge, Attitude, Acceptability and Misconceptions towards the Usage of Menstrual Cup among Female University Students in Sikkim

The menstrual cup (MC) is a highly effective and sustainable menstrual hygiene product that significantly contributes to women's health, empowerment, and overall quality of life. Despite its long-standing availability in Indian markets, its usage remains remarkably low, especially among young women. This study was undertaken to assess the knowledge, attitudes, acceptability, and misconceptions regarding the use of menstrual cups among female undergraduate students across five universities in Sikkim. The current study employed a cross-sectional design. Data were collected from 366 female undergraduate students enrolled in regular courses at five universities in Sikkim between November and December 2023, using a pretested, expert-validated questionnaire. Students were selected through proportionate stratified random sampling, excluding those enrolled in medical courses, those medically contraindicated to use the cup, or those with specific health conditions. Most students (87%) reported having regular menstrual cycles, and sanitary pads were the most commonly used product (88%). Only 5.5% of participants had ever used a menstrual cup, and 67% demonstrated poor knowledge about its use. Over one-third of students (36%) held unfavourable attitudes towards the cup, and 64% expressed willingness to use it if it were freely available. The internet was the primary source of information (60%). Misconceptions were widespread: 37% believed it could not be used during heavy flow; 52% thought it could cause reproductive tract infections; and 42% associated it with urinary tract infections. About 22% incorrectly assumed it could serve as a contraceptive. Statistical analysis was conducted using SPSS software (V 24.0), applying Chi-square tests and Fisher's exact tests to examine associations among knowledge, attitudes, misconceptions, and socio-demographic as well as menstrual factors (p < 0.05). Knowledge and attitudes regarding menstrual cup use were generally inadequate or moderately adequate, with several misconceptions persisting among participants. These findings indicate the value of further education initiatives, information workshops, and awareness programs to support informed choices and encourage safe and sustainable menstrual hygiene practices.