Prevalence of menstrual cup usage among reproductive-age women in asian countries: a systematic review and meta-analysis

Effective menstrual hygiene management (MHM) is essential for women’s health, especially in low-resource settings. Menstrual cups are an eco-friendly and cost-effective alternative to disposable menstrual products. This study aims to systematically review the prevalence of menstrual cup use across Asian countries, providing insights into its acceptance, and potential for wider adoption. The study protocol was registered in PROSPERO (CRD42024546114). A systematic search was conducted in PubMed, Scopus, EMBASE, CINAHL, and Ovid up to June 2023. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. A meta-analysis was performed using Generalized Linear Mixed Models (GLMMs) with logit transformation. Heterogeneity was evaluated using the I2 statistic and Cochran’s Q test, and a random-effects model was applied. Publication bias was examined through visual inspection of funnel plots and tested using Begg and Mazumdar’s rank correlation method. Statistical analyses were conducted using the Meta and Metafor packages in R software. The study identified 3,919 records from various databases, including PubMed (624), Scopus (1,824), EMBASE (998), CINHAL (181), and Ovid (178). After removing 1,641 duplicate records, 2,278 records were screened, out of which 13 studies that reported the prevalence of menstrual cup usage were included in the final analysis. The pooled prevalence of menstrual cup usage was estimated at 2.68% (95% CI: 1.24%–5.67%), based on a total sample size of 257,347 individuals. The pooled estimate did not change significantly in subgroup analysis and sensitivity analysis. However, substantial heterogeneity was observed (I2 = 99.6%), indicating significant variation across studies. Menstrual cup usage among Asian women remains limited and is primarily confined to a specific, educated subgroup. Due to the high heterogeneity of studies, the pooled estimates should be interpreted with caution. Future research should focus on community-based epidemiological studies to gain a better understanding of adoption patterns, address barriers, and promote acceptance among reproductive-aged women. The study protocol was registered in PROSPERO (Registration ID: CRD42024546114)