Interview With FemmyCycle Inventor Dr. Alfred Shihata

What started out as a small unmet need for women has grown into a great demand, as countless women are making the switch from disposable menstrual products to menstrual cups. In the health and eco-conscious world of today, women no longer want to use bleached and chemically treated pads and tampons. They are looking for safer, more environmentally and economically friendly options.

As the demand for menstrual cups has increases, new companies are popping up to meet this demand. However, while small improvements have been made, the funnel shaped design has remained almost identical in more than 40 brands of menstrual cups.

FemmyCycle designer, Dr. Alfred Shihata, a renowned gynecologist from Scripps Memorial hospital in San Diego, CA, decided it was time to go back to the drawing board and create a truly physiologically and anatomically accurate cup that would make menstrual cup use even more accessible to woman.

Leah: Dr. Shihata, what drew your interest to the topic of menstrual cups?
 
Dr. Shihata:  Well, about 16 years ago, my team and I invented the FemCap which is a cervical cap. With backing from US government grants, we designed and put into production an inovative barrier contraceptive device a new generation of health conscious women.

We actually had many FemCap users ask if there was a larger FemCap that could be used as a menstrual cup. Of course, the FemCap itself should not be used as a menstrual cup, but it inspired us to take a look at this interesting subject.

Leah: What was your first impressions of menstrual cups?

Dr. Shihata: I was impressed but also a bit confused. We ordered samples from many different manufacturers, and while the concept is undoubtedly better than traditional menstrual products that absorb blood, we were also curious as to why the funnel design is almost identical in the vast majority of menstrual cups on the market.

Leah: You don’t think that classic shape is best?


                                          


Dr. Shihata: It’s true that these menstrual cups are functional and work for many women.  As a gynecologist and as a designer, I tend to look at things from an anatomical and physiological perspective.

Mittens are simple to produce and keep your fingers warm. But when you study the anatomy of the hand you see that gloves would be a far superior design.

We wanted to create a highly functional cup according to the actual anatomy of a woman. Our goals were simple - a cup that has a high capacity and is still very comfortable. The shape of the cup plays a big role in achieving these goals and that's how we came up with the notably unique bulbous shape.

Leah: So you reinvented the menstrual cup. Impressive! Can you describe the differences in the FemmyCycle cup as opposed to other cups?

Dr. Shihata: First of all the FemmyCycle does away with the funnel design. Using that shape reduces capacity and makes the cup much longer than it needs to be. So the first visible difference is that the FemmyCycle is more of a bowl shape. This results in a greater capacity in a shorter length.
 
The wider bottom also has another logical benefit. When a cup tapers out and becomes narrower closer to the entrance of the vagina, it is more likely to be expelled, particularly when you cough or sneeze.   
 
 
Another obvious difference is the no-spill design. Rather than just relying on a tight fit to stop leaks and overflow, we designed and patented a no-spill neck. This can be tipped, rolled and inclined and no liquids escape until you want them to. This means you are more likely to be able to run, jump, swim, sleep, and just live life without any leaks. It’s also handy that when you remove your full cup, you know the blood won’t splash over the edges of the cup.

Leah: Is it true that the period length could be shortened when using a menstrual cup?

Dr. Shihata: Let's talk about the suction, or "Pull-Factor."

We’ve found that the length of the menstruation can be reduced if the blood is drawn out, rather than just waiting it to make its way out at its own pace. We are backing this up with medical studies being conducted on our behalf with our research colleagues at Simons College at Boston MA.
 

A very light, subtle suction applied to the cervix has a very positive effect on menstrual flow.

That's one of the main reasons we did not add air holes in the FemmyCycle design —to take full advantage of the suction. 

By the way, the second reason for no air holes is simply hygiene. Air holes are notorious for getting clogged with old menstrual blood that is hard to clean. These holes have very little benefit, but have the potential to harbor lots of bacteria. So we did away with them completely.

Leah: When an experienced cup user first looks at the FemmyCycle, it’s clear that this cup is completely different.  

Dr. Shihata: All other cups are based off the same design. Interesting fact, that is why they don’t need a patent. Our patented cup is completely different, and we hope it addresses the shortcoming found in other cups. 

Several version of the FemmyCycle were tested and we used that feedback to perfect the design.

We now have three different size cups, each diligently designed for maximum comfort. We have a smaller cup, a regular cup, and a shorter cup for women who have a low cervix. Until now menstrual cups were generally quite uncomfortable or even unsuitable for those with a low cervix.   

Leah: So the large size is for women over 30 or those who have given birth, right?

Dr. Shihata: Nope! The enlarging of the cervix and the dilation of the vaginal canal during childbirth does mean that women who have given birth usually need a larger cup. But I really have no idea why some cups say that turning 30 years old suddenly makes your vagina larger or looser. I have 35 years in the field of clinical gynecology and I have treated thousands of women.  Nothing happens between the age of 29 and 31 which changes the structure or form of the vagina.

Each women is different, some have a tighter vaginal canal, some a wider canal, and we have cups to suit each individual need.

Leah: What is unique about the low cervix version?

Dr. Shihata: As many as 30% of women who have given birth have a low cervix, and some women just naturally have low cervixes. Most of the time a women won't even realize her cervix is low, but when inserting a funnel shaped menstrual cup the stem of the cup protrudes outside the vagina.  Ironically the companies that designed the long stem recommend that it should be cut, making removal even more difficult. The FemmyCycle Low Cervix is wider and shorter than all other cups, and the removal ring is much shorter. This results in a high capacity cup that fits below the cervix and is comfortable and easy to remove. 

Leah: Thanks for taking the time to speak to us here at Ethical Family Planning. We really appreciate it.

Dr. Shihata: My pleasure!
 

Father's Day Special: Getting Your Husband To Agree To NFP (from the archives)

 

If you're interested in natural family planning, or have been dreaming about going off hormones   but the thought having that conversation with your partner send you into a mild panic attack This is the blog post for you. 

Because you are not alone. In fact, fear of your partners reaction this is one of the top reasons women claim they can never go off hormones.

Unfortunately, we can’t say that there is a quick fix solution or offer you magic fairy dust to sprinkle on your husband to make him open to the possibility. Actually though, the first step towards a NFP boils to a simple factor: joint knowledge and communication. We all know communication is the foundation of every lasting relationship and communicating effectively about sex is extra important. And extra difficult. But because communication is the foundation of NFP, just look at this conversation as the first step in your journey towards a deeper connection as a couple. The show starts right now.

From middle school sex ed, all the way through marriage, most men view contraception as primarily a women’s problem. She ovulates and gets her period, she takes the pill, she represses her fertility, and she takes care of business to insure “worry free” sex.

But where is the honesty and communication in that equation? The relationship, the ‘WE’ of the intense bond of a sexual relationship, is mitigated by eliminating the need to discuss the aspect of fertility and sex. 

Sex is a powerful and intimate experience, one that is constantly changing and evolving, and should be a central discussion in any committed relationship. But in all honesty, it’s just not that easy to communicate lovingly and sensitively about the topic of sex. And the longer we can go without mentioning it, the more we tend to fall into repetitive, perhaps negative, habits.

Many women think that their husband or partner will push aside the idea of NFP as a contraceptive method, but in fact, once men gain the knowledge and are explained the logic of an alternative method, they can see the appeal and agree that it might be time for a shift.

Your partner wants the best for you. He wants you to be healthy, happy, and secure. He wants to be involved and invested, willing to look at fertility as a ‘OUR issue’ instead of ‘YOUR issue. Remember — you are in a loving, mutually respectful relationship. No husband wants his wife to be exposed to harmful chemicals that have short term side effects and potential long term health hazards.

 And above all, both you and your partner want to develop the art and language of positive communication. A discussion about NFP and birth control is only the first step in a wondrous journey of communicating effectively. Because after all, if you can make communicating lovingly about sex a habit in your marriage, you’ll be able to communicate lovingly about just about anything else. 

 

With Special Thanks To Ira Winter RN MSc BSc CFCP at Life FertlityCare

To learn more about the benefits of NFP visit http://lifefertilitycare.co.uk/ .

Diaphragms 101

As awareness grows about the dangers of  hormonal birth control, more women are looking to barrier contraceptives as an alternative contraception method. Although diaphragms were once almost pushed into oblivion, a growing trend is moving back towards this often overlooked hormone free birth control solution. 

Milex OmniFelx Diaphragm

 The traditional diaphragm is shaped like a dome with a spring molded into the rim and is made of silicone or soft latex. The spring creates a seal against the walls of the vaginal canal to block sperm from entering the cervix. A spermicide or alternative contraceptive gel placed around the perimeter of the diaphragm to helps insure a tight suction and to seal any openings that sperm could get through. 

According to contraceptive technology, the method failure rate of the 'traditional' diaphragm used with spermicide is 6% per year. Thats a whopping 94% effectivness! 

 However, annual pregnancy rates of 10% to 39% of diaphragm users have also been reported.The large variation in statistics is a result of the high risk for user error with a diaphragm.
 

Diaphragms are not hard to use, but they must be used correctly to be effective. This is not a set it and forget it birth control. Sizing is critical, and you must be measured by a doctor or qualified health practitioner. Sizing of the vaginal canal does change, so if you gain or loose a significant amount of weight, or if you give birth, it's important to be refitted. 

Another factor in correct use is placement. Have your doctor show you the proper placement so you can get used inserting it correctly. If you take these steps, there is no reason why you should not enjoy high efficiency with a a diaphragm. 

Diaphragms, unlike cervical caps,  are equally effective for women who have given birth as they are for women who have not. So if you are breastfeeding and want to avoid hormones, a diaphragm is the way to go. 

Caya Diaphragm

The Caya diaphragm is the newly designed 21st century diaphragm that is making waves around the world. It is FDA,EU, and Health Canada approved is enabling more women then ever to finally make the switch to hormone free birth control. It is made of thinner yet stronger materials, has a more flexible frame, and a radically different shape that makes it easier to insert and remove.

Caya is suitable for women who would use diaphragm sizes 65mm-80mm. It is important to be measured to make sure you fall within that size range. If you do, Caya eliminates the need for frequent resizing. 

Like all other diaphragms, Caya must be used with a spermicide or contraceptive gel. 

Many women and their partners experience side effects from Nonoxynol-9 spermicide, and some sources have suggested the spermicide may actually be unnecessary. Studies on this matter however, are greatly lacking. One study reported a 24% rate of actual pregnancy per year among women using the diaphragm without spermicide. But the women in this study were not fitted individually by a clinician and were instead all given a 60mm diaphragm— so these results are obviously unreliable.  

Unfortunately, there are not enough studies that accurately assess the importance of a contraceptive gel. Our recommendation? This is one area where it's not worth risking it. Always use your diaphragm with a contraceptive gelfor maximum protection.

If you don't want to expose yourself to the toxic ingredients in N-9 spermicides, or if you experience irritation, ContraGel is an all natural spermicide gel alternative. 

Natural Spermicide Alternative

Using diaphragms has been known to increase the risk of contracting urinary tract infections (UTIs). Urinating before inserting the diaphragm and also after intercourse may reduce this risk.  The increased risk of UTIs may be due to the diaphragm applying pressure to the urethra, which is common if the diaphragm is too large. Additionally, Nonoxynol-9 is itself associated with an increased risk of UTI, so if you are prone to UTIs, use ContraGel in place of spermicide.

A very rare side effect of diaphragm use is toxic shock syndrome. This occurs almost exclusively when the diaphragm is left inside the vagina for over 24 hours.

Those allergic to latex or who's partners are allergic to latex should choose a silicon diaphragm, such as the Milex OmniFlex.