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A menstrual sponge can be one of two things: part of a real, living sea sponge or part of a synthetic one.

Either way, they’re said to be very absorbent and act a bit like a tampon without the string.

So it’s not surprising that people may have used them to absorb menstrual blood for thousands of years, according to Planned Parenthood.

Nowadays, menstrual sponges are promoted as natural and sustainable period products. But they’re not the safest type and require some serious consideration before use.

Pros

  • Absorbent. They expand to keep liquid inside (but it’s difficult to say exactly how absorbent a natural sea sponge is).
  • Reusable. Manufacturers claim you can reuse them for between 6 and 12 months, which may benefit the environment and your finances.
  • Comfortable. The sponge is flexible and soft, meaning it changes shape to suit your body once inside.

Cons

  • Safety concerns. They are not allowed to be sold as a menstrual product in the United States without special approval from the Food and Drug Administration (FDA) due to a risk of toxic shock syndrome (TSS) and other infections.
  • Messy to remove. You’ll need to stand in the shower or over the toilet to avoid blood dripping onto the floor.
  • Require thorough cleaning. But there’s no research into how to best clean them for sanitary use.
  • Only suitable for a few hours. So you’ll need multiple sponges or other period products.

Menstrual sponges are similar to tampons —they’re inserted into the vagina and absorb menstrual blood, expanding to keep the blood inside the sponge.

But they do not have any kind of applicator for easy insertion or a string or rim to help with removal.

Unlike tampons, they can be washed and reused after removal.

No, according to the FDA.

Sea sponges labeled as menstrual sponges, hygienic sponges, or sanitary sponges require special approval due to a significant safety risk.

That’s because 12 natural sponges were examined back in the ‘80s and found to contain the likes of grit, sand, and bacteria.

One case of TSS was also associated with sea sponge use and another with a potential sponge association.

There are other safety concerns, too. For example, there are no clear instructions on how to wash a menstrual sponge, meaning it may not be clean enough to insert into the vagina, adding further bacteria.

Plus, their natural texture may cause small scratches inside the body when inserted and removed, allowing bacteria and other materials to enter the body more easily.

Toxic shock syndrome

Toxic shock syndrome (TSS) is a potentially life threatening condition that has been linked to certain tampon use in the past.

But menstrual sponges were found to contain the bacteria Staphylococcus aureus, a major cause of TSS, according to research from 1982 that studied vaginal bacterial floral during the menstrual cycle.

Although the condition is rare in today’s society, the risk of TSS means menstrual sponge use is not recommended.

As mentioned, there are serious safety concerns with menstrual sponges. That means they’re not a recommended period product for anyone to use.

But on a practical level, people with heavy periods may find them unsuitable as the absorbency level can vary from sponge to sponge.

Again, menstrual sponge use is not recommended.

But if you decide to go down that route, here are some tips to help you minimize risk.

Inserting a menstrual sponge

Whether your menstrual sponge is natural or synthetic, the insertion process remains the same.

First, wash your hands thoroughly.

Then, wet the sponge with water or a water-based lubricant. (Some manufacturers advise using essential oil as a lubricant, but there’s no research to support this and the chance of irritation.)

Then, squeeze the sponge to remove any excess liquid.

The next step is to get yourself into a comfortable position, whether that’s sitting on the toilet or putting one leg up.

Scrunch the sponge up and insert it into your vagina just like you would insert a tampon.

If you experience discomfort, you may need to remove the sponge and trim the edges to create a better fit.

When to remove a menstrual sponge

Manufacturers often advise removing the sponge after 4 to 8 hours —a similar amount of time to a tampon.

It takes a while to clean, so you’ll probably need another one or an alternative period product to use in the meantime.

And remember that they do not last forever. The maximum recommended time by WaterAid is 6 months.

Removing a menstrual sponge

There’s no string to remove a menstrual sponge.

So you’ll just need to stand over the toilet, shower, or some other surface that’s easy to wipe clean and insert two fingers into your vagina.

If the sponge is difficult to reach, bearing down on your pelvic muscles can help.

When you can feel it, pinch each side and gently pull it out. Remember it can be a messy process so expect there to be blood.

Cleaning a menstrual sponge

The cleaning process is super important to reduce the chance of bacteria and other pathogens remaining inside the sponge and entering your body. (You should also clean your sponge before you use it for the first time.)

But there’s no research on the most effective cleaning process.

General advice is to:

  • Add one tablespoon of vinegar or one teaspoon of hydrogen peroxide to a cup of warm water.
  • Soak the sponge for 5 to 10 minutes in a solution of apple cider vinegar or hydrogen peroxide.
  • Rinse thoroughly, squeeze out any excess water, and hang it somewhere clean to dry.

While some companies recommend boiling, this isn’t advised as it may break up the sponge and cause trauma to the inside of the vagina once re-inserted.

Some of the most popular options range from around $20 to $40 for a pack of two in various sizes.

But you can find cheaper sponges that cost around $10 per pack.

Sea sponges require premarket approval from the FDA before being marketed as menstrual, hygienic, or sanitary sponges. So you probably will not find many under this label.

Instead, they’re more likely to just be called sea sponges or even cosmetic sponges.

Due to these restrictions, there are not many options available.

Natural sea sponges are often framed as sustainable. But there are safer eco-friendly period products.

For example, menstrual cups are reusable. The DivaCup comes in three different models, depending on your age and menstrual flow. It’s available via the likes of Amazon, Walmart, and Target.

You can also buy reusable menstrual pads from Rael via Amazon, Walmart, and Walgreens among other retailers.

Thinx period underwear absorbs menstrual blood without the need for a separate product. Buy a variety of styles from the brand’s site as well as the likes of Urban Outfitters and Kohl’s.

Even some tampons have an eco-friendly element to them nowadays. Cora and LOLA organic cotton tampons are available via Amazon, while Dame sells reusable applicators online.

Some people even choose to free bleed, requiring no product at all.

If you’re not sure which menstrual product to choose, a healthcare professional can help with talking you through all your options.

And if you experience any of the following symptoms after using a menstrual sponge, seek medical attention as soon as possible:

  • high temperature
  • difficulty breathing
  • nausea or vomiting
  • flu-like symptoms
  • dizziness
  • a rash similar to a sunburn
  • irritation or pain in or around the vaginal area

Although menstrual sponges may be more sustainable than other period products, they’re not a recommended way to manage your period.

There are significant safety concerns, and companies are not allowed to market them as menstrual products without approval from the FDA.

If you’re looking for a safer reusable option, consider the likes of menstrual cups or period underwear. They can be just as effective and do not come with the same risks to your health.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.