International Institute for Population Sciences
Deemed to be University (An Autonomous Organization of Ministry of Health & Family Welfare, Government of India)

Background Menstrual hygiene management is crucial for women's health, particularly in low-resource settings. The menstrual cup, an eco-friendly and cost-effective alternative to disposable menstrual products. This meta-analysis estimates the prevalence of menstrual cup usage across Asian countries, synthesizing data from multiple studies to provide a pooled estimate. Methods A systematic literature search was conducted in PubMed, Scopus, EMBASE, CINHAL, and Ovid databases, yielding 3,919 records. After removing 1,641 duplicates, 2,278 records were screened, and 13 studies are included in meta-analysis. The effect size for each study was determined using Generalized Linear Mixed Models (GLMMs) with logit transformation. Heterogeneity was assessed using the I² statistic and Cochran’s Q test, and a random-effects model was applied. Confidence intervals were computed using the Clopper-Pearson method. Publication bias was evaluated using funnel plots and Begg and Mazumdar’s rank correlation test. Data extraction was performed in Microsoft Excel 2021, and all statistical analyses were conducted using the Meta and Metafor packages in R software. Results 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. However, substantial heterogeneity was observed (I² = 99.6%), indicating significant variation across studies. Individual study prevalence ranged from 0.30% to 41.50%, reflecting differences in socio-cultural factors, awareness levels, and accessibility of menstrual cups. Conclusion Menstrual cup adoption remains low in Asia, with substantial variation across populations. Increased awareness campaigns, accessibility improvements, and culturally sensitive interventions are needed to enhance menstrual cup uptake, particularly in resource-constrained settings.