Cervical Position (CP)

What is the cervix?

The cervix forms a passage between the lower end of the uterus/womb and the top of the vagina. During menstruation blood passes from the uterus through the cervix and into the vagina.

cervixillustration.jpg

Image: The female anatomy
Source: http://www.ccsb.org/

Why would you want to know your cervix position?

Checking your cervical position (CP) may be familiar to people who have used this method to monitor ovulation however it can also be useful to a menstrual cup user. Knowing your cervical position may help you decide if a brand of cup will suit your anatomy or if you should trim the stem on your cup.

When should you check it?

It helps to check at roughly the same time each day.

It’s also a good idea to check and record your cervix position a few times a week for a month, as your cervix is likely to move.

Do not check your cervical position before, during or immediately after sexual arousal or intercourse as this may cause the cervix to move.

It is easiest to check your cervical position in the shower as you are likely to be relaxed and can wash easily.

A quick method to check your cervix position

  1. Wash your hands well to avoid infection.
  2. Find a comfortable position such as standing with one leg up on the bathtub. It’s best to check your cervical position standing or sitting and not lying down, as this is the cervix’s ‘normal’ position with the effects of gravity.
  3. Insert your index or middle finger into your vagina and slide it upward until you feel your cervix. Your cervix is the shape of a small doughnut (as shown below) and it feels a bit like the tip of your nose.

    cervixillustration2.jpg

    Image: The Cervix
    Image source: http://www.webmd.com

  4. Take note of how far your finger is inside the vagina when you reach the cervix. To do this you can use the ‘knuckle rule’. Your cervix is;
    cervicalpositionknucklerule1.png

Image: The 'knuckle rule' used to determine cervical position

As a general rule, your cervix is;

Low Cervix

juju-cp-low-lr.jpg

Medium Cervix

juju-cp-med-lr.jpg

High Cervix

juju-cp-high-lr.jpg

If you can feel your cervix at your 1st knuckle or the first bend in your finger, you have a low cervix and a Model 4 is recommended.

If you can feel your cervix at your 2nd knuckle, roughly half way up your finger, you have a medium or average height cervix and a Model 1 or Model 2 is recommended.

If you can feel your cervix between your 2nd and 3rd knuckle or can barely reach your cervix you have a high cervix and a Model 3 is recommended.

After monitoring your cervix position for a month, you will have a good gauge of your overall cervix position.

A more accurate method to check your cervix position

As finger length varies from person to person, a more accurate measure of cervical positions involves performing this same measure and against a ruler to get a more precise vaginal length/cervical position.  

Step 1: Whilst standing, insert your finger until you can feel your cervix. Take note of the position on your finger where it protrudes from the vaginal opening. (Note the anatomical model used for the purpose of this demonstration below has a high cervix and your cervix is likely to be lower)

Step 2: Using a ruler, measure the distance from the tip of your finger to the exit point on your finger.

Step 3: Check this measurement against the JuJu Cups sizing to make sure you have the cup that suits your cervical position.

JuJu Cup lengths, including the stem are as follows; Model 1 = 65mm, Model 2 = 69mm, Model 3 = 78mm, Model 4 = 50mm

cp-step-1-small.jpg  cp-step-2-small.jpg  cp-step-3-small.jpg  cp-step-4-small.jpg

Is your cervix on the move?

For some people, their cervix is almost always high and for others, almost always low.

However, if your cervix does move around a bit it’s not surprising! These model wombs are anatomically correct in size, shape and weight. They show the non-menstruating uterus (pink) and the menstruating uterus (red).

As you can see from the models the menstruating uterus is considerably larger and heavier at 23g when compared to the non-menstruating uterus at 12g.

jujuwombmodels4.jpg  jujuwombmodels3.jpg

Image: Clay models depicting a non-menstruating (pink) and menstruating (red) uterus. 

As the lining of the uterus thickens, the uterus grows and can double in size and weight. This extra weight coupled with the increased size of the uterus can push the cervix lower prior to and during menstruation. Then, as the lining of the uterus is shed during menstruation, the uterus will start to return to its original size and the cervix may move higher. 

Why does cervical position matter when choosing a menstrual cup?

Your cervical position will influence the size of cup you choose. Use the following guide to choose the right size JuJu Cup based on your cervical position;

Low cervix

Your cup may be forced to sit lower due to the cervix location and the stem of the cup may protrude. In this case, we recommend you trim the stem of your JuJu as it may cause labial skin irritation. Please only do this if you are comfortable with the removal of you JuJu at all stages of your cycle as your cervix may ‘retract’ towards the end of your cycle and be hard to reach. Alternately, you may wish to consider a Model 4 JuJu Cup.

Medium cervix

If you have a medium cervix a Model 1 is recommended if you are under 30 and have not given birth and Model 2 is recommended if you are over 30 or have given birth.

You may like to trim the stem of your JuJu at the base of one of the 'nodes' on the stem if you find it protrudes. Please only do this if you are comfortable with the removal of you JuJu at all stages of your cycle and only remove a small amount at a time, re-inserting after removing each node to check if it is at a comfortable length. 

High cervix

We recommend you choose a Model 3 JuJu Cup if your cervix is high as this is a longer bodied cup, designed specifically for a high cervix/long vaginal canal.

The shorter-bodied Model 4 JuJu Cup is not recommended for a high cervix as removal may be more difficult.

If you have a high cervix and are using a Model 1 or 2 JuJu Cup, please ensure you insert your JuJu Cup low – just inside the vaginal opening. Your cup may ‘travel’ on its own as sit higher than where you originally placed it and this is completely normal however removal may take a bit longer to master given your menstrual cup will be harder to reach.

If you are having difficulties reaching the base of your cup to release the suction seal because it is sitting high try the following tips;

  • take a deep breath and relax - this is the most important tip as getting stressed will also cause the vaginal muscles to tense and make removal harder
  • either sit on the toilet and tilt your pelvis forward (i.e. tuck/curl your tailbone under) or squat down in the shower as both of these positions will help shorten the vaginal canal and make your cup easier to reach
  • whilst bearing down lightly, insert your index finger only up beside the cup and press it towards the centre to release the suction seal

If you have just woken up your cervix is likely to be higher too so give yourself an hour of being up and about as gravity will often help move the cervix and cup lower during the day. 

If you are still having difficulties take a break and try again in an hour. If you continue to experience difficulties removing your cup, please make an appointment with your doctor or visit the emergency department. 

See the Menstrual Cup Removal Tips section of our User Guide for some additional tips on removal.

Prolapse

If your cervix or cup is; sitting very low in the vaginal canal, causing bladder sensitivity or causing any discomfort as this may be an indication of a loss of pelvic floor tone or pelvic organ prolapse.

There are many forms of pelvic organ prolapse (as shown below) and the type and severity of prolapse may affect your ability to successfully use a menstrual cup.

If your cervix or cup is very low, please see a qualified health care professional to discuss the cause and a suitable treatment plan.

uterine-prolapse.jpg

Image: Types of pelvic organ prolapse
Source: Afairgo

 

Uterus Position Deviation

There are many variations in uterine positions. This is referred to as having a displaced uterus or deviation of the uterus and the degree to which the uterus is displaced may vary from person to person. The images below show varios forms of deviation;

A. Anteversion: The fundus is tipped forward

B. Anteflexion: The body of the uterus is sharply bent forward at the junction with the cervix

C. Retroversion: The fundus is tipped backward

D. Retroflexion: The body of the uterus is sharply bent backward 

  

displaceduterus.png 

Image: Types of diviation of the uterus
Source: What-when-how

Whilst menstrual cups work for most people, some forms of, or the severity of uterus displacement, may affect your ability to successfully use a menstrual cup. Please see a qualified health care professional if you have any gynaecological concerns.  

 

Remember

  • Our bodies are all different and there’s a wide range of ‘normal’ in terms of our vaginal anatomical shape and size.
  • During menstruation, your cervix is likely to sit lower.
  • During ovulation, your cervix is likely to sit higher.
  • The size and weight of the menstruating uterus can affect the location of the cervix.
  • Kegel exercises will increase your pelvic floor tone and assist with keeping your cup in place.
  • Please consult your physician if you feel you have an extremely low cervix (i.e. you can feel your cervix just inside the opening to the vagina) or if have a feeling of heaviness, discomfort or pressure within the vagina as this may be related to pelvic organ prolapse which affects approximately one third of women at varying levels of severity.

 

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