Don't know about that. From talking with my wife they are very messy and need to be cleaned a lot or they smell, like boiled every day or two - so that's why there are disposable ones and they are more popular. Also you need a lot of clean tissues each time you insert, rinse, and replace it - which brings you right back to the using dirty rags again cause there is stigma to clean and dry them properly in those cultures. Anyway her ob/gyn told her to stop using them when she got a IUD, and that's another issue with them.
My wife has had a different experience; she reports she's quite happy with hers and it requires less maintenance than alternatives. Of course, this is a very small sample size, a second hand report, and, of course, still surrounded by all the attendant larger issues....
It sounds like your wife is the kind of person who wants her body to be completely free of any sort of body smells and doesn't want to come in contact with any kind of body fluids. Those are exactly what I was referring to when I said there is cultural resistance. My community are "pro-natural" and don't have issue with the smell, nor do they use tissues. They just use their hands and believe that vaginas and menstrual fluid have scents and that it's ok. It's just cultural differences.
Erik, please do not make assumptions about my wife, she is far less bothered by ick than me or many people I know. Smell can be caused by bacteria, can be different than scent you refer to, and bacteria are a real concern so to clean the cup well and to have clean hands and area there are in fact very important. She used cup for years (due to heavy flow - cup easily contains more than tampon/pad absorbs well in practice - a pro of cup), then after we had all our children she had IUD for contraceptive and at that point her ob/gyn said the two are not supposed to be used in concert, so she stopped using cup. The IUD also lessened her flows so the reason for using the cup for her was removed as well. I thought I was completely polite and simply listed some reasons why a cup may not be appropriate in India where just washing and drying rags well in comparison is a concern according to the BBC article.
