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Against the odds
Sperm can overcome seemingly insurmountable obstacles (including condoms, diaphragms, and cervical caps) in their quest to fertilize an ovum. The sperm-killing agents (spermicides) in contraceptive foams, creams, and jellies have a tough task. They're fighting time, body chemistry, and the sheer relentlessness of the sperm. But chances are they will kill close to one in four, reducing your risk of pregnancy in the process. Use spermicides in conjunction with a physical barrier to further reduce the risk.
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Spermicides 101
- While spermicides aren't 100% effective, studies show they can reduce the risk of pregnancy by more than 70%. This makes them an excellent backup for your condom, cervical cap, or diaphragm.
- Foams come in a pressurized container with an applicator that's similar to a tampon; a cylinder holds the foam and injects it into the plunger. The plunger pushes it into the vagina. Be sure to shake the container thoroughly. Shaking produces bubbles that spread throughout the vagina to form a sperm-threatening barrier. When inserting the applicator, go as deep as feels comfortable, then pull it out about one-half inch. Push on the plunger slowly and keep it pressed in as you draw out the applicator.
- Creams and jellies don't have the expansion capability of foam, but they make a fine lubricant. Most are made for use with a diaphragm or cervical cap, but you can buy them with an applicator. Using these with a condom will also decrease the pregnancy potential.
- Whatever you choose, always follow the manufacturer's instructions carefully; mistakes will increase your chances of an unwanted pregnancy.
- Insert spermicide no more than 30 minutes before intercourse. Reinsert after every act of intercourse.
- Since sperm can live after intercourse, don't douche for at least eight hours.
Emergency Contraception
- If something goes wrong with your contraceptive, you don't have to resign yourself to a wait-and-see approach. Emergency contraception is available and highly effective.
- Morning-after pills (MAP) must be taken within 48 to 72 hours of intercourse, with the cut-off time depending on which pills are right for you. You can get both estrogen/progestin and progestin-only pills.
- These are not abortion pills (RU486) and do not cause abortion. MAP will not help if you're already pregnant. It can only help prevent pregnancy.
- This measure has been known to cause various side effects and should not be used regularly.
- Call your doctor or clinician as soon as possible.
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Lubricants
As well as providing lubrication, lubricants keep condoms from breaking, which ruins all the protective benefits of putting on a condom in the first place. Oil-based lubricants will dissolve latex products -- condoms, diaphragms, and cervical caps.
Spermicides
Spermicides enhance the effectiveness of condoms by killing sperm. When spermicides are combined with condoms, you have two safeguards against pregnancy.
| Lubricants | Ingredient | Description |
|---|
| Glycerin | ? | A slippery, watery chemical that draws moisture from the air. It makes for a great lubricant that won't dissolve latex. It is usually safe and nonallergenic. | | Propylene glycol (PEG) | ? | Does its job by keeping moisture up and friction down without dissolving latex. It can permeate the skin and carry water with it better than other ingredients. It is a solvent and a moisturizing agent. There is greater allergic sensitivity to this compound than to glycerin. | | Spermicides | Ingredient | Description |
|---|
| Nonoxynol-9 | ? | Aids in preventing pregnancy. Frequent use can cause vaginal inflammation and increase the risk of urinary tract infection. Nonoxynol prevents the separation of oil and water in the product. |
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Appropriate Uses
Contraceptive foam
Contains a chemical called spermicide that kills sperm. When it contains nonoxynol-9, foam may reduce the risk of gonorrhea and chlamydia transmission. Also provides a contraceptive backup when condoms break or when the diaphragm or female condom becomes dislodged.
Contraceptive cream
Contains a chemical called spermicide that kills sperm. When it contains nonoxynol-9, cream may reduce the risk of gonorrhea and chlamydia transmission. Also provides a contraceptive backup when condoms break or when the diaphragm or female condom becomes dislodged.
Contraceptive jelly
Contains a chemical called spermicide that kills sperm. When it contains nonoxynol-9, jelly may reduce the risk of gonorrhea and chlamydia transmission. Also provides a contraceptive backup when condoms break or when the diaphragm or female condom becomes dislodged.
Contraceptive suppository
Contains a chemical called spermicide that kills sperm. When it contains nonoxynol-9, a suppository may reduce the risk of gonorrhea and chlamydia transmission. Also provides a contraceptive backup when condoms break or when the diaphragm or female condom becomes dislodged.
Common Misconceptions
Contraceptive foam
Used by itself, it's not very effective in preventing pregnancy; it should be combined with another method of birth control. It cannot claim to prevent the transmission of most STDs, including HIV. In fact, irritation caused by the spermicide chemical may increase susceptibility to HIV and other STDs.
Contraceptive cream
Used by itself, it's not very effective in preventing pregnancy; it should be combined with another method of birth control. It cannot claim to prevent the transmission of most STDs, including HIV. In fact, irritation caused by the spermicide chemical may increase susceptibility to HIV and other STDs.
Contraceptive jelly
Used by itself, it's not very effective in preventing pregnancy; it should be combined with another method of birth control. It cannot claim to prevent the transmission of most STDs, including HIV. In fact, irritation caused by the spermicide chemical may increase susceptibility to HIV and other STDs.
Contraceptive suppository
Used by itself, it's not very effective in preventing pregnancy; it should be combined with another method of birth control. It cannot claim to prevent the transmission of most STDs, including HIV. In fact, irritation caused by the spermicide chemical may increase susceptibility to HIV and other STDs.
Keeping Spermicides Effective
- When you use spermicides for birth control, do not douche until at least eight hours after intercourse in order to maintain the spermicide's effectiveness.
- When using as contraception, be sure the package is marked "contraceptive" or "birth control."
- If unprotected intercourse has occurred, emergency contraception may prevent pregnancy; see a clinician.
One-Two Punch Against Pregnancy
- Condoms combined with other contraceptive techniques reduce the chance of pregnancy more than when a single contraceptive technique is used.
Cervical Caps and Diaphragms
- If using a cervical cap or diaphragm, remember that they need to be fitted by your clinician.
- Wash your hands thoroughly to remove dirt and germs before handling.
- Check cervical cap and diaphragm for leaks or holes. Fill up with water to check for drips.
- Fill the cervical cap one-third full of spermicidal jelly and the diaphragm one-half full. Do not use oil-based products or spermicidal foam. These will deteriorate the latex.
- Squeeze the diaphragm like a taco and insert it into the vagina so that it completely covers the cervix. For the cervical cap, squeeze and insert it into the vagina. Press the cervical cap over the cervix and release. The suction should hold it in place.
- The diaphragm can be inserted immediately before intercourse or up to six hours prior. The cervical cap must be inserted at least 20 minutes before intercourse or up to eight hours prior.
- Do not keep diaphragms in your vagina for more than 24 hours or cervical caps for more than 48 hours to reduce the risk of toxic shock syndrome (TSS), a serious and sometimes fatal infection.
Foams and Suppositories
- Foam must be inserted at least 30 minutes before intercourse or up to one hour prior. Shake the container for at least 20 seconds. Fill the applicator and insert it into the vagina as far as it will comfortably go, then push the plunger in slowly. Withdraw the applicator from the vagina while keeping the plunger pressed.
- Insert a contraceptive suppository into the vagina at least 10 to 15 minutes before intercourse. Place a suppository capsule as close the cervix as possible. If you are using suppository film, using the tip of a finger, placing the film at the cervix. Do not crumple it into a ball or wait to insert it with the penis.
For Each Act of Intercourse
- After intercourse, your cervical cap or diaphragm must be in place for at least six to eight hours. Apply another dose of spermicidal jelly to the diaphragm without removing the diaphragm, but do not add more jelly to the cervical cap because it may dislodge the cap.
- Reapply foam before every act of intercourse.
- Use at least one suppository for each act of intercourse.
Toxic Shock Syndrome
Symptoms of toxic shock syndrome (TSS) include:- High fever
- Diarrhea
- Vomiting
- Body pains
- Vertigo
- Lightheadedness
- A rash resembling a sunburn
TSS is a serious bacterial infection that may become deadly. Remove your diaphragm or cervical cap and seek medical attention.
In Case of Emergency
- If your condom broke, your cervical cap came loose, your foam expired, or some other birth control nightmare occurred, emergency contraception may still prevent pregnancy. See a clinician and ask for MAP (the Morning After Pill). This is only effective if taken within 48 to 72 hours of intercourse.
- Various side effects may occur; this measure should not be used regularly.
- MAP is not the abortion pill RU486. MAP does not cause an abortion and will not help if you are already pregnant. It can only prevent pregnancy.
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Nothing Is 100% Guaranteed
- Consult a doctor if you suspect that the contraceptive device was ineffective.
- Pregnancy is still a possibility.
- Failure rate is high when used alone. Vaginal creams, sponges, suppositories, foam, and gels should be used with a mechanical barrier.
Know What You're Using
Proven safe and effective:Safe, but not proven effective:- Dodecaethyleneglycol monolaurate
- Laureth 10S
- Methoxypolyoxyethyleneglycol 550 laurate
Unsafe:- Phenylmercuric acetate (PMA) contains mercury, which can be absorbed into the bloodstream.
- Phenylmercuric nitrate contains mercury, which can be absorbed into the bloodstream.
Be Alert
- Beware of signs of toxic shock syndrome (TSS). Seek emergency medical attention for the following symptoms: chills, fever, skin rash, muscle aches, weakness, confusion, and redness of mucous membranes.
- If you experience vaginal discharge, irritation or rash, consult a doctor.
- If you have cloudy or bloody urine, consult a doctor.
- Adverse side effects are more frequent and severe in people over age 60.
Keep In Mind
The following topical vaginal medications will reduce the effectiveness of spermicides: sulfa drugs, soaps or disinfectants, nitrates, permanganates, lanolin, hydrogen peroxide, iodides, cotton dressings, aluminum citrates, and salicylates.
Do not use if you are allergic to octoxynol, nonoxynol, or benzalkonium chloride.
Effectiveness is reduced when:- Vaginal douching is performed within eight hours after intercourse.
- Used during menstruation with a cervical cap, sponge, or diaphragm.
- When using for contraceptive reasons, be sure the package is marked "contraceptive" or "birth control."
- Use at least one suppository for each act of intercourse.
- Do not crumple suppository film into a ball for insertion.
- Do not take orally.
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Websites, Organizations & Manufacturers
- American Medical Association, "Contraception Information Center"
- AVSC International, "Spermicides: Answers to Your Questions"
- Family Health International
- Planned Parenthood
- Sexual Health Info Center, "Vaginal Spermicides"
- Teenwire
- Women in the Know (by Ortho-McNeil Pharmaceuticals and Personal Products Company), "Non-Prescription Barrier Methods - Spermicides"
- Dr. Ruth Online
- EPIGEE, "Condoms, Spermicides and Barrier Methods"
- Health Square, "Barrier Contraceptives: A Growing Array of Options"
- Indiana University Health Center, "How to Use a Diaphragm"
- Planned Parenthood of East Central, "Birth Control"
- Teen Health Home Page, "Examples of Misconceptions: Vaginal Spermicides"
Sources & Further Reading
Books
- 1. Covington, TR; RR Berardi, LL Young, SC Kendall, MJ Hickey.Handbook of Nonprescription Drugs. American Pharmaceutical Association, Washington DC, 1996.
- 2. Knowles, J; M Ringel.All About Birth Control. Three Rivers Press, New York, 1998.
- 3. Food & Drug Administration.Federal Register 12/19/96; 2/3/95.
Find more books on health and wellness at  barnesandnoble.com.
Articles
- 1. Nordenberg, T.Protecting Against Unintended Pregnancy; A Guide to Contraceptive Choices. FDA Consumer. US FDA, April 1997.
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