Definition

Spermicides and vaginal sponges are two over-the-counter birth control methods used during sex to prevent pregnancy. Over-the-counter means that they can be purchased without a prescription.

Alternative Names

Birth control - over the counter; Contraceptives - over the counter; Family planning - vaginal sponge; Contraception - vaginal sponge

Information

Spermicides and vaginal sponges do not work as well at preventing pregnancy as some other forms of birth control. However, using a spermicide or sponge is much better than not using birth control at all.

SPERMICIDES

Spermicides are chemicals that stop sperm from moving. They come as gels, foams, creams, or suppositories. They are inserted into the vagina before sex. You can buy spermicides in most drug and grocery stores.

• Spermicides alone do not work very well. About 15 pregnancies occur out of every 100 women who correctly use this method alone over 1 year.
• If spermicides are not used correctly, the risk of pregnancy is more than 25 for every 100 women each year.
• Using spermicides along with other methods, such as male or female condoms or the diaphragm, will reduce the chance of pregnancy even more.
• Even by using a spermicide alone, however, you are still much less likely to become pregnant than if you did not use any birth control.

How to use spermicide:

• Using your fingers or applicator, place the spermicide deep into the vagina 10 minutes before having sex. It should continue to work for about 60 minutes.
• You will need to use more spermicide every time you have sex.
• DO NOT douche for at least 6 hours after sex. (Douching is never recommended, as it can cause infection in the uterus and tubes.)

Spermicides do not reduce your chance of an infection. They may increase the risk for spreading HIV.

Risks include irritation and allergic reactions.

VAGINAL SPONGE

Vaginal contraceptive sponges are soft sponges covered with a spermicide.

A sponge can be inserted into the vagina up to 24 hours before intercourse.

• Follow the specific instructions that came with the product.
• Push the sponge as far back into the vagina as possible, and place it over the cervix. Make sure the sponge covers the cervix.
• Leave the sponge in the vagina for 6 to 8 hours after having sex.

DO NOT use the sponge if you have:

• Vaginal bleeding or are having your period
• An allergy to sulfa drugs, polyurethane, or spermicides
• An infection in the vagina, cervix, or uterus
• Recently had an abortion, miscarriage, or a baby

How well does the sponge work?

• About 9 to 12 pregnancies occur out of every 100 women who use sponges correctly over 1 year. Sponges are more effective in women who have never given birth.
• If sponges are not used correctly, the risk of pregnancy is 20 to 25 for every 100 women each year.
• Using sponges along with male condoms will reduce the chance of pregnancy even more.
• Even by using a sponge alone, you are still much less likely to become pregnant than if you did not use any birth control at all.

Risks of the vaginal sponge include:

• Vaginal irritation
• Allergic reaction
• Difficulty removing the sponge
• Toxic shock syndrome (rare)

References

Harper DM, Wilfling LE, Blanner CF. Contraception. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 26.

Marcdante KJ, Kliegman RM, Schuh AM. Adolescent gynecology. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 69.

Rivlin K, Davis AR. Contraception and abortion. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.