Contraception - Spermicidal Agents
What Is a Spermicide and How Does it Work? A spermicide is a chemical that is inserted into the vagina prior to intercourse to kill sperm and act as a physical barrier to prevent any surviving sperm cells from entering into the cervix. Spermicides are available in the form of foam (most effective), films, creams, jellies, and suppositories. Nonoxynol-9, the main ingredient in most spermicides, also provides some protection against sexually transmitted diseases (STDs), including HIV. Most nonoxynol-9 products are odorless and colorless, they may have a slight bitter taste.
What is the Effectiveness of Spermicidal Agents?
The use of spermicidal foam alone is said to be only 70-80% effective in protecting against unwanted pregnancy. While spermicidal agents are frequently used on their own most experts suggest that they are most effective in protecting against both unwanted pregnancy and STDs when used with male condoms or the female diaphragm.
Table 1
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Theoretical Effectiveness*
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Actual Effectiveness**
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Spermicide alone
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94%
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79%
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Condom plus spermicide
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99.9%
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98%**
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Condom without spermicide
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97%
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88%
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Diaphragm with spermicide
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94%
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82%
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* Theoretical effectiveness rates are based on studies that have been done to determine how effective a method itself can be, apart from user behaviors.
** Actual effectiveness rates reflect what happens to the pregnancy rate in a group of people who do not use this method correctly some of the time and who do not use this method every time they have intercourse.
*** This is the best figure available.
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How Are Spermicides Used?
The spermicide is used by the woman when she inserts foam, cream, jelly or suppositories deep into her vagina as close as possible to her to her cervix. It must be used within 15 to 20 minutes of having intercourse. A new application must be for each act of intercourse or if there is a delay of intercourse for more than 30 minutes after application. Because spermicides are not very effective in preventing pregnancy when used alone, they should only be used with another form of contraception such as a condoms or a diaphragm. For information on use of a diaphragm ask for our handout, Diaphragm. For information on use of condoms ask for our handout Condoms - Contraception and Safe Sex.
Of the condom breaks a second application of foam or spermicidal cream should be sued to provide maximum protection.
Never douche immediately after having sex if you are using spermicidal agents. If you wash the spermicidal agent out even a single sperm left in the vagina can caused an unwanted pregnancy. You may douche 6 or more hours later without risk.
What Are the Advantages of Condoms and Spermicides?
They are both readily available over-the-counter. Inexpensive, and no prescription or medical exam is necessary.
When they used correctly both increase protection against HIV, gonorrhea, chlamydia and herpes
Condoms allow the man to take an active role and shared responsibility in preventing unwanted pregnancy.
Spermicidal agents are 100% free of any serious health risks.
Condoms may increase the man's ability to maintain an erection longer.
Spermicides provide lubrication for intercourse.
What Are the Disadvantages of Condoms and Spermicides?
They may interrupt foreplay or the lovemaking process, because the condom must be placed on erect penis and the spermicide must be inserted into the vagina prior to intercourse.
They can be ineffective against protecting unwanted pregnancy or STDs, if used incorrectly or if the condom breaks.
They, one or both, may reduce sensitivity and pleasure of the sex act.
Allergic reactions to latex, spermicide, or lubricant can occur.
They may be messy or inconvenient.
They may necessitates prompt withdrawal to keep the condom from slipping off.
They may result in less energetic lovemaking from fear that condom may slip off or break.
They may taste bad (scented condoms such as mint are not spermicide lubricated).
They may not protect against transmission of HPV (genital warts)
Who Can Use Condoms and Spermicides?
Condoms and spermicide can be an effective birth control method for many people. However, you should not rely solely on use of condoms alone for prevention of unwanted pregnancy and STDs:
If you do not use a spermicidal agent consistently
If your partner (man or woman) is not supportive of the method and resists its use actively or passively.
If you or your partner are allergic to latex or specific spermicides or lubricants.
Do Spermicidal Agents Protect or Prevent STDs?
The answer to this question is yes. However, they are not always 100% effective. If you are sexually active with someone you do not know or who will not use a condom, spermicidal agents do provide some valuable protection against STDs. The use of condoms alone cannot always prevent STD transmission, but they can help reduce the risk. Many studies now show that spermicidal agents containing nonoxynol-9 when used correctly along with condoms used correctly provide the very best protection against most STDs available, other then complete abstinence.
Special Notes:
It should be made clear that animal membrane condoms (lambskin) and spermicides that do not contain nonoxynol-9 and therefore do not give as much protection against HIV infection and other sexually transmitted diseases as is afforded with latex condoms and spermicides that contain nonoxynol-9 Therefore it is always best, if you are concerned about contracting STDs to use latex or polyurethane condoms with nonoxynol-9. If STDs are not an issue any condom may be used for protection against unwanted pregnancy alone.
Special Warning:
Spermicidal agents should not be used during pregnancy, there may be increased risks of birth defects. If you suspect that you are pregnant discontinue use of any spermicidal product and see your doctor for a pregnancy test and evaluation.
Condoms and spermicidal agents should always be kept out of reach of children.
Spermicidal agents should never be taken orally.
If pelvic pain, vaginal discharge or discharge from the penis occur, see your doctor to rule out a STD.
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