Spermicides are non-prescription and easily
available in many different preparations (creams, foams, jellies, suppositories).
Ideally, spermicides should be used with another method, such as condoms or
diaphragms. Vaginal spermicides, when used alone, are much less effective in
preventing pregnancy than birth control pills, the IUD, or spermicides used
with another form of birth control, such as cervical caps, condoms, or diaphragms.
Studies have shown that when spermicides are used alone, pregnancy usually
occurs in 21--26 of each 100 women during the first year of spermicide use.
The number of pregnancies is significantly reduced when spermicides are used
with another barrier method, particularly the condom. They work by blocking
entry of sperm into the uterus with foam or thick cream and creating an environment
in which sperm cannot survive. All types contain a sperm-killing chemical such
Issues to consider include:
- Read product instructions carefully. Some spermicides require the couple
to wait 10 minutes or more after inserting the spermicide before having sex.
One dose of spermicide is usually effective for one hour. For repeated intercourse,
additional spermicide must be applied. After intercourse, the spermicide has
to remain in place for at least six to eight hours (different depending upon
the product) to ensure that all sperm are killed. Women should not douche,
rinse the vagina, or bathe during this time. If using a spermicide
with another barrier contraceptive, make sure the directions for the spermicide
you choose state that it is safe for use with latex cervical caps, condoms,
or diaphragms. If the directions do not specify that the spermicide is
safe with latex products, it may cause cervical caps, condoms, or diaphragms
to weaken and leak or cause condoms to break during intercourse.
- Laboratory studies have shown that the most common spermicidal agent,
nonoxynol-9 kills or stops the growth of the AIDS virus (HIV) and herpes simplex
I and II viruses. It was also shown to be effective against other types of
organisms that cause gonorrhea, chlamydia, syphilis, trichomoniasis, and other
sexually transmitted diseases (venereal disease, VD, STDs). Although
this has not been proven in human studies (clinical trials),
some scientists believe that if spermicides are put into the vagina
or on the inside and outside of a latex (rubber) condom, they may kill
these germs before they are able to come in contact with the vagina.
- It is not known whether spermicides can cause breaks in the skin that could
actually increase the chances of getting a sexually transmitted disease, especially
AIDS. A recent large study in South Africa found that the most widely
used spermicide, nonoxynol-9 is associated with an increased risk of HIV infection
in South African women prostitutes who used it frequently (up to 20 times
per day). Nonoxynol-9 is widely used in the US for contraception alone
and with condoms. About one-third of lubricated condoms sold in the
United States are covered with it. This study may change the recommendation
to use condoms with nonoxynol-9. Not only might it not afford the protection
it had been assumed to provide, it may cause an increased risk
for HIV infection. This study's results must be interpreted with great
reserve however. It is unclear how applicable the differences are from a population
of prostitutes having intercourse with up to 20 different partners per day
and using this spermicide 20 times per day in a country where HIV infection
is becoming epidemic to the American sexually active adult population.
- As a result of this research, however, at least two other studies of nonoxynol-9
gel in African women have been halted as have 2 studies of nonoxynol-9 in
the US. Based on this information, American women who are using condoms
solely to prevent disease or who are at increased risk of HIV should
choose condoms that are not coated with nonoxynol-9 and choose another spermicide.
- For those who are not in a confidently monogamous relationship, the use
of a spermicide is still recommended even when you are using non-barrier methods
of birth control, such as birth control pills (the Pill) or intrauterine devices
(IUDs) to confer additional protection from STDs.
- As with any medicine, when considering whether to use vaginal
spermicides, their risks must be weighed against their potential benefits.
This is a decision you and possibly your doctor will make.
Allergies-If you have ever had any unusual or allergic reaction to benzalkonium
chloride, nonoxynol-9, or octoxynol-9, it is best to check with your doctor
and read the ingredients carefully before using any vaginal spermicides.
How do you know if you have an allergy (or sensitivity) to one of these products?
During use of spermicides, either partner may feel burning, stinging, warmth,
itching, or other irritation. Using a weaker strength of vaginal spermicide
or one with different ingredients may be necessary. If you are using benzalkonium
chloride suppositories, it may help to wet them before they are inserted into
the vagina. If any of these effects continue after you have changed products,
you may have an allergy to these products or an infection, and should contact
a doctor as soon as possible.
Pregnancy-Studies have shown that the use of vaginal spermicides
does not increase the risk of birth defects or miscarriage. The only reason
to use a spermicide during pregnancy is for STD protection although many women
have used spermicides for contraceptive purposes when they were already pregnant.
Breast-feeding-It is not known if vaginal spermicides pass into breast
milk in humans. However, their use has not been reported to cause problems in
Adolescents-These products have been used by teenagers and have
not been shown to cause different side effects or problems than they do in adults.
However, some younger users may need extra counseling and information on the
importance of using spermicides properly to maximize their effectiveness.
certain medical problems may affect the use of vaginal spermicides. In some
cases spermicides should not be used. If you have any of the following
medical conditions, check with your doctor before using spermicides:
- Allergies, irritations, or
infections of the genitals.
- Conditions or medical problems
where it is important that pregnancy does not occur.
- Recent childbirth, miscarriage, or
- Toxic shock syndrome (history
of)-Cervical caps or diaphragms should not be used in these cases because
there is an increased chance of developing toxic shock syndrome.
- Sores on the genitals (sex
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Created: 10/31/2001  - Donnica Moore, M.D.