Contraceptive sponge

Contraceptive sponge
Protectaid sponge, in its plastic tray. It is removed from the tray before use.
Background
Birth control type	Barrier
First use	1983
Failure rates (first year)
Perfect use	Nulliparous:9% Parous:26%
Typical use	Nulliparous:16% Parous:32%
Usage
Reversibility	Immediate
User reminders	?
Advantages and disadvantages
STD protection	No
Benefits	May be inserted 12–24 hours before intercourse
Risks	yeast infection, rarely toxic shock syndrome

The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.^[1]

Sponges work in two ways. First, the sponge is inserted into the vagina, so it can cover the cervix and prevent any sperm from entering the uterus. Secondly, the sponge is produced with spermicide already inside of it, which is used to prevent the sperm from moving. ^[2]

The sponges are inserted vaginally prior to intercourse and must be placed over the cervix to be effective. Sponges provide no protection from sexually transmitted infections (STIs).

Effectiveness

The manufacturer of the Today sponge reports effectiveness for prevention of pregnancy of 89% to 91% when used correctly and consistently. When packaging directions are not followed for every act of intercourse, effectiveness rates of 84% to 89% are reported.^[3] Other sources cite poorer effectiveness rates for women who have given birth - 74% during correct and consistent use, and 68% during typical use.^[4]

Studies of Protectaid have found effectiveness rates of 77% to 91%.^[5][6]

Studies of Pharmatex have found perfect use effectiveness rates of over 99% per year.^[7] Typical use of Pharmatex results in effectiveness of 81% per year.^[8] Sponges may be used in conjunction with another method of birth control such as condoms to increase effectiveness.

Use

To use the Today sponge, it must be run under water until thoroughly wet, about 2 tablespoons.^[3] The water is used as a mechanism to activate the spermicide inside the sponge.^[9] No extra spermicide is needed.^[10] The Protectaid^[1] and Pharmatex^[8] sponges come ready to use.

The sponge can be inserted up to 24 hours before intercourse. It must be left in place for at least six hours after intercourse. It should not be worn for more than 30 hours in a row.^[11]

The sponge should never be reused once it has been removed after having sexual intercourse. ^[12]

History

The devices have had periods of unavailability in some markets since being introduced. All three brands are currently available outside their normal marketing areas through internet retailers.

Today sponge

Main article: Today sponge

The Today Sponge was developed beginning in 1976 and introduced in the United States in 1983. Today was removed from the market in 1994. Following several delays, the Today brand became available again in Canada in March 2003, and in the U.S. in September 2005. After the manufacturer's parent company declared bankruptcy in 2007, the brand was off the market until relaunched in 2009.

Pharmatex sponge

The Pharmatex sponge was introduced in France and the Quebec province in Canada in 1984.^[13]

Protectaid sponge

The Protectaid sponge was introduced in Canada in 1996, and in Europe in 2000.^[1]

Spermicide

Sponges are a physical barrier, trapping sperm and preventing their passage through the cervix into the female reproductive system. The spermicide is an important component of pregnancy prevention; each brand offers a different formula.

The Today sponge contains 1,000 milligrams (mg) of nonoxynol-9.^[14] Protectaid contains 5,000 mg of the F-5 gel, with three active ingredients (6.25 mg of nonoxynol-9, 6.25 mg of benzalkonium chloride, and 25 mg of sodium cholate).^[8] Pharmatex contains 60 mg of benzalkonium chloride.^[1]

Side effects

Some people are allergic to the spermicide used in the sponge. Women who use contraceptive sponges have an increased risk of yeast infection and urinary tract infection. Improper use, such as leaving the sponge in too long, can result in toxic shock syndrome.

The Today sponge contains the spermicide nonoxynol-9, which may contain certain risks for those using the sponge multiple times a day, or for those at risk for HIV. In these cases, nonoxynol-9 can irritate the tissue, which leads to an increased risk of HIV and other sexually transmitted infections.^[15]

In U.S.A popular culture

• Shortly after they were taken off the U.S. market, the sponge was featured in an episode of the sitcom Seinfeld titled "The Sponge". In the episode, the character Elaine Benes conserves her remaining Today sponges by refusing intercourse unless she is certain her partner is "sponge-worthy".^[16]
• The film Clueless features a scene where the characters Dionne and Tai are discussing sex and Dionne is heard to ask Tai if the sponge would still work if the user has sex in water.
• On the TV series "My So-Called Life," the doctor tells Angela to use a sponge if she's thinking of having sex.

Footnotes

1. ^ ^{a b c d} "Sponges". Cervical Barrier Advancement Society. 2004. http://www.cervicalbarriers.org/information/sponges.cfm. Retrieved 2006-09-17. 
2. ^ Planned Parenthood. (2011). Retrieved February 3, 2010.
3. ^ ^{a b} "How Well Does Today Sponge Prevent Pregnancy?". Today Sponge. Allendale Pharmaceuticals. Archived from the original on 2006-07-17. http://web.archive.org/web/20060717204734/http://www.todaysponge.com/howwell.htm. Retrieved 2006-08-17. 
4. ^ Hatcher, RA; Trussel J, Stewart F, et al. (2000). Contraceptive Technology (18th ed.). New York: Ardent Media. ISBN 0-9664902-6-6. http://www.contraceptivetechnology.com/table.html. 
5. ^ Creatsas G, Elsheikh A, Colin P (2002). "Safety and tolerability of the new contraceptive sponge Protectaid". Eur J Contracept Reprod Health Care 7 (2): 91–5. doi:10.1080/713604323. PMID 12201327. 
6. ^ Creatsas G, Guerrero E, Guilbert E, Drouin J, Serfaty D, Lemieux L, Suissa S, Colin P (2001). "A multinational evaluation of the efficacy, safety and acceptability of the Protectaid contraceptive sponge". Eur J Contracept Reprod Health Care 6 (3): 172–82. doi:10.1080/713604234. PMID 11763982. 
7. ^ "Ovule Pharmatex: results of 10 years of research in contraception". Nurs Que 3 (2): 33. 1983. PMID 6552435. 
   Serfaty D (1982). "The contraceptive sponge". Entret Bichat Pitie Salpetriere Ther: 225–8. PMID 12340222. 
   Leroy B, Serror R (1979). "Contraception through the use of intravaginal spermicides during the post-partum period". Rev Fr Gynecol Obstet 74 (1): 63–5. PMID 424660. 
8. ^ ^{a b c} "The Birth Control Sponge". Global Health Options. 2004. http://www.g-h-o.co.uk/sponge.htm. Retrieved 2006-10-06. ^{[dead link]}
9. ^ Mayo Clinic. (2010). Retrieved February 3, 2011
10. ^ Mayo Clinic. (2010). Retrieved February 3, 2011
11. ^ [1]
12. ^ Mayo Clinic. (2010). Retrieved February 3, 2011
13. ^ Menard F (1984). "The health of women and contraception in Quebec". IPPF Eur Reg Inf 13 (1): 18–20. PMID 12178356. 
14. ^ Best, Kim (2000). "New Devices May Be Easier to Use". Network (Family Health International) 20 (2). http://www.reproline.jhu.edu/english/6read/6issues/6network/v20-2/nt2023.html. Retrieved 2006-10-01. 
15. ^ Planned Parenthood (2011). Retrieved February 3, 2011.
16. ^ Lavery, David and Sara Lewis Dunne (2006). Seinfeld, master of its domain: revisiting television's greatest sitcom, p. 247. Continuum International Publishing Group, ISBN 9780826418036

External links

• Contraceptive Sponge - American Pregnancy Association
• Contraceptive Sponge - CoolNurse.com
• Spongeworthiness - Salon.com
• The Contraceptive Sponge - DrDonnica.com
• Contraceptive Sponges (Today / Protectaid / Pharmatex) - FAQ thread on Ovusoft.com message boards