Contraceptive sponge

Contraceptive sponge
Protectaid sponge, in its plastic tray. It is removed from the tray before use.
Background
TypeBarrier
First use1983
Failure rates (first year)
Perfect useNulliparous:9%[1]
Parous:20%[1]
Typical useNulliparous:12%[1]
Parous:24%[1]
Usage
ReversibilityImmediate
User reminders?
Advantages and disadvantages
STI protectionNo
BenefitsMay be inserted 12–24 hours before intercourse
Risksyeast 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.[2]

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 contains spermicide.[3]

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. Sponges can provide contraception for multiple acts of intercourse over a 24 hour period, but cannot be reused beyond that time or once removed.[4]

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 87% are reported. Other sources cite poorer effectiveness rates for women who have given birth: 74% during correct and consistent use, and 68% during typical use.

Studies of Protectaid have found effectiveness rates of 77% to 91%.

Studies on Pharmatex have found perfect use effectiveness rates of over 99% per year. Typical use of Pharmatex results in effectiveness of 81% per year. 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 with about two tablespoons of water.[5][6] The water is used as a mechanism to activate the spermicide inside the sponge.[7] No extra spermicide is needed.[7] The Protectaid[2] 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.[3]

The sponge should never be reused once it has been removed after having sexual intercourse.[7]

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

The Today sponge was developed beginning in 1976 and introduced in the United States in 1983. Today was removed from the market in 1994 due to manufacturing problems. 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, production was shut down again, until the new manufacturer, Mayer Laboratories Ltd., reintroduced Today to the U.S. market in 2009.

Pharmatex sponge

The Pharmatex sponge was introduced in France and the Canadian province of Quebec in 1984.[9]

Protectaid sponge

The Protectaid sponge was introduced in Canada in 1996, and in Europe in 2000.[2]

Spermicide

Sponges are a physical barrier, trapping sperm and preventing their passage through the cervix into the 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.[10] 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.[2]

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.[3]

  • 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, Elaine Benes conserves her remaining Today sponges by choosing to not have intercourse unless she is certain her partner is "sponge-worthy".[11] This was later revisited in the series finale when the pharmacist testifies against Elaine and her morality for buying a whole case of the sponges.
  • 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 is thinking of having sex.
  • In the TV series Downton Abbey, Anna Bates, lady's maid to Lady Mary Crawley, buys a 1920s contraceptive sponge for her mistress. Later the device is found by Anna's husband John Bates who assumes she is using it herself.

References

  1. 1 2 3 4 Trussell, James (2011). "Contraceptive efficacy". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.
  2. 1 2 3 4 "Sponges". Cervical Barrier Advancement Society. 2004. Archived from the original on 2009-01-14. Retrieved 2006-09-17.
  3. 1 2 3 "Bith Control Sponge". Archived from the original on 9 January 2014. Retrieved 13 September 2014.
  4. ↑ "Today Sponge Vaginal Contraceptive Sponge Consumer Information Leaflet" (PDF). Mayer Laboratories, Inc. Retrieved 3 March 2019.
  5. ↑ "How Well Does Today Sponge Prevent Pregnancy?". Today Sponge. Allendale Pharmaceuticals. Archived from the original on 2006-07-17. Retrieved 2006-08-17.
  6. ↑ "Contraceptive sponge". Mayo Clinic. Retrieved December 12, 2020.
  7. 1 2 3 Mayo Clinic. Archived 2010-10-12 at the Wayback Machine (2010). Retrieved February 3, 2011
  8. 1 2 "The Birth Control Sponge". Global Health Options. 2004. Archived from the original on August 19, 2006. Retrieved 2006-10-06.
  9. ↑ Menard F (1984). "The health of women and contraception in Quebec". Planned Parenthood in Europe Regional Information Bulletin. 13 (1): 18–20. PMID 12178356.
  10. ↑ Best, Kim (2000). "New Devices May Be Easier to Use". Network. Family Health International. 20 (2). Retrieved 2006-10-01.
  11. ↑ Lavery, David and Sara Lewis Dunne (2006). Seinfeld, master of its domain: revisiting television's greatest sitcom, p. 247. Continuum International Publishing Group, ISBN 978-0-8264-1803-6
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