Let’s Talk Contraception: Is Spermicide Effective?

According to the Guttmacher Institute, 0.5 percent of all contraceptive users surveyed in 2010 relied on spermicides as their contraceptive. Although not used often, they are a part of the contraceptive choices sexually active people have to prevent pregnancy. How effective are they, however?

The only available spermicide in the United States is nonoxynol-9. It is available in many products, such as a foam, cream, gel, suppository, or dissolvable film. Nonoxynol-9 is also the main ingredient in the Today contraceptive sponge.

Some spermicides increase risk of HIV transmission.

As a contraceptive by itself, it is not very effective at preventing pregnancy. Throughout the course of one year, and with proper use at every sexual act, 18 women out of 100 will become pregnant using spermicides alone. If used less than perfectly, that number rises to 29 out of every 100 women becoming pregnant. When used with a condom, however, the effectiveness is greatly increased. And spermicides are regularly used in combination with diaphragms and cervical caps.

There are advantages to using a spermicide:

  • they are easy to use
  • they are inexpensive and easily available on the pharmacy shelves
  • their use can be under a woman’s control
  • they do not contain hormones and are OK to use if breastfeeding
  • using a spermicide is a better contraceptive choice than using nothing at all

The disadvantages include:

  • some users experience allergic reactions or irritations
  • there is a possibility of toxic shock syndrome, vaginitis, or increased urinary tract infections
  • no protection against sexually transmitted diseases or HIV — they may actually increase transmission of disease from an infected partner
  • they are not very effective at preventing pregnancy

It was once thought that nonoxynol-9 would be a good contraceptive to reduce the transmission of HIV because it showed activity against some sexually transmitted diseases (STDs). In lab tests, nonoxynol-9 was able to inactivate microbes that caused gonorrhea, chlamydia, and HIV. During the years of the AIDS epidemic, nonoxynol-9 was anecdotally promoted as effective prevention against HIV transmission when used for anal sex. But effectiveness in a test tube is often different from actual results in human usage.

Nonoxynol-9 is a surfactant, which means it works like a detergent to “irritate” and disrupt a sperm cell membrane and destroy it. Clinical studies in humans using nonoxynol-9 showed that this activity actually increased the transmission of infections by irritating sensitive vaginal, cervical, or rectal tissues, which created small tears, scrapes, or lesions. These irritations then allowed for greater transmission of infections and HIV. If used more often than once a day, the chance of transmission was enhanced even more.

In 2007, the Food and Drug Administration responded to this new information by requiring manufacturers to place warnings on their nonoxynol-9 products stating that these products DO NOT PROTECT AGAINST STDs OR HIV. They also stated that nonoxynol-9 products should not be used for rectal intercourse.

To use a spermicide properly, it must be inserted into the vagina before intercourse, according to individual package instructions. The spermicide kills the sperm in the vagina, so it is important not to douche or rinse the vagina for 6 to 8 hours after intercourse. Spermicides should not be used with latex condoms if you or your partner has HIV/AIDS. For best prevention against infections or pregnancy, a latex condom without nonoxynol-9 may be a more reliable and effective non-prescriptive choice.

More information about spermicides is available on Planned Parenthood’s website, where you can also find information about other contraceptives. Health care providers at your local Planned Parenthood health center can talk to you about the wide variety of birth-control options and teach you how to use them properly. Make an appointment today!

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