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Birth Control Bingo: Spermicides

  • 82% effective with perfect use; 18 out of every 100 women will become pregnant each year
  • 71% effective with typical use: 29 out of every 100 women will become pregnant each year

Additional Sources for Effectiveness Ratings and Use:

  • 71% typical use/82 - 85% perfect use: Contraceptive Technology, 18th Revised Edition; Hatcher, Trussell, Stewart, Nelson, Cates, Guest, Kowal: Ardent Media, 2004.
  • 71% typical use/ 82% effective perfect use: Feminist Women's Health Center
  • 71% typical use/85% perfect use: Planned Parenthood

The What, the Why, the Where, the When, and the How-to: The way spermicides work is by using a chemical agent -- though through history, we have also had more natural spermicides: some people still experiment with natural spermicides now -- to kill sperm, and/or through the thickness of some kinds of spermicides, by helping to block the opening to the cervix. Think of spermicides as the bug-zappers of birth control. Spermicides are inserted into the vagina in several ways before intercourse, and do their thing if and when a man ejaculates or pre-ejaculates.

There are several kinds of spermicides: spermicidal foam is a bit like shaving cream, and is squirted into the vagina, spermicidal suppositories, which dissolve in the vagina slowly (usually in around 20 minutes or less), spermicidal film, a thin sheet placed into the vagina which dissolves, and spermicidal creams or jellies, which are either put into the vagina with an applicator, or used with a cervical barrier method. Some condoms also are coated with a small amount of spermicide. Most spermicides have the active ingredient Nonoxynol-9, a surfectant also used in some cleaning products, such as dish soap or washing-up liquid.

Spermicide alone is one of the least effective methods of birth control there is, even with perfect use. The perfect use rate for spermicides is lower than the typical use rates for most methods. It is far better to use in combination with another contraceptive, as a backup method, like with condoms.

But unlike some other methods, spermicides are very inexpensive, available over-the-counter, they can be used by those who can't or do not want to use hormonal methods or behavioral methods, and they are a decent backup method for almost any other method. They can be messy, and some people don't like them for that reason. Spermicides can also provide extra lubrication during genital intercourse, though it can also be irritating to many people's genitals. When it is an irritant, that lubrication may both dry up quickly and also leave either partner feeling even drier or more raw than they might otherwise because of irritated genital tissue.

In a similar vein, studies have found that spermicides increase the risks of acquiring sexually transmitted infections, including HIV, for some people, primarily those very frequently using spermicides, or who are having a lot of intercourse or many partners. Nonoxynol-9 can cause small, micro-abrasions of the genitals, which create greater opportunities for infections from viruses and bacteria. To play it safe, both in terms of STIs and for general vaginal health and comfort, if spermicides feel irritating to you or your partner -- if they leave either of you feeling rubbed a bit raw, sore, swollen or itchy -- it's probably best not to use them. As well, some HIV and STI prevention organizations suggest that non-monogamous couples not use spermicides because of the possibly increased risks of acquiring infections.

The World Health Organization has made clear that there is no evidence that spermicidally-lubricated condoms provide any additional protection against pregnancy or STIs compared with condoms lubricated with other products. They add that since adverse effects due to the addition of Nonoxynol-9 to condoms cannot be excluded, such condoms should no longer be promoted, and also suggest that Nonoxynol-9 not ever be used rectally/anally.

You can get spermicides from the same places -- and usually in the same aisle -- where you can get condoms: pharmacies, grocers, megastores, online vendors, student and community health centers and clinics (where they can often be found for free) and in other places.

Think or know you used this method improperly, or know that you have had a pregnancy risk due to unprotected sex? It might not be too late for you to prevent an unwanted pregnancy with a method of emergency contraception.

When Good Birth Control Does Bad Things: Even when used perfectly, spermicides will often fail. But they are even more likely to fail if they are not inserted before intercourse, or early enough for some methods -- namely, film -- also sometimes called VCF -- or suppositories, which are not effective instantly like foam or jellies are.

Other methods which can be used as a backup method with spermicides:

Other methods you might like if you like spermicides:

Why would spermicides be a good option for me? If any of the following are true:

  • You are looking for a cheap, easy-to-find, easy-to-use backup method to use with other methods
  • You also use a cervical barrier method(STIs)
  • You cannot or do not want to use hormonal or behavioral methods of birth control
  • You are looking for a method with few potential side effects
  • You are looking for a method you can get over-the-counter
  • You are looking for an inexpensive method of birth control, or one you do not have to commit to pay for regularly
  • You are not sensitive or allergic to them
  • You are looking for a method you only have to think about at the time you're going to have sex
  • You are currently breastfeeding

For a brief overview of all BC methods, have a look at Margaret Sanger's Disneyland: Choosing Contraceptives. Want to start over with Birth Control Bingo? Click here.

Don't forget: Statistically, sexually active young adults are as, if not more, likely to acquire a sexually transmitted infection (STI) as you are to become pregnant. Although 15-24-year-olds represent only one-quarter of the sexually active population, they account for nearly half of all new STIs each year, and of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15-24-year-olds (AGI). Often people have some funny ideas about who is most likely to get an STI, but the fact of the matter is that younger people -- of any sexual orientation, any economic class, any kind of relationship -- have been the highest risk group for some time now.

Condoms are the only method of birth control which also provide protection against STIs. It's pretty typical for younger people to ditch condoms if they have another method of birth control, so just remember that STIs are still a risk if you're using another method. You can read all about safer sex here -- Safe, Sound & Sexy: A Safer Sex How-To -- but the rule of thumb most medical experts and prevention organizations suggest, which we also encourage at Scarleteen is six months of safer sex, six months of sexual monogamy, and then TWO full STI screenings for each partner -- once at the start of that six months, once at the end -- before ditching latex barriers.