Birth Control Bingo: Spermicides
Spermicides are another of the oldest forms of contraception. The first written record of spermicide use was found to be in Egypt, in 1850 BCE, and included crocodile dung, yet again, a common ingredient in early pessaries, too. How happy are you not to have to put crocodile dung in your vagina? I know I'm stoked.
Other early spermicides used ingredients like dates, honey, acacia, lactic acid and sour milk. People have had some pretty strange (and also flat-out wrong, as well as potentially dangerous) ideas over the years about what can act as a spermicide over the years, thinking things like soda could act as a spermicide.
- 83% effective with perfect use; 17 out of every 100 people will become pregnant each year
- 72% effective with typical use: 29 out of every 100 people will become pregnant each year
Additional Sources for Effectiveness Ratings and Use:
- 72% typical use/82% perfect use: Contraceptive Technology, 20th Revised Edition; Hatcher, Trussell, Stewart, Nelson, Cates, Guest, Kowal: Ardent Media, 2004.
- 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 make sperm less able to move and to reach the cervix, and to make the cervical opening less accessible to sperm. Think of spermicides as the bug-zappers of birth control. Spermicides are inserted into the vagina before intercourse, and do their thing if and when a person with a penis ejaculates or pre-ejaculates by rendering sperm cells impotent.
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 are also 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 at all 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. In other words, condoms with spermicide have the exact same efficacy -- they are no more effective -- as condoms without a spermicidal lubricant added. 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 never 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.
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. As spermicides are one of the least effective forms of contraception even in perfect use, if used, they are likely best used as a backup with another method.
What will/might you need to discuss or negotiate with a partner?
- When they/you will need or want to insert the spermicide, if not inserting in advance
- Possible spermicide sensitivities or allergies
- Possible semen/fluid allergies or sensitivities (it is currently estimated as many as around 10% of people may have them), if not using condoms
- How you/they feel about ejaculation inside the vagina if condoms are not also being used
- STI status and history, if the sponge is not being combined with condom use
Other methods which can be used as a backup method with spermicides:
- Cervical Barriers (Diaphragms, Lea's Shield and Cervical Caps)
- Combined Oral Contraceptives (The Pill)
- the Contraceptive Implant (Implanon)
- the Contraceptive Patch
- Depo-Provera (The Shot)
- Emergency Contraception (Plan B or the Morning-After-Pill)
- Fertility Awareness (FAM)
- Intrauterine Devices (IUD, IUC or IUS)
- Progesterone-Only Oral Contraceptives (Minipills)
Other methods you might like if you like spermicides:
- Cervical Barriers (Diaphragms, Lea's Shield and Cervical Caps)
- the Sponge
- the Vaginal Ring (Nuvaring)
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
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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.
Illustrations copyright 2014, Isabella Rotman