Birth Control Bingo: Contraceptive Sponge
The Sponge is:
- 91% effective with perfect use; 9 out of every 100 people will become pregnant each year
- 86% effective with typical use: 16 out of every 100 people will become pregnant each year
Additional Sources for Effectiveness Ratings and Use:
- 88% typical use/91% perfect use: Contraceptive Technology, 20th Revised Edition; Hatcher, Trussell, Stewart, Nelson, Cates, Guest, Kowal: Ardent Media, 2011.
- 84% typical use/ 91% effective perfect use (for those who have never given birth): ARHP
- 84% typical use/91% perfect use (for those who have never given birth): Planned Parenthood
Contraceptive sponges are far less effective for people who have given birth: they are best used by those who have never given birth.
The What, the Why, the Where, the When, and the How-to: Contraceptive sponges are a combination of cervical barriers and spermicides. They work in two ways: by providing a barrier over the cervix to prevent sperm from entering, and also incorporate a spermicidal foam to kill sperm. In areas and countries where sponges are available, they can be purchased over-the-counter without a prescription or fitting: they are one-size-fits-all. Three common brands of contraceptive sponges are the Today Sponge, the Pharmatex Sponge and the Protectaid. Sponges are currently available in Canada and Europe but not currently in the United States (the company which makes Today recently went bankrupt).
Sponges are used by first wetting and then squeezing them to activate the spermicidal foam within them. They are then placed deep into the vagina as you would a menstrual cup, as far in advance of sexual activity as 24 hours. After sexual activity, they need to be left in place for at least 6 hours, but should usually be removed within 24 hours. For instructions specific to your brand of sponge, consult the insert that came in the package. To remove a sponge, you just reach into the vagina and gently pull it out then dispose of it.
Like with diaphragms or cervical caps, using sponges is usually easy once you get the hang of it, but just like using menstrual cups or tampons, it usually takes a bit of practice to get the hang of it, and the first few times you use them, you may have some difficulty, or make a bit of a mess (or more of one: the foam in sponges does mean they're kind of a messy method) putting them in. Too, just as can happen with men and condoms, it's important for the user not to feel under pressure to quickly put a method in: partners should allow the person using the sponge the time they need to get the device in comfortable and correctly.
Some 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 -- the active ingredient in spermicides inside sponges -- 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 the sponge feels irritating to you or your partner -- if it leaves either of you feeling rubbed a bit raw, sore, swollen or itchy -- it's probably best not to use it. As well, some HIV and STI prevention organizations suggest that non-monogamous couples not use spermicides or methods which contain spermicides because of the possibly increased risks of acquiring infections.
What will/might you need to discuss or negotiate with a partner?
- That you're using the sponge, so they know it's inside the vagina, and they may potentially feel it; that it does also foam if you don't want that to be a surprise
- When they/you will need or want to insert the sponge, if not inserting in advance
- Possible semen/fluid allergies or sensitivities (it is currently estimated as many as around 10% of people may have them), if not using condoms
- Possible spermicide sensitivities or allergies
- 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
Some benefits of contraceptive sponges people usually enjoy are:
- You can put them in in advance of sexual activity and they can be used for more than one act of genital intercourse
- Other than the possible risk of more frequent bladder infections or allergy or sensitivity to spermicide, they don't pose any side effects, nor do they alter your normal body chemistry in any way
- They are relatively inexpensive and you do not need a prescription to get them.
- They can be a good backup method for use with condoms.
Since they are barrier methods, they don't carry any big possible side effects. People who have had toxic shock syndrome (TSS) should not use them, nor should those who are sensitive or allergic to spermicides, polyurethane or sulfa drugs. Some people may find they cause them to experience more frequent bladder or urinary tract infections. You or your partner may be able to feel the device during use, and that may occur more frequently in younger people who are more nervous during sex, and thus less aroused, so the device may be closer to the vaginal opening than it would be otherwise. Contraceptive sponges also may not be used during menstruation, and are not as effective as many other methods of birth control, including other cervical barriers.
When Good Birth Control Does Bad Things: The most common reasons a sponge will fail is because it was not used at all for a given act of intercourse, or was not used properly -- such as by forgetting to wet it first, by using it for longer than 24 hours, or by not inserting it properly. Again, when you're first learning how to use them, they can be a pain in the butt, which makes it a really good idea to practice by yourself at times when you aren't about to have sex: that way, you can get the hang of it without feeling any pressure from a partner waiting on you.
As well, sponges may pose a risk of TSS, so be sure to remember they're in there and not leave them in for any longer than they are supposed to be to reduce that risk. That also helps you avoid vaginal infections or imbalances from the device being left in too long (and the really funky odor that can happen when you do that).
For more information on cervical barriers from the Cervical Barrier Advancement Society, click here.
Other methods which can be used as a backup method with contraceptive sponges:
- 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 contraceptive sponges:
- Cervical Barriers (Diaphragms, Lea's Shield and Cervical Caps)
- the Vaginal Ring (Nuvaring)
Why would a contraceptive sponge be a good option for me? If any of the following are true:
- You don't have an issue with touching your own genitals
- You want or need a method which is non-hormonal and doesn't mess with your body chemistry or pose serious side effects
- You want a method which is easily reversible, and which you don't have to use at times you're not sexually active
- You aren't able to get a method that isn't over-the-counter
- You want something you can use as an easy backup method with condoms
- You are looking for a method which you are completely in charge of yourself, where you don't have to rely on a partner to help with or be responsible for birth control
- You are looking for an inexpensive method of birth control, or one you do not have to commit to pay for regularly
- You want a method you only have to think about a bit in advance of or at the time of sex, rather than during sex, or at times when you are not sexually active or going to have intercourse, and which you can use for multiple acts of intercourse
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.