Birth Control Barrier Methods (cont.)
The cervical cap is a soft cup-shaped latex device that fits over the base of a womans cervix. It is smaller than a diaphragm and may be harder to insert. It too must be fitted by your doctor because it comes in different sizes. Its use is derived from the eighteenth- to twentieth-century European practice of placing the rind of a lemon or small orange against the cervix prior to intercourse.
A groove along the inner circumference of the rim improves the seal between the inner rim of the cap and the base of the cervix. Spermicide is needed to fill the cap one third full prior to its insertion. It is inserted as long as 8 hours before sexual activity and can be left in place for as long as 48 hours.
A cervical cap acts as both a mechanical barrier to sperm migration into the cervical canal and as a chemical agent with the use of spermicide.
- How effective: The effectiveness depends on whether a woman has had children before because it affects the shape of her cervix. With perfect use in the first year, a woman who has not had children has a failure rate of 9% (but more typically 20%), as opposed to 20% in a woman who has delivered children (and more likely 40% failure rate).
- Advantages: It provides continuous contraceptive protection as long as it is in place regardless of the number of intercourse acts. Additional spermicide, unlike for the diaphragm, is not necessary for repeated intercourse. The cervical cap does not involve ongoing use of hormones.
- Disadvantages: Cervical erosion may lead to vaginal spotting. A theoretical risk of toxic shock syndrome exists if the cervical cap is left in place longer than the prescribed period. The cervical cap requires professional fitting and training for use. Severe obesity may make placement difficult. A relatively high failure rate exists. Women must have a history of normal results on Pap smears. This method does not protect against STDs.
Francisco Talavera, PharmD, PhD
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