Birth Control Barrier Methods (cont.)
The vaginal sponge, introduced in 1983 and taken off the market shortly after, is making a comeback. The contraceptive was deemed safe by the FDA. However, the plant it was manufactured in was not. A new company has moved production to a new plant and should be available in pharmacies again in fall 2003.
The sponge is a soft circular polyurethane device that contains nonoxynol-9, a spermicide. It is disposable and should be discarded after use. It is over the counter, and may be appealing to women who wish to avoid using hormones.
The sponge is inserted into the vagina and placed over the cervix. The polyurethane foam is designed to trap and absorb semen before entry of sperm into the cervix, and the spermicide kills or immobilizes sperm. The sponge has a polyester loop for removal.
It offers an immediate and continuous presence of spermicide throughout a 24-hour period. It continues to be effective if sexual intercourse is repeated during this time. The sponge should be left in place for at least 6 hours after sex. It should be removed no more than 30 hours after insertion because of a low risk of toxic shock syndrome.
The FDA lists the failure rate for the previously marketed sponge to be 14-28 pregnancies per 100 women per year.
Serious medical risks are rare and include irritation and allergic reactions and difficulty with removal. Toxic shock syndrome is a rare but serious infection that can occur if the sponge is left in place longer than recommended. Nonoxynol-9 provides some protection against pregnancy, but the sponge does not protect against STDs.
Francisco Talavera, PharmD, PhD
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