Place in Therapy
Efficacy
- The contraceptive sponge should not be recommended as a first line barrier method of contraception. The reported efficacy of the contraceptive sponge ranges from 60 to 91% depending on the particular brand, as well as parity. Failure rates are much higher (often doubled) in parous users versus nulliparous women.1,4 The sponge is less effective compared to the diaphragm and its rate of discontinuation is higher.3 It may be an option for women who want to avoid hormonal contraception and desire the 12 hours of prolonged protection. It may be preferred over spermicide (alone or in combination) as it is less messy. The sponge increases the efficacy rate if used in combination with the male condom.4 There is no high quality evidence that the sponge protects against sexually transmitted infections.
Safety
- The contraceptive sponge is reported to be well-tolerated by a variety of sexually active women but it can lead to potentially serious complications.1,4 Frequent use of nonoxynol-9 may damage the vaginal epithelium and increase the risk of HIV infection. At this time, there is no conclusive evidence to prove or disprove this concern. Women who have multiple intercourse acts per day should avoid using nonoxynol-9 products, which includes the contraceptive sponge. The contraceptive sponge also increases the risk of toxic shock syndrome but this risk is very small (2 to 3 cases per 100 000 women).4
Cost/convenience
- In order to use the sponge, women must know and be able to insert and remove it correctly; this may be challenging for some. It is also recommended that women wait at least 6 hours before removing the sponge. Waiting can be quite inconvenient, especially since the woman must wait at least 6 hours after sex but it cannot remain inserted for more than 12 hours in total. Although the sponge is effective for 12 hours regardless of the number of acts of intercourse, multiple daily acts are not recommended due to safety concerns. The sponge is fairly expensive, ranging from $12.99 to $19.00 for a pack of 3 ($4.33 -$6.33 per sponge).
References
1. Creatsas G, Guerrero E, Guilbert E, et al. A multinational evaluation of the efficacy, safety and acceptability of the Protectaid contraceptive sponge. Eur J Contracept Reprod Health Care. 2001 Sep;6(3):172-82.
2. Black A, Francoeur D, Rowe T et al. SOGC clinical practice guidelines: Canadian contraception consensus. J Obstet Gynaecol Can. 2004 Mar;26(3):219-96.
.
Efficacy
- The contraceptive sponge should not be recommended as a first line barrier method of contraception. The reported efficacy of the contraceptive sponge ranges from 60 to 91% depending on the particular brand, as well as parity. Failure rates are much higher (often doubled) in parous users versus nulliparous women.1,4 The sponge is less effective compared to the diaphragm and its rate of discontinuation is higher.3 It may be an option for women who want to avoid hormonal contraception and desire the 12 hours of prolonged protection. It may be preferred over spermicide (alone or in combination) as it is less messy. The sponge increases the efficacy rate if used in combination with the male condom.4 There is no high quality evidence that the sponge protects against sexually transmitted infections.
Safety
- The contraceptive sponge is reported to be well-tolerated by a variety of sexually active women but it can lead to potentially serious complications.1,4 Frequent use of nonoxynol-9 may damage the vaginal epithelium and increase the risk of HIV infection. At this time, there is no conclusive evidence to prove or disprove this concern. Women who have multiple intercourse acts per day should avoid using nonoxynol-9 products, which includes the contraceptive sponge. The contraceptive sponge also increases the risk of toxic shock syndrome but this risk is very small (2 to 3 cases per 100 000 women).4
Cost/convenience
- In order to use the sponge, women must know and be able to insert and remove it correctly; this may be challenging for some. It is also recommended that women wait at least 6 hours before removing the sponge. Waiting can be quite inconvenient, especially since the woman must wait at least 6 hours after sex but it cannot remain inserted for more than 12 hours in total. Although the sponge is effective for 12 hours regardless of the number of acts of intercourse, multiple daily acts are not recommended due to safety concerns. The sponge is fairly expensive, ranging from $12.99 to $19.00 for a pack of 3 ($4.33 -$6.33 per sponge).
References
1. Creatsas G, Guerrero E, Guilbert E, et al. A multinational evaluation of the efficacy, safety and acceptability of the Protectaid contraceptive sponge. Eur J Contracept Reprod Health Care. 2001 Sep;6(3):172-82.
2. Black A, Francoeur D, Rowe T et al. SOGC clinical practice guidelines: Canadian contraception consensus. J Obstet Gynaecol Can. 2004 Mar;26(3):219-96.
.