Place in Therapy
Efficacy
Spermicides containing nonoxynol-9 prevent pregnancy by damaging the cell membrane of sperm limiting their viability. Vaginal film contraceptives as well as sponges contain a mechanical barrier that prevents the sperm from entering the cervix1. Spermicidal agents exist as either foams or vaginal contraceptive films and have a failure rate of 18% with perfect use and a failure rate of 29%, respectively with typical use2. The use of spermicide coated condoms should not be used unless the alternative is no condom at all2. The failure rate is decreased when used in combination with another contraceptive method. Spermicidal agents are to be used as contraceptive agents and not for the prevention of HIV or STIs2. If a woman is to avoid pregnancy due to medical reasons, spermicidal use is not recommended as first line therapy2.
Safety
Spermicidal use should be avoided in patients containing an allergy or hypersensitivity to nonoxynol-9 or at high risk of contracting STIs or HIV2. Vaginal irritation is the most common reported side effect and genital lesions may occur with frequent use raising concern to increasing risk of STI transmission2.
Convenience
Spermicidal products need to be reapplied with every act of sexual intercourse (foam and VCF) or after 3 hours since last application (VCF). The products are relatively easy to use, but they may be messy (foam) and have an unpleasant taste or smell. In addition, both need to be placed at least 15 minutes before sexual intercourse requiring some planning before engaging in sexual intercourse. Spermicidal products are relatively inexpensive ($1.67/film) and $9.99/foam canister.
For females opting for non-hormonal contraception used on an as needed basis that is fairly inexpensive and relatively easy to use, spermicidal products are an option, preferably used in combination with another barrier method4. Efficacy, safety and convenience have influenced the use of spermicidal agents in being the lowest contraceptive method used today3.
References:
1. Patient Self Care 1st Edition. 2002. Canadian Pharmacists Association. Contraception: Chapter 49; pp 650-670.
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.
3. Micromedex 2. Thomson Reuters. Updated October 25, 2011. Accessed on July 9, 2012. http://www.thomsonhc.com.proxy.lib.uwaterloo.ca/micromedex2
.
Efficacy
Spermicides containing nonoxynol-9 prevent pregnancy by damaging the cell membrane of sperm limiting their viability. Vaginal film contraceptives as well as sponges contain a mechanical barrier that prevents the sperm from entering the cervix1. Spermicidal agents exist as either foams or vaginal contraceptive films and have a failure rate of 18% with perfect use and a failure rate of 29%, respectively with typical use2. The use of spermicide coated condoms should not be used unless the alternative is no condom at all2. The failure rate is decreased when used in combination with another contraceptive method. Spermicidal agents are to be used as contraceptive agents and not for the prevention of HIV or STIs2. If a woman is to avoid pregnancy due to medical reasons, spermicidal use is not recommended as first line therapy2.
Safety
Spermicidal use should be avoided in patients containing an allergy or hypersensitivity to nonoxynol-9 or at high risk of contracting STIs or HIV2. Vaginal irritation is the most common reported side effect and genital lesions may occur with frequent use raising concern to increasing risk of STI transmission2.
Convenience
Spermicidal products need to be reapplied with every act of sexual intercourse (foam and VCF) or after 3 hours since last application (VCF). The products are relatively easy to use, but they may be messy (foam) and have an unpleasant taste or smell. In addition, both need to be placed at least 15 minutes before sexual intercourse requiring some planning before engaging in sexual intercourse. Spermicidal products are relatively inexpensive ($1.67/film) and $9.99/foam canister.
For females opting for non-hormonal contraception used on an as needed basis that is fairly inexpensive and relatively easy to use, spermicidal products are an option, preferably used in combination with another barrier method4. Efficacy, safety and convenience have influenced the use of spermicidal agents in being the lowest contraceptive method used today3.
References:
1. Patient Self Care 1st Edition. 2002. Canadian Pharmacists Association. Contraception: Chapter 49; pp 650-670.
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.
3. Micromedex 2. Thomson Reuters. Updated October 25, 2011. Accessed on July 9, 2012. http://www.thomsonhc.com.proxy.lib.uwaterloo.ca/micromedex2
.