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Non-hormonal Contraceptive Methods

(Published July 2013)

Sponge

Description

The vaginal sponge is a small, circular, polyurethane sponge that contains 1 gram of nonoxynol-9 spermicide. The sponge has a dimple on one side that fits over the cervix and a loop on the opposite side for removal. The Today® sponge is the only sponge that is currently available in the United States. The vaginal sponge can be purchased at a pharmacy without a prescription.

Use

SpongeThe sponge is intended for one-time use only. It is moistened with tap water before use, squeezed once to evenly distribute the spermicide, and inserted into the vagina with the dimpled side fit against the cervix. There is no need for repeated applications of spermicide with additional acts of intercourse.

The sponge remains effective for up to 24 hours after insertion, regardless of the number of times intercourse occurs during that time. After the last act of intercourse, it should be left in place for at least 6 hours but for no more than 2430 hours (i.e., if the last act of intercourse occurs 24 hours after insertion, it should be left in place for another 6 hours and then removed), because the risk of toxic shock syndrome (TSS) increases after that time. Women should not rinse the vagina or douche while wearing the sponge and for at least 6 hours after the last act of intercourse. Some women have difficulty with proper placement and/or removal of the sponge. (For more information, visit http://www.todaysponge.com/about.html.)

Effectiveness

  • This method is somewhat effective. The sponge is less effective in gravid women. In nulliparous women, the failure rate is 12 percent with typical use.7
  • In gravid women, the failure rate is 24 percent with typical use.7 

Risks

  • There is an increased risk of yeast infections and TSS if sponge is left in place for longer than 2430 hours.
  • The risk of unintended pregnancy is 12 percent for nulliparous women and 24 percent in parous women.

Side Effects

Some women experience vaginal dryness with sponge use.

Contraindications and Precautions

Medical Eligibility Criteria for Copper T IUD

Category 4

(unacceptable health risk if the contraceptive method is used)

  • High risk for HIV infection

Category 3

(theoretical or proven risks usually outweigh the advantages of using the method)

  • HIV infection or AIDS
  • Antiretroviral therapy
  • Allergy to spermicides

Advantages

  • Relatively discreet (can be inserted ahead of time)
  • Over-the-counter availability
  • Easily reversible

Disadvantages

  • Required with every act of intercourse
  • Lower efficacy than some other methods with typical use
  • Significantly lower efficacy in gravid women
  • Increased risk of yeast infection and TSS if sponge is left in too long
  • No protection against STIs

Counseling Messages

  • Because it is much less effective in gravid women, the vaginal sponge is a better contraceptive choice for women who have never been pregnant.
  • There is an increased risk of TSS if the sponge is left in longer than the recommended time. (Providers should educate patients about the signs of TSS.)
  • This method does not protect against STIs.
  • Patients who use the sponge should obtain emergency contraception in advance. (Note that patients who are less than 17 years old will need a prescription for EC.)