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Choosing a Birth Control Method

(Published September 2011)

Spermicides

Description

Spermicides are creams, foams, gels, suppositories, and films that contain a chemical lethal to sperm. They can be used alone or together with a barrier method. Some condoms can be purchased at the pharmacy over the counter; others are available in the family planning aisle of pharmacies and retail stores.

Use

Creams, foams, and gels are placed high up in the vagina, near the Spermicidescervix, with a plastic plunger-type applicator. Spermicidal suppositories and films are inserted into the vagina and take 1015 minutes to dissolve and become effective. Spermicides can be applied up to 1 hour before intercourse and must be reapplied with each act of intercourse. Women should not rinse the vagina or douche for at least 6 hours after the last act of intercourse.

Effectiveness

This method is somewhat effective. Spermicides have a failure rate of 18% with perfect use and 28% with typical use.18

Risks

Possible mucosal damage to the vagina and cervix with high or prolonged exposure91

Side Effects

Increased risk of vaginal irritation, yeast infection, bacterial vaginosis, UTI, and HIV transmission with frequent use (twice daily or more).92

Contraindications and Precautions

Medical Eligibility Criteria for Spermicides

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

Source: Reference 5

Advantages

  • Over-the-counter availability
  • Easy to use
  • Easily reversible

Disadvantages

  • Lower effectiveness compared with most other contraceptive methods
  • Increased risk of vaginal irritation and infection with prolonged use
  • No protection against STIs

Counseling Messages

  • Spermicides can be used alone but are most effective when used with barrier methods.
  • Spermicides do not protect against STIs.
  • If used frequently, spermicides can increase the risk of vulvovaginal irritation, vaginal infection, and HIV transmission.