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Contraceptive sponge
Image:Éponge spermicide.jpg
Protectaid Sponge
Background
B.C. type	Barrier
First use	1983
Failure rates (per year)
Perfect use	Nulliparous:9% Parous:26%
Typical use	Nulliparous:16% Parous:32%
Usage
Reversibility	Immediate
User reminders	?
Advantages
Benefits	May be inserted 12-24 hours before intercourse
Disadvantages
STD protection	No
Weight gain	No
Risks	yeast infection, rarely toxic shock syndrome

The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed -- Today, Protectaid, and Pharmatex -- although only Today is available in the U.S.<ref name="CBAS">Sponges. Cervical Barrier Advancement Society (2004). Retrieved on 2006-09-17.</ref>

The sponges are inserted vaginally prior to intercourse and must be placed over the cervix to be effective. To facilitate removal, Today has an elastic band across the sponge; Protectaid has two slots.

Sponges are not effective against sexually transmitted diseases (STDs).

Contents 1 Effectiveness 2 Use 3 History 4 Spermicide 5 Side effects 6 In Popular Culture 7 Footnotes 8 External links

[edit] Effectiveness

The manufacturer of the Today sponge reports effectiveness for prevention of pregnancy -- 89% to 91% when used correctly and consistently. When packaging directions are not followed for every act of intercourse, effectiveness rates of 84% to 89% are reported.<ref name="mfg">How Well Does Today® Sponge Prevent Pregnancy?. Today Sponge. Allendale Pharmaceuticals. Retrieved on 2006-08-17.</ref> Other sources cite poorer effectiveness rates for women who have given birth - 74% during correct and consistent use, and 68% during typical use.<ref>Hatcher, RA, Trussel J, Stewart F, et al (2000). Contraceptive Technology, 18th Edition, New York: Ardent Media. ISBN 0-9664902-6-6.</ref>

Studies of Protectaid have found effectiveness rates of 77% to 91%.<ref>Creatsas G, Elsheikh A, Colin P (2002). "Safety and tolerability of the new contraceptive sponge Protectaid.". Eur J Contracept Reprod Health Care 7 (2): 91-5. PMID 12201327.</ref><ref>Creatsas G, Guerrero E, Guilbert E, Drouin J, Serfaty D, Lemieux L, Suissa S, Colin P (2001). "A multinational evaluation of the efficacy, safety and acceptability of the Protectaid contraceptive sponge.". Eur J Contracept Reprod Health Care 6 (3): 172-82. PMID 11763982.</ref>

Studies of Pharmatex have found perfect use effectiveness rates of over 99% per year.<ref>"Ovule Pharmatex: results of 10 years of research in contraception". Nurs Que 3 (2): 33. PMID 6552435.
Serfaty D. "The contraceptive sponge". Entret Bichat Pitie Salpetriere Ther: 225-8. PMID 12340222.
Leroy B, Serror R (1979). "Contraception through the use of intravaginal spermicides during the post-partum period". Rev Fr Gynecol Obstet 74 (1): 63-5. PMID 424660.</ref> Typical use of Pharmatex results in effectiveness of 81% per year.<ref name="GHO">The Birth Control Sponge. Global Health Options (2004). Retrieved on 2006-10-06.</ref>

Sponges may be used in conjunction with another method of birth control such as condoms to increase effectiveness.

[edit] Use

The Today sponge must be run under water until thoroughly wet before insertion.<ref name="mfg" /> The Protectaid<ref name=CBAS /> and Pharmatex<ref name="GHO" /> sponges come ready to use.

Insertion of the sponge requires reaching the cervix and is generally performed by the woman. Intercourse can proceed when it is placed or hours afterwards. The sponge must be left in place for several hours after the final act of intercourse (Today and Protectaid recommend six hours, Pharmatex two).<ref name=CBAS />

All sponges must be removed within the time limits specified by the manufacturer - 24 hours for Today and Pharmatex and 12 for Protectaid.<ref name=CBAS />

[edit] History

The Today Sponge was introduced in 1983. It was removed from the U.S. market in 1994 after problems were found at the factory where they were produced for Wyeth Pharmaceuticals. Wyeth stopped selling the sponge rather than upgrade its plant. In 1998, Allendale Pharmaceuticals scraped together money to buy the patents and the complex manufacturing equipment. Tough new FDA standards for manufacturing and record-keeping forced repeated delays (some users started calling it the "Real soon now sponge"), but the Today sponge was finally re-introduced in Canada in March 2003, and in the U.S. in September 2005.

The Pharmatex sponge was introduced in France and the Quebec province in Canada in 1984,<ref>Menard F (1984). "The health of women and contraception in Quebec.". IPPF Eur Reg Inf 13 (1): 18-20. PMID 12178356.</ref> and has not spread much beyond those areas, although it is available online from North America. The Protectaid sponge was introduced in Canada in 1996, and in Europe in 2000.<ref name=CBAS />

[edit] Spermicide

Sponges are a physical barrier, trapping sperm and preventing their passage through the cervix into the female reproductive system. The spermicide is an important component of pregnancy prevention; each brand offers a different formula.

The Today sponge contains 1,000milligrams (mg) of nonoxynol-9.<ref>Best, Kim (2000). "New Devices May Be Easier to Use". Network 20 (2). Retrieved on 2006-10-01.</ref> Protectaid contains 5,000mg of the F-5 gel, with three active ingredients (6.25mg of nonoxynol-9, 6.25mg of benzalkonium chloride, and 25mg of sodium cholate).<ref name="GHO" /> Pharmatex contains 60mg of benzalkonium chloride.<ref name=CBAS />

[edit] Side effects

The contraceptive sponge has a few risks, including tearing, yeast infection, and allergic reactions from the spermicide. Improper use, such as leaving the sponge in too long, can result in toxic shock syndrome.

The sponges are not effective in preventing sexually transmitted diseases. The spermicide nonoxynol-9 in fact increases the risk.

[edit] In Popular Culture

Shortly after they were taken off the U.S. market, the sponge appeared as an in-joke on the sitcom Seinfeld. In the episode "The Sponge", the character Elaine Benes refuses to use a contraceptive sponge (and thus intercourse) unless she is certain her partner is "spongeworthy".

[edit] Footnotes

<references />

[edit] External links

• Contraceptive Sponge - American Pregnancy Association
• Contraceptive Sponge - CoolNurse.com
• The Contraceptive Sponge - DrDonnica.com
• Contraceptive Sponges (Today / Protectaid / Pharmatex) - FAQ thread on Ovusoft.com message boards

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