Written by Dr David Delvin, GP and family planning specialist
|Chemical contraceptives can be used with a barrier method, such as a condom, sponge, cap or diaphragm.|
Spermicides are chemicals that destroy sperm. They were widely used until the 1990s – often on their own (that is, without a cap or diaphragm).
But then they fell out of favour for three reasons.
- Manufacturers stopped marketing these products because there was so little profit to be made from them – though from time to time some brands have been re-launched.
- There were concerns that spermicides might cause small abrasions or breaks in the lining of the vagina – and that this could make women more vulnerable to HIV infection.
- While using them without a cap or diaphragm, alarming numbers of women became pregnant.
However, in the last year or two there has been renewed interest in spermicidal contraceptives, partly because it has become easy to buy them online – often very cheaply.
How should chemical contraceptives be used?
Chemical contraceptives have traditionally been used in one of two ways.
- On their own (not recommended!). A spermicide (usually in the form of a foam, jelly or tablet) is inserted into the vagina about half an hour before having sex. If the sexual ‘session’ happens to go on for a long time, a top-up dose of spermicide should be inserted.
- With a barrier method, such as a condom, sponge, cap or diaphragm. Generally, you smear a spermicidal jelly or cream onto the diaphragm or cap before putting the device inside you. This ‘seals the edges’ and makes it less likely that your partner’s sperms will get past the barrier.
It used to be common to use spermicides to ‘boost’ the effectiveness of condoms. But this is now quite a rare practice.
One advantage of these products is that you can buy them without prescription. So a woman who purchases a spermicide can feel that she is, to some extent, in control of her own fertility – without having to go and see a doctor at all.
But please note that these agents really shouldn't be used on their own because they're not effective enough. If you use them by themselves, there's a high chance that sperm will get through sometimes – and cause pregnancy.
So, all family planning experts agree that chemical contraception should only be used in combination with a 'barrier method'.
It has been claimed that women who know that their fertility is low (for instance, when they're experiencing the menopause) could ‘take a risk’ and just rely on spermicides alone.
I really don't recommend this. But if you and your partner are both really desperate to make love, a chemical contraceptive is better than nothing at all.
How do chemical contraceptives work?
They work by killing sperm inside the vagina. They do this because they contain a spermicide – an agent that attacks sperm.
The most common spermicide used in these products is nonoxinol-9. It's moderately effective, but it can't be relied on to get rid of all sperm.
Some chemical contraceptives produced in overseas countries use a related compound called ‘octoxynol’. Others contain an agent called ‘benzalkonium chloride’ (BKC) – but we have no reliable information on its effectiveness.
How do you use them?
You put them into the vagina before intercourse. Either the woman or the man can do this. Some couples actually make it part of foreplay.
In the case of solid preparations (pessaries – see below), you must give them time (say, 30 minutes) to dissolve before you start having sex. Follow the instructions on the leaflet in the package.
What types of chemical contraceptives are there?
There are various kinds available worldwide, though at the moment the choice in Britain is limited.
The only one that's currently prescribed on the NHS is called Gygel, a jelly containing nonoxinol-9. But one called Conceptrol Vaginal Gel (which also contains nonoxinol-9) is quite widely used in North America, and is available via the Internet.
Generally, people make their choice on the basis of what appeals to them aesthetically. For instance, one couple may prefer the feel, appearance and taste of foam, while others prefer the simplicity of a vaginal tablet.
The main types are as follows.
These are in aerosol form. You insert them into the vagina, with a special applicator, immediately before sex. Many couples like foam, but one man told me he felt as though he was fighting a fire.
These are also widely known as pessaries.
In some books about sex, you may still find them referred to as 'suppositories'. This term has now been dropped – because most people understand the word 'suppository' to mean something put into the rectum.
Because they’re solid, you must give them time (half an hour) to dissolve before you make love.
Gels, jellies and creams
These are mainly intended for spreading onto contraceptive diaphragms or caps before insertion.
Squares of contraceptive film are still marketed in some countries, though they have fallen out of favour in the UK.
At one time, manufacturers suggested that the film should be put on the tip of the penis before the start of intercourse. This is risky, and I do not recommend it, since it will probably fall off.
Sponges containing spermicide were popular in the 1980s and 1990s. One brand gained fame through being the central feature of an episode in the TV series Seinfeld. But sponges dropped out of fashion for some years, before making a recent reappearance.
The ‘Today Sponge’ is a soft polyurethane sponge, containing nonoxinol-9. The idea is that you place it over your cervix – so it forms a barrier, as well as being spermicidal. There's a small loop on the underside to make it easy for you to remove.
In 1995, the manufacturers ceased making it, purely because of commercial reasons. But after various industrial ups and downs, it was re-introduced it to the USA, and it's now available again in Canada and some parts of Europe.
Sponges which are currently available in other countries include Pharmatex (France) and Protectaid (Canada). Don't use sponges while you're menstruating because they may increase the risk of toxic shock syndrome (TSS).
Can chemicals harm you?
Various fragrances, colourings and other components are in spermicidal products. Not surprisingly, both men and women can become allergic to these ingredients.
Symptoms of allergy include soreness, swelling, redness and itching. If allergy occurs, take medical advice and switch to another method.
Nonoxinol-9 has been shown to cause vaginal irritation in some women. AIDS experts are concerned that damage to the delicate surface of the vagina could make it easier for the HIV virus to be contracted.
Please note that in some countries, pharmacists may still be selling old-fashioned spermicidal products that can attack rubber. These products, which are mainly oil-based, could make holes in rubber condoms or caps.
Will spermicidal chemicals protect you against disease?
Will spermicidal chemicals last all night?
No. In general, spermicides are only effective for about 45 to 60 minutes. If you go on having sex longer than that (or if you have sex twice), you need to insert a top-up of spermicide.
What brands are available?
This varies from country to country.
The only brand available in clinics in the UK in 2015 is Gygel, which is a gel that won't harm condoms, diaphragms or caps.
But many other brands can now be found online.
For further help with your contraception, please see our other articles about different contraceptive methods on the site.
Up-to-date information is always available from pharmacists, family planning clinics, youth advisory clinics and some GPs.
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