Spermicide
Spermicide | |
---|---|
Background | |
Type | Spermicide |
First use | Ancient |
Failure rates (first year) | |
Perfect use | 6% |
Typical use | 16%[1] |
Usage | |
Reversibility | Immediate |
User reminders | More effective if combined with a barrier method |
Advantages and disadvantages | |
STI protection | No |
Weight gain | No |
Benefits | Provides lubrication |
Spermicide is a
Spermicides are typically unscented, clear, unflavored, non-staining, and lubricative.
Types and effectiveness
The most common active ingredient of spermicides is nonoxynol-9. Spermicides containing nonoxynol-9 are available in many forms, such as jelly (gel), films, and foams. Used alone, spermicides have a perfect use failure rate of 6% per year when used correctly and consistently, and 16% failure rate per year in typical use.[1]
Spermicide brands
This list of examples was provided by the Mayo Clinic:[3]
- VCF Vaginal Contraceptive Film
- VCF Vaginal Contraceptive Gel
- VCF Contraceptive Foam
- Conceptrol
- Crinone
- Encare
- Endometrin
- First-Progesterone VGS
- Gynol II
- Prochieve
- Today Sponge
- Vagi-Gard Douche Non-Staining
Menfegol is a spermicide manufactured as a foaming tablet.[6] It is available only in Europe.
The spermicides benzalkonium chloride and sodium cholate are used in some contraceptive sponges.[8] Benzalkonium chloride might also be available in Canada as a suppository.[9]
The 2008 Ig Nobel Prize (a parody of the Nobel Prizes) in Chemistry was awarded to Sheree Umpierre, Joseph Hill, and Deborah Anderson, for discovering that Coca-Cola is an effective spermicide,[10] and to C.Y. Hong, C.C. Shieh, P. Wu, and B.N. Chiang for proving it is not.[11][12]
Lemon juice solutions have been shown to immobilize sperm in the laboratory,[13] as has Krest Bitter Lemon drink.[14] While the authors of the Krest Bitter Lemon study suggested its use as a postcoital douche, this is unlikely to be effective, as sperm begin leaving the ejaculate (out of the reach of any douche) within 1.5 minutes of deposition. No published studies appear to have been done on the effectiveness of lemon juice preparations in preventing pregnancy, though they are advocated by some as 'natural' spermicides.[15]
Lactic acid preparations have also been shown to have some spermicidal effect, and commercial lactic acid-based spermicides are available.[16][17] A contraceptive containing lactic acid, citric acid, and potassium bitartrate (Phexxi) was approved for use in the United States in May 2020.[18]
Extractives of the
Use with condoms
Spermicides are believed to increase the contraceptive effectiveness of condoms.[2]
However, condoms that are spermicidally lubricated by the manufacturer have a shorter shelf life[21] and may cause urinary tract infections in women.[22] The World Health Organization says that spermicidally lubricated condoms should no longer be promoted. However, they recommend using a nonoxynol-9 lubricated condom over no condom at all.[23]
Spermicides used alone are only about 91 percent effective.[24] When spermicides are used in conjunction with condoms and other barrier methods there is a 97 percent effective rate for pregnancy prevention.
Side effects
Temporary local skin irritation involving the vulva, vagina, or penis is the most common problem associated with spermicide use.[25]
Frequent use (two times or more a day) of nonoxynol-9 containing spermicide is inadvisable if STI/HIV exposure is likely, because in this situation there is increased vulvovaginal epithelial disruption and increased risk of HIV acquisition.[25]
In 2007, the United States Food and Drug Administration (FDA) mandated that labels for nonoxynol-9 over-the-counter (OTC) contraceptive products carry a new warning saying they do not protect against STDs and HIV/AIDS.[26][27]
History
The first written record of spermicide use is found in the
Further formulations are found in the Ebers Papyrus from approximately 1500 BCE. It recommended mixing seed wool, acacia, dates and honey, and placing the mixture in the vagina. It probably had some effectiveness, in part as a physical barrier due to the thick, sticky consistency, and also because of the lactic acid (a known spermicide) formed from the acacia.[29]
Writings by
Laboratory testing of substances to see if they inhibited sperm motility began in the 1800s. Modern spermicides nonoxynol-9 and menfegol were developed from this line of research.[28] However, many other substances of dubious contraceptive value were also promoted. Especially after the prohibition of contraception in the U.S. by the 1873 Comstock Act, spermicides—the most popular of which was Lysol—were marketed only as "feminine hygiene" products and were not held to any standard of effectiveness. Worse, many manufacturers recommended using the products as a douche after intercourse, too late to affect all the sperm. Medical estimates during the 1930s placed the pregnancy rate of women using many over-the-counter spermicides at seventy percent per year.[30]
A misconception about spermicides existed in the 1980s and 1990s. A 1988 literature review article noted that in vitro studies of nonoxynol-9 and other spermicides showed inactivation of STI pathogens, including HIV.[31] But a 2002 systemic review and meta-analysis of nine randomized controlled trials of vaginal nonoxynol-9 for HIV and STI prevention involving more than 5,000 women (predominantly sex workers) found no statistically significant reduction in risk of HIV and STIs, but found a small statistically significant increase in genital lesions among nonoxynol-9 spermicide users.[32] And in a high-risk population using a nonoxynol-9 vaginal gel more than three applications per day on average, the risk of HIV acquisition was increased.[25]
See also
References
- ^ PMID 24307556.
- ^ PMID 1743276.
- ^ Clinic, Mayo. "Spermicide (Vaginal Route)". Mayo Clinic. Retrieved April 1, 2014.
- ^ World Health Organization. "WHO/Conrad Technical Consultation" (PDF). Geneva. Retrieved April 1, 2014.
- PMID 11387285.
- ^ "Spermicides: Neo-Sampoon (Menfegol)". RemedyFind. Archived from the original on 2016-06-10. Retrieved 2006-10-01.
- ^ "Status of Certain Additional Over-the-Counter Drug Category II and III Active Ingredients". Federal Register. Food and Drug Administration. May 9, 2002. Retrieved 2006-08-18.
- ^ "Sponges". Cervical Barrier Advancement Society. 2004. Archived from the original on 2009-01-14. Retrieved 2006-09-17.
- ^ "Spermicides (Vaginal)". MayoClinic.com. August 1997. Archived from the original on July 8, 2006. Retrieved 2006-10-16.
- PMID 4058526.
- PMID 3679247.
- ^ Mikkelson, Barbara (March 16, 2007). "Killer Sperm: Coca-Cola Spermicide". Snopes. Retrieved 2008-10-03.
- ^ Roger Short; Scott G. McCoombe; Clare Maslin; Eman Naim; Suzanne Crowe (2002). "Lemon and Lime juice as potent natural microbicides" (PDF). Archived from the original (PDF) on 2006-08-21. Retrieved 2006-08-13.
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(help) - PMID 1493713.
- ^ "MoonDragon's Contraception Information: Spermicides". MoonDragon Birthing Services. c. 1997. Archived from the original on 2006-08-13. Retrieved 2006-08-13.
- ^ "Femprotect - Lactic Acid Contraceptive Gel". Woman's Natural Health Practice. Archived from the original on June 1, 2006. Retrieved 2006-09-17.
- PMID 12259192.
- ^ "U.S. FDA Approves Evofem Biosciences' Phexxi (lactic acid, citric acid and potassium bitartrate), the First and Only Non-Hormonal Prescription Gel for the Prevention of Pregnancy". Evofem Biosciences (Press release). 22 May 2020. Retrieved 22 May 2020 – via PR Newswire.
- PMID 8968666.
- S2CID 7402936.
- ^ "Spermicide (Nonoxynol-9)". Other disadvantages. Retrieved 2008-04-23.
- ^ "Condoms: Extra protection". ConsumerReports.org. February 2005. Archived from the original on June 26, 2006. Retrieved 2006-08-06.
- ^ WHO (2002). "HIV/AIDS Topics: Microbicides". Geneva: World Health Organization. Retrieved August 6, 2006.
- ^ WebMD. "Spermicide for Birth Control - Topic Overview". WebMD. Retrieved April 1, 2014.
- ^ OCLC 781956734. p. 399:
p.399–400:Currently available spermicides containing nonoxynol-9 are ineffective as microbicides, in particular as HIV-preventive measures.17 Thus, spermicides used alone are not recommended to prevent HIV or other STIs. Furthermore, frequent use (more than 2 times a day) of spermicide causes more vulvovovaginal epithelial disruption,18 which theoretically could increase susceptibility to HIV. In a high-risk population using a vaginal gel with nonoxynol-9 more than three applications per day on average, the risk of HIV acquisition was increased compared with placebo.19
p. 401:Disadvantages and cautions
Local irritation
Temporary skin irritation involving the vulva, vagina, or penis caused by either local toxicity or allergy to the formulation is the most common problem associated with spermicide use... Although vaginal epithelial disruption has been associated with frequent use (twice a day or more) of spermicides containing N-9, this is usually asymptomatic. In a low risk population, long-term use of N-9 containing methods was not associated with epithelial disruption.22N-9 spermicides are inadvisable if STI/HIV exposure is likely in situations that would involve frequent use defined as 2 times or more a day.
- ^ FDA (December 18, 2007). "FDA mandates new warning for nonoxynol 9 OTC contraceptive products. Label must warn consumers products do not protect against STDs and HIV/AIDS (news release)". Silver Spring, Md.: Food and Drug Administration. Retrieved April 16, 2014.
- ^ FDA (December 19, 2007). "Final rule. Over-the-counter vaginal contraceptive and spermicide drug products containing nonoxynol 9; required labeling". Federal Register. 72 (243): 71769–71785.
- ^ a b c "Evolution and Revolution: The Past, Present, and Future of Contraception". Contraception Online (Baylor College of Medicine). 10 (6). February 2000. Archived from the original on September 26, 2006.
- ^ a b Towie, Brian (January 19, 2004). "4,000 years of contraception on display in Toronto museum". torontObserver. Centennial College journalism students. Archived from the original on February 25, 2004.
- Gale A18498205.
- PMID 3276230.
- PMID 12383611.