Spermicides

Spermicides are chemicals that kill sperm. They act by preventing the sperm from reaching the egg. Spermicides are available in different forms, including creams, film, foams, gels, and suppositories.

Spermicides are easy to use, do not require a prescription, and have no effect on a woman’s hormones. However, they can be a bit messy and can cause irritation to some users, especially on frequent use. Further, they are not for anal or oral use.

In addition to many drugstores, spermicides can be purchased at Amazon.com. The cost is about $10-15 for 10-30 uses.

Spermicides should always be used with barrier methods of birth control, such as the condom, diaphragm, cervical cap, and sponge. They are very unreliable by themselves.

However, spermicides are not for rectal or oral use, nor for more than once-a-day vaginal use. In fact, there is evidence that spermicide use may increase the transmission of HIV because the active ingredient (nonoxynol-9) is a surfactant (a soap), which may irritate sensitive tissue on frequent use, allowing easier entry by HIV.39 Thus, if your partner has HIV, you should look for a different form of birth control and disease prevention—such as condoms coupled with withdrawal.

As with most forms of birth control, spermicides do not reduce the risk of contracting STD’s, especially the viral infections.

Therefore, if disease transmission is a concern, a male condom or female condom must be used as well.

There are condoms that are labeled as having spermicides on them. However, the amount is insignificant, and a second spermicide should be used with a condom.40 In addition, some men find the spermicide irritating.

Correct spermicide use varies slightly based on the type you buy (film, cream, gel, etc.). For best practices, always follow the instructions on the packaging.

Most forms require you clean your hands thoroughly with soap and water and then sit or lay down to apply. Then, using a finger or an applicator, gently insert the spermicide deep into the vagina, waiting at least 10 minutes between applying it and having sex. It usually stays effective for one hour after insertion, but you must apply more each time you have sex.

It is important that spermicide remain in place at least 6-8 hours after intercourse. Otherwise this can compromise the effectiveness because the spermicide takes a few hours to completely neutralize the sperm. Therefore, a woman should not douche (rinse the vagina) for 6-8 hours after sex.

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Endnote 39

Nonoxynol-9 ineffective in preventing HIV infection, World Health Organization, available online at http://www.who.int/mediacentre/news/notes/release55/en/ (“two studies mentioned in the report point to an increased risk of sexually transmitted infections, including HIV infection, in women using nonoxynol-9 [spermicide] products. A possible reason, suggested by the findings of other studies, is that nonoxynol-9 can disrupt the epithelium, or wall, of the vagina, thereby potentially facilitating invasion by an infective organism. . . The frequency of this epithelial disruption seems to depend on the intensity of use of the product—from 18% of women using the product every other day to 53% using it four times a day, in one study.”).

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Endnote 40

Id. (“Nonoxynol-9 is sometimes added to male condoms as a lubricant. The experts found no evidence that nonoxynol-9-lubricated condoms provided any more protection against pregnancy or sexually transmitted infections than condoms lubricated with silicone”).


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