birth control sponge

What is a contraceptive sponge

Birth control sponge also called contraceptive sponge is a type of birth control (contraceptive) that prevents sperm from entering the uterus. Birth control sponge is soft and disk-shaped and made of polyurethane foam. A birth control sponge is called a barrier method because it keeps the sperm and eggs apart. Birth control sponge contains spermicide, which blocks or kills sperm. Before having sex, you insert the sponge deep inside the vagina so that it covers the cervix. Your vaginal muscles hold it in place. Birth control sponge has a strap on one side for easier removal.

You don’t need a prescription to buy the birth control sponge, and you can find it in most drugstores and online.

Birth control sponge can prevent pregnancy but doesn’t protect against sexually transmitted infections (STIs). Spermicide nonoxynol-9 can irritate the vagina and rectum. It may increase the risk of getting HIV (the virus that causes AIDS) from an infected partner.

You insert the sponge into your vagina. After you insert the sponge, you have protection for up to 24 hours. You must leave the sponge in place for 6 hours after sex. Don’t leave it in for more than a total of 30 hours.

How well the birth control sponge works depends on whether you have delivered a child vaginally or not.

  • For women who have not had a vaginal childbirth:
    • In the first year of use, when the sponge is used exactly as directed, 9 women out of 100 have an unplanned pregnancy. When it is not used exactly as directed, 12 women out of 100 have an unplanned pregnancy.
  • For women who have had a vaginal childbirth:
    • In the first year of use, when the sponge is used exactly as directed, 20 women out of 100 have an unplanned pregnancy. When it is not used exactly as directed, 24 women out of 100 have an unplanned pregnancy.

DO NOT use birth control sponge if you have:

  • Vaginal bleeding or are having your period
  • An allergy to sulfa drugs, polyurethane, or spermicides
  • An infection in the vagina, cervix, or uterus
  • Had an abortion, miscarriage, or a baby

Birth control sponge benefits:

  • Birth control sponge can be bought in many stores. You don’t need to see a doctor or have a prescription to get the sponge, and it’s sold over-the-counter at most drugstores, some supermarkets, community health centers, Planned Parenthood health centers, and online.
  • Birth control sponge doesn’t interrupt sex. You can safely put your sponge in up to 24 hours before sex, so you don’t have to worry about birth control in the heat of the moment. Putting your sponge in place before things get hot and heavy means you can take care of pregnancy prevention without pausing the action. And once the sponge is in your vagina, you can have sex multiple times for the next 24 hours without doing anything else.
  • Each sponge contains enough spermicide for repeated acts of sex during a 24-hour period. Once you put the sponge in, you can have sex as many times as you want for the next 24 hours. The sponge is effective as soon as you put it in, and it’s easy to stop using it, too. If you decide that you want to try to get pregnant, just don’t put a sponge in before sex.
  • Birth control sponge has no effect on a woman’s natural hormones. Some people prefer non-hormonal birth control, or can’t use methods with hormones because of medical problems — the sponge can be a good option for them. And because it’s hormone-free, it’s safe to use the sponge while breastfeeding.
  • Birth control sponge does not affect milk supply if you are breastfeeding.

Birth control sponge possible risks and side effects:

  • Birth control sponge doesn’t prevent the spread of sexually transmitted infections (STIs). Sponges do NOT protect you from sexually transmitted infections (STIs). The sponge can actually increase your risk for HIV and other sexually transmitted infections because the spermicide in sponges can irritate your vagina and make it easier for sexually transmitted germs to enter your body. The good news is adding condoms to the mix helps protect you from sexually transmitted infections (STIs) and — bonus! — gives you an extra boost of pregnancy prevention. If you’re going to have sex, using condoms every time and getting tested regularly are the best ways to avoid sexually transmitted infections (STIs).
  • Because the spermicide in the sponge can increase the risk of getting HIV from an infected partner, you should use the sponge only if you have one sexual partner and both of you are at low risk of HIV infection.
  • Birth control sponge use may cause vaginal burning and irritation from the spermicide. Some people are allergic to spermicide or to the polyurethane or sulfites found in the sponge and may have a reaction.
  • Getting toxic shock syndrome when using the sponge is rare, but it has occurred in a few women. Do not use it during your menstrual period, if you gave birth less than 6 weeks ago, or if you have had toxic shock syndrome before from a tampon or a sponge. Do not wear the sponge for more than 30 hours total.
  • The sponge can be hard to use correctly. Some people have trouble inserting the sponge, and it can take some practice to get really good at it. You also have to make sure you leave the sponge in for at least 6 hours after the last time you had sex, but no more than 30 hours total. It’s really important to use the sponge the right way, or it won’t work as well to prevent pregnancy. So make sure to follow the directions that come in the package.

When can I put a contraceptive sponge in?

The birth control sponge starts working as soon as you activate the spermicide with water and put it in your vagina.

The sponge can be inserted up to 24 hours before sex, so you can get your birth control in place BEFORE the action starts — interruption free. And once the sponge is in, you can have sex as many times as you want in the next 24 hours without replacing it.

How long do I leave the contraceptive sponge in?

Always leave the sponge in place for at least 6 hours after sex, but don’t leave the sponge in your vagina for more than 30 hours total. (This means you can safely have sex for up to 24 hours after putting in the sponge, and still leave it in for the required 6 hours after sex.)

You don’t have to leave the sponge in for the full 30 hours — just make sure you leave it in for at least 6 hours after the last time you had sex.

Is the contraceptive sponge safe for me?

Most people can use the birth control sponge safely and easily, but it may not be right for you if:

  • you’re allergic or sensitive to spermicide, sulfites, or polyurethane
  • you’re not comfortable putting your fingers in your vagina
  • you have trouble putting in the sponge
  • you’ve recently had an abortion, miscarriage, or birth
  • you have an infection in or around your vagina
  • you have a history of toxic shock syndrome (TSS)

You shouldn’t use the contraceptive sponge when you have your period or have any kind of vaginal bleeding. Using the sponge can increase your risk of toxic shock syndrome, a rare but serious disease.

How do I take the contraceptive sponge out?

Slide a clean finger inside your vagina and hook it around the fabric loop on the bottom of the sponge. Then slowly and gently glide the sponge out of your vagina. You can grab the sponge itself to pull it out if you can’t find the fabric loop (see Figure 2 below).

If you have a hard time reaching the sponge, bear down (push with your vaginal muscles like you’re going to the bathroom) while reaching for it.

Toss the used sponge into the trash — don’t flush it down the toilet.

Sponges aren’t reusable, and you can’t take them out and put them back in. Each sponge is only good for one 24-hour period once it’s inside your vagina.

Where can I buy the contraceptive sponge?

The only contraceptive sponge brand available in the U.S. is called the Today Sponge.

You can buy the Today Sponge over-the-counter at pharmacies, drugstores, and some supermarkets and grocery stores. It’s also available on the Today Sponge website and other online retailers. Some family planning clinics and Planned Parenthood health centers carry the sponge as well.

You don’t need a prescription and there are no age restrictions — anybody can buy the sponge.

How much does the birth control sponge cost?

The Today Sponge comes in packs of three, which cost around $15. Prices may vary depending on where you buy your sponges.

You may be able to get low-cost or free sponges at Planned Parenthood and other community health centers. Contact your local Planned Parenthood health center for more information (https://www.plannedparenthood.org/health-center).

How does the contraceptive sponge work?

Birth control sponge is a disk-shaped polyurethane sponge-like device with the spermicide N9 (nonoxynol-9) in it. It is inserted into the vagina to cover the cervix and keeps sperm from entering the uterus. The spermicide also inactivates sperm.

Birth control sponge does not protect against sexually transmitted infections (STIs), including HIV.

Birth control sponge can be put in up to 24 hours before sex and should be left in place for at least 6 hours after sex. The sponge should be worn for no longer than 30 hours total. If you have sex again in this time frame, you do not have to replace the sponge. Throw the sponge away after use.

The sponge is less effective in women who have given birth. If you want to use the sponge after having a baby, you should wait 6 weeks after giving birth until the uterus and cervix return to their normal size.

What is spermicide and how do I use it?

Spermicide is a chemical that inactivates sperm. Most spermicides in the United States contain a chemical called nonoxynol-9. Spermicide can be used alone or with all other barrier methods except the sponge, which already contains a spermicide. It comes in different forms, including foams, creams, gels, suppositories, and films.

When used alone, a spermicide should be inserted into the vagina close to the cervix. You need to wait 10–15 minutes after insertion for the spermicide to become effective. Read the label carefully to see how long before sex you need to insert the spermicide into your vagina. Keep in mind that spermicides are effective for only 1 hour after they are inserted. You must reinsert spermicide for each act of sex. Do not douche or try to remove the spermicide for at least 6 hours after insertion.

What are the benefits, risks, and side effects of using spermicide?

Benefits:

  • Spermicides are easy to use and can be bought in many stores.
  • They cost less to use than other birth control methods.
  • They have no effect on a woman’s natural hormones.
  • Spermicides do not affect milk supply if you are breastfeeding.

Possible risks and side effects:

  • Spermicides can cause vaginal burning and irritation. Some people are allergic to spermicide and may have a reaction.
  • Spermicides that contain nonoxynol-9 do not protect against STIs, including infection with human immunodeficiency virus (HIV), and may increase the risk of getting HIV from an infected partner if used many times a day. Spermicides should only be used if you have only one sexual partner and both of you are at low risk of HIV infection.

What is contraceptive sponge effectiveness?

Birth control sponge effectiveness depends on whether you have delivered a child vaginally or not. Birth control sponge effectiveness range from 12 per 100 women within their first year of typical use among women who have never given birth before to 24 per 100 women within their first year of typical use among women who have given birth 1).

Chance of getting pregnant with typical use (number of pregnancies expected per 100 women who use this method for one year):

  • Out of 100 women who use birth control sponge correctly over 1 year, 12 may get pregnant. Sponges are more effective in women who have never given birth. If sponges are not used correctly, the risk of pregnancy is 20 to 25 for every 100 women each year.
  • Using sponges along with male condoms will reduce the chance of pregnancy even more.
  • Even by using a sponge alone, you are still much less likely to become pregnant than if you did not use any birth control at all.
  • It may not work as well for women who have given birth. Childbirth stretches the vagina and cervix and the sponge may not fit as well. Out of 100 women who use this method who gave birth, 24 may get pregnant.

What is the best method of birth control?

There is no “best” method of birth control for every woman. The birth control method that is right for you and your partner depends on many things, and may change over time.

Before choosing a birth control method, talk to your doctor or nurse about:

  • Whether you want to get pregnant soon, in a few years, or never
  • How well each method works to prevent pregnancy
  • Possible side effects
  • How often you have sex
  • The number of sex partners you have
  • Your overall health
  • How comfortable you are with using the method (For example, can you remember to take a pill every day? Will you have to ask your partner to put on a condom each time?)

Learn about types of birth control that you or your partner can use to prevent pregnancy.

Keep in mind that even the most effective birth control methods can fail. But your chances of getting pregnant are lower if you use a more effective method.

Table 1. Types of birth control

Method Number of pregnancies per 100 women within their first year of typical use 2)
Side effects and risks*

*These are not all of the possible side effects and risks. Talk to your doctor or nurse for more information.

How often you have to take or use
Abstinence (no sexual contact)Unknown

(0 for perfect use)

No medical side effectsNo action required, but it does take willpower. You may want to have a back-up birth control method, such as condoms.
Permanent sterilization surgery for women (tubal ligation, “getting your tubes tied”)Less than 1
  • Possible pain during recovery (up to 2 weeks)
  • Bleeding or other complications from surgery
  • Less common risk includes ectopic (tubal) pregnancy
No action required after surgery
Permanent sterilization implant for women (Essure®)

The Essure® birth control device will no longer be sold or distributed in the United States after December 31, 2018.

Less than 1
  • Pain during the insertion of Essure; some pain during recovery
  • Cramping, vaginal bleeding, back pain during recovery
  • Implant may move out of place
  • Less common but serious risk includes ectopic (tubal) pregnancy
No action required after surgery
Permanent sterilization surgery for men (vasectomy)Less than 1
  • Pain during recovery
  • Complications from surgery
No action required after surgery
Implantable rod (Implanon®, Nexplanon®)Less than 1
  • Headache
  • Irregular periods
  • Weight gain
  • Sore breasts
  • Less common risk includes difficulty in removing the implant
No action required for up to 3 years before removing or replacing
Copper intrauterine device (IUD) (ParaGard®)Less than 1
  • Cramps for a few days after insertion
  • Missed periods, bleeding between periods, heavier periods
  • Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.
No action required for up to 10 years before removing or replacing
Hormonal intrauterine devices (IUDs) (Liletta, Mirena®, and Skyla®)Less than 1
  • Irregular periods, lighter or missed periods
  • Ovarian cysts
  • Less common but serious risks include pelvic inflammatory disease and the IUD being expelled from the uterus or going through the wall of the uterus.
No action required for 3 to 5 years, depending on the brand, before removing or replacing
Shot/injection (Depo-Provera®)6
  • Bleeding between periods, missed periods
  • Weight gain
  • Changes in mood
  • Sore breasts
  • Headaches
  • Bone loss with long-term use (bone loss may be reversible once you stop using this type of birth control)
Get a new shot every 3 months
Oral contraceptives, combination hormones (“the pill”)9
  • Headache
  • Upset stomach
  • Sore breasts
  • Changes in your period
  • Changes in mood
  • Weight gain
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35
Take at the same time every day
Oral contraceptives, progestin-only pill (“mini-pill”)9
  • Spotting or bleeding between periods
  • Weight gain
  • Sore breasts
  • Headache
  • Nausea
Take at the same time every day
Skin patch
(Xulane®)
9

May be less effective in women weighing 198 pounds or more 3)

  • Skin irritation
  • Upset stomach
  • Changes in your period
  • Changes in mood
  • Sore breasts
  • Headache
  • Weight gain
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35
Wear for 21 days, remove for 7 days, replace with a new patch
Vaginal ring (NuvaRing®)9
  • Headache
  • Upset stomach
  • Sore breasts
  • Vaginal irritation and discharge
  • Changes in your period
  • High blood pressure
  • Less common but serious risks include blood clots, stroke and heart attack; the risk is higher in smokers and women older than 35
Wear for 21 days, remove for 7 days, replace with a new ring
Diaphragm with spermicide (Koromex®, Ortho-Diaphragm®)12

If you gain or lose than 15 pounds, or have a baby, have your doctor check you to make sure the diaphragm still fits.

  • Irritation
  • Allergic reactions
  • Urinary tract infection (UTI)
  • Vaginal infections
  • Rarely, toxic shock if left in for more than 24 hours
  • Using a spermicide often might increase your risk of getting HIV
Insert each time you have sex
Sponge with spermicide (Today Sponge®)12

(among women who have never given birth before)

or

24

(among women who have given birth) 4)

  • Irritation
  • Allergic reactions
  • Rarely, toxic shock if left in for more than 24 hours
  • Using a spermicide often might increase your risk of getting HIV
Insert each time you have sex
Cervical cap with spermicide (FemCap®)23 5)
  • Vaginal irritation or odor
  • Urinary tract infections (UTIs)
  • Allergic reactions
  • Rarely, toxic shock if left in for more than 48 hours
  • Using a spermicide often might increase your risk of getting HIV
Insert each time you have sex
Male condom18
  • Irritation
  • Condom may tear, break or slip off
  • Allergic reactions to latex condoms
Use each time you have sex
Female condom21
  • Irritation
  • Condom may tear or slip out
  • Allergic reaction
Use each time you have sex
Withdrawal — when a man takes his penis out of a woman’s vagina (or “pulls out”) before he ejaculates (has an orgasm or “comes”)22
  • Sperm can be released before the man pulls out, putting you at risk for pregnancy
Use each time you have sex
Natural family planning (rhythm method)24
  • Can be hard to know the days you are most fertile (when you need to avoid having sex or use back-up birth control)
Depending on method used, takes planning each month
Spermicide alone28

Works best if used along with a barrier method, such as a diaphragm

  • Irritation
  • Allergic reactions
  • Urinary tract infection
  • Frequent use of a spermicide might increase your risk of getting HIV
Use each time you have sex

Footnote: Please note that Essure® will not be sold or distributed in the United States after December 31, 2018.

Which types of birth control help prevent sexually transmitted infections (STIs)?

Only two types can protect you from STIs, including HIV: male condoms and female condoms.

While condoms are the best way to prevent STIs if you have sex, they are not the most effective type of birth control. If you have sex, the best way to prevent both STIs and pregnancy is to use what is called “dual protection.” Dual protection means you use a condom to prevent STIs each time you have sex, and at the same time, you use a more effective form of birth control, such as an IUD, implant, or shot.

Which types of birth control can I get without a prescription?

You can buy these types of birth control over the counter at a drugstore or supermarket:

  • Male condoms
  • Female condoms
  • Sponges
  • Spermicides
  • Emergency contraception (EC) pills. Plan B One-Step® and its generic versions are available in drugstores and some supermarkets to anyone, without a prescription. However you should not use EC as your regular birth control because it does not work as well as regular birth control. EC is meant to be used only when your regular birth control does not work for some unexpected reason.

Which types of birth control do I have to see my doctor to get?

You need a prescription for these types of birth control:

  • Oral contraceptives: the pill and the mini-pill (in some states, birth control pills are now available without a prescription, through the pharmacy)
  • Patch
  • Vaginal ring
  • Diaphragms (your doctor or nurse needs to fit one to the shape of your vagina)
  • Shot/injection (you get the shot at your doctor’s office or family planning clinic)
  • Cervical cap
  • Implantable rod (inserted by a doctor in the office or clinic)
  • IUD (inserted by a doctor in the office or clinic)

You will need surgery or a medical procedure for:

  • Female sterilization (tubal ligation)
  • Male sterilization (vasectomy)
  • Tubal implant (Essure®). Note that Essure® will not be sold or distributed in the United States after December 31, 2018.

How to use contraceptive sponge

How to use birth control sponge:

  1. Wash your hands with soap and water.
  2. Take the sponge out of the wrapper and wet it with clean water.
  3. Gently squeeze the sponge until it’s sudsy. It needs to be totally wet to activate all of the spermicide. Don’t squeeze it dry — the sponge should be wet and foamy when you insert it.
  4. With the indented side of the sponge facing up, fold the sides upward (away from the fabric loop on the bottom) until it’s long and narrow. When you insert the sponge, the indented side should face the front side of your body and the fabric loop side should face the back side of your body.
  5. Get into a comfortable position, like when you’re putting in a tampon. You can stand with one foot on a chair, sit on the edge of a chair, lie down, or squat — whatever works for you.
  6. Slide the sponge deep into your vagina and push it as far back as you can with your fingers. The sponge will unfold and cover your cervix when you let go.
  7. Check the placement of the sponge by sliding your finger around the edge, making sure your cervix is covered. You should be able to feel the fabric loop on the bottom of the sponge.
  8. Birth control sponge protects for up to 24 hours.
  9. You do not need to use more spermicide each time you have sex.
  10. You must leave the sponge in place for at least 6 hours after last having sex.
  11. You must take the sponge out within 30 hours after you put it in. Throw it away after you use it.

The sponge should be worn for no longer than 30 hours total. If you have sex again in this time frame, you do not have to replace the sponge. Throw the sponge away after use.

The sponge is less effective in women who have given birth. If you want to use the sponge after having a baby, you should wait 6 weeks after giving birth until the uterus and cervix return to their normal size.

Birth control sponge does not protect against sexually transmitted infections (STIs), including HIV.

Using the sponge gets easier the more you do it.

You may have trouble removing a sponge every once in a while. If you have a hard time getting to the sponge, bear down (push with your vaginal muscles like you’re going to the bathroom) while reaching for it. You can grab the sponge itself and pull it out if you can’t find the fabric loop.

Figure 1. How to use contraceptive sponge

How to use contraceptive sponge
How to use contraceptive sponge

Figure 2. How to remove contraceptive sponge

How to remove contraceptive sponge

Contraceptive sponge side effects

Risks of the birth control sponge include:

  • Vaginal irritation
  • Allergic reaction
  • Difficulty removing the sponge
  • Toxic shock syndrome (rare)

Birth control sponge contains a spermicide called nonoxynol-9 that can irritate your vagina and rectum. That irritation increases your risk for the virus that causes AIDS) and other STDs (sexually transmitted diseases) from an infected partner because it gives infections an easy pathway into your body. Using condoms along with your sponge is a great way to help prevent the spread of STDs and get extra protection from pregnancy.

If your vagina or your partner’s penis feels sore or irritated after having sex with the sponge in, one of you may be sensitive to its ingredients. If you rule out other possible causes, like an STD or a sensitivity to any latex condoms and/or lubricants you may be using, and the irritation keeps happening when you use the sponge, it may not be a good birth control method for you.

Birth control sponge users may be at a slightly increased risk of toxic shock syndrome (TSS), a super rare but serious disease. Warning signs of toxic shock syndrome (TSS) include:

  • a sudden high fever
  • a rash that looks and feels like a sunburn
  • diarrhea or vomiting
  • a sore throat
  • aching muscles and joints
  • dizziness, faintness, and weakness

If you notice any of these symptoms, take out your sponge and call a doctor right away.

To lower your risk for toxic shock syndrome:

  • Don’t leave the sponge in place longer than 30 hours.
  • Don’t use the sponge soon after an abortion, giving birth, or a miscarriage. Ask your doctor when it’s safe to use the sponge.
  • Never use the sponge during your period.

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