Spongey

Fortunately for sponge enthusiasts, as of May 2009 the Today Sponge has returned to pharmacy and drug store shelves. The contraceptive sponge is inserted deep into the vagina before intercourse. It contains and "dispenses" spermicide (nonoxynol-9), serves as a physical contraceptive barrier, and absorbs semen after ejaculation. This round polyurethane sponge is about two-and-a-quarter inches across and three-quarters of an inch thick, has an indentation or "dimple" in the center, and a small loop to hook your finger around for easy removal.

According to the original manufactures of the sponge, Allendale Pharmaceuticals (now out of business), the sponge is 89 to 91 percent effective with correct and consistent use; it is 84 to 87 percent effective with incorrect and/or inconsistent use. This does not mean that the sponge will fail once or twice for every 10 uses, but rather that during a year of perfect and imperfect use by couples, it is expected that there will be one pregnancy for about 1,000 acts of intercourse.

Correct use means a number of things: (1) the sponge is thoroughly wet with clean tap water to activate the spermicide; (2) it's squeezed several times until it becomes sudsy (it needs to be sudsy during insertion); (3) it's inserted as far back into the vagina as fingers will allow, with the dimple directly on the opening of the cervix and the loop hanging under the sponge; (4) the sponge completely covers the cervix (this can be checked by tracing the edge of the sponge with a finger); and, (5) the sponge is left in place for at least six hours after sex.

Some errors that could compromise the effectiveness of the sponge include not wetting the sponge well enough, removing the sponge less than six hours after intercourse, not inserting the sponge until after a penis has been inserted or intercourse has began, and not using the sponge every time a person has intercourse.

In choosing a form of contraception, it's important to consider additional factors besides effectiveness; for example, the sponge:

• is safe and effective for up to 24 hours (if intercourse takes place close to the 24-hour mark, the sponge needs to be removed after the recommended six hours have passed; it should not be left in place for more than 30 hours)
• is hormone-free
• easily allows for spontaneous intercourse (it can be inserted up to 24 hours before sex)
• easily accommodates repeated intercourse with protection (again, it needs to stay in for at least six hours after last intercourse)
• doesn't need to be fitted by a health care provider
• is available over-the-counter (no prescription needed)
• is less messy than other contraceptive methods that use spermicidal creams, foams, or gels
• is convenient — one size fits all
• is instantly reversible — users can decide when they want or no longer want protection from pregnancy
• is usually unnoticed by either partner
• is easy to use with practice

The sponge's disadvantages:

• less effective than hormonal methods
• possible tearing or shredding inside
• 2 to 3 percent of women report expelling the sponge, usually during a bowel movement
• some women get yeast infections more frequently when using the sponge
• some women are sensitive to spermicide and may experience more frequent urinary tract infections
• its long-term safety has not been determined (i.e., polyurethane, toxic shock risk, what happens if it shreds, etc.)

If you are at Columbia, you can call x4-2284 or log in to Open Communicator to make an appointment with a health care provider to discuss contraceptive options and choices, including the contraceptive sponge. If you are not at Columbia, you can talk with a gynecologist, nurse practitioner, primary care provider, or a local Planned Parenthood for more information. 

Take care,

Alice

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