Allergy to spermicides. The action of spermicidal contraceptives. Diaphragm and cap not shown

Chemical contraceptives are not limited to hormonal drugs. In the West, for several decades, women have been using spermicides, which are barrier methods of protecting against unwanted pregnancies. This material is devoted to the features of the use of spermicides, their advantages and disadvantages.

Spermicide Are chemical female contraceptives containing an active substance capable of destroying sperm in a short period of time (up to 60 seconds). The need for a quick reaction is explained by the ability of spermatozoa after ejaculation to immediately penetrate into the cervical canal and reach the fallopian tubes in 90 seconds, after which it is impossible to provide pregnancy without the use of hormonal drugs.

Doctors do not recommend considering vaginal spermicides as an independent method of contraception, since their effectiveness is not high enough. It is desirable to combine these substances with other contraceptives, for example, condoms or oral contraceptives.

Benefits of spermicides:

• ease of use;
• reduce the risk of contracting sexually transmitted diseases and some other infections (genital herpes, gonococci, Trichomonas);
• do not violate the hormonal background;
• suitable for pregnant and breastfeeding women;
• can be used as a contraceptive for women over 35;
• have a moisturizing effect with a lack of natural lubrication;
• sold in pharmacies without a prescription.

Disadvantages of spermicides:

• some drugs require application 10-15 minutes before intercourse, which is inconvenient;
• not recommended as a separate means of contraception due to their relatively low reliability;
• after intercourse, you can not take a shower for the period specified in the instructions;
• some women have side effects on spermicides (allergic reactions and skin irritation), in such situations, an urgent need to consult a doctor.

Spermicide release forms

Spermicides are of the following types (forms):

• foam and jelly;
• vaginal suppositories (suppositories that melt from body temperature);
• sponges;
• foaming tablets;
• soluble films.

The use of spermicides is justified in the following situations:

1. To improve the reliability of condoms (Dutch contraceptive method);
2. At the beginning of taking hormonal contraceptives, which begin to work after a while.
3. If a woman has forgotten to take an oral contraceptive on schedule, and more than 12 hours have passed since that moment.
4. Together with any other contraceptives for the prevention of genital infections, if you are not sure that your partner is completely healthy.

General instruction for the administration of spermicides

For each intercourse, a new dose of the substance is required, even if only a couple of minutes have passed. Before the introduction, it is recommended to read the manufacturer's instructions, since the use of each drug is individual, depending on the active substance and the form of distribution.

Tablets and suppositories are injected immediately after removal from the package to the uterus itself along the back wall of the vagina (see figure). Further, before intercourse, you should wait for the specified time.


When applying foam, gel or cream, first shake the bottle, fill and insert the applicator deep into the vagina. Next, extrude all the contents. Then wash the applicator in soap and water.

Gels, foams, and creams are considered the best forms of spermicides because they are easy to apply and act immediately.

Spermicide names (brands)

To compare the drugs available in Russia, we suggest taking a look at the following table.

Name of the	Active spermicide	Release form
Pharmatex	Benzalkonium chloride
Erotex	Benzalkonium chloride
Conceptrol	Non-oxylone-9	Creams and jellies
Delphin	Non-oxylone-9
Ortho	Octoxynol
Rendell	Octoxynol
Koromex	Octoxynol
Ortho-Ginol	Octoxynol
Alpagel	Benzalkonium chloride
Pharmatex	Benzalkonium chloride	Candles and pills
Erotex	Benzalkonium chloride
Neo-sampun	Menfegol
Enkea	Non-oxylone-9
Pharmatex	Non-oxylone-9
Norm	Phenylmercury acetate
Delphin	Non-oxylone-9	Foam
Emko Koromex	Non-oxylone-9
Patentex	Non-oxylone-9
Pharmatex cream	Benzalkonium chloride	Films

The choice of a specific drug depends on the woman's individual tolerance of the active substance and the type of spermicide (foam, suppositories, etc.). In order to avoid side effects, we recommend that you consult with a specialist before use.

Modern methods of contraception make it possible to choose those contraceptives that are most convenient for a woman. To make the right choice, you need to know as much as possible about the existing methods of preventing unwanted pregnancy. One of the safest, inexpensive and effective ways is to use spermicides. It is a chemical method of contraception that has advantages over other methods.

Spermicides are chemicals whose contraceptive effect develops by destroying sperm cells. The active components of spermicides inactivate male germ cells in no more than a minute. This speed of action is due to the high activity of sperm: 1.5 minutes after ejaculation, they are able to reach the fallopian tubes.

The effectiveness of spermicides depends on the rules for their use. In some cases, doctors recommend using additional methods of contraception to improve reliability. When spermicidal preparations are combined with condoms, the degree of protection of a woman from accidental pregnancy and diseases transmitted through sexual contact reaches 98-99%.

The combination of spermicides and hormonal contraceptive pills for internal use has a positive effect in such situations:

• If a woman has just started taking hormonal pills, while their contraceptive effect has not yet developed, spermicides are used for two weeks from the moment they start taking hormones.
• If the next pill is missed for more than 12 hours, spermicides are used as an additional method of contraception only on the day the pill is missed.
• If the pill is missed for more than a day - in this case, the use of spermicidal agents in parallel with taking birth control pills is continued until the next menstrual bleeding begins.

Positive aspects of drugs

Spermicidal drugs are female contraceptive methods, so a woman can use them without warning her partner about it. Due to the many positive properties of spermicides are popular: every fifth woman uses this method of contraception.

Positive properties of spermicides:

• Easy to use.
• Low cost.
• Ability to use unnoticed by a partner.
• There are no substances in the composition that change the hormonal background in the body.
• Local action, no penetration into blood and breast milk.
• Softening and moisturizing effect on the vaginal mucosa.
• Antiseptic effect, the ability to fight certain types of viruses, fungi and protozoa.

The chemical method of contraception is convenient to use in case of irregular sexual activity, when there is no need to use other methods. And spermicidal agents are also recommended during breastfeeding, since hormonal drugs are prohibited at this time.

Disadvantages of the chemical method of contraception

Despite the advantages, spermicidal drugs are not without drawbacks. The negative sides of the means can be decisive when choosing a method of contraception. Many women choose other methods of contraception due to spermicide deficiencies.

Cons of spermicidal agents:

• The inability to start intercourse immediately after using spermicide, after its introduction into the vagina, you need to wait about 15 minutes.
• Do not shower and wash with soap (shower gel) immediately after intercourse, so as not to weaken the effect of chemicals.
• Many women experience itching and irritation of the mucous membranes due to exposure to chemicals. If, after using spermicide, there is a burning sensation in the genital area, you need to wash it off as soon as possible and use another type of contraception. If you continue intercourse using an irritating substance, it can lead to allergic swelling of the vaginal mucosa.
• Does not provide 100% protection against unwanted pregnancies and sexually transmitted diseases.

Forms of release and rules of application

Spermicidal products are available in various dosage forms, each of which has its own characteristics of use. The contraceptive effect can only be guaranteed if the drugs are used correctly.

Spermicidal forms:

Spermicidal condoms and contraceptive sponges deserve special consideration. These means are combined methods of contraception and combine a chemical and mechanical method of preventing unwanted pregnancy. Features of combined contraceptives:

• Spermicidal condoms are conventional latex condoms coated with a chemical that, if the latex breaks accidentally during intercourse, protects the woman from the risk of becoming pregnant. This method of contraception is very popular, as it not only protects a woman from unwanted pregnancy, but also protects both partners from contracting sexually transmitted infections.
• Contraceptive sponges - the instruction describes them as round polyurethane products that contain a contraceptive substance and collagen. Before insertion into the vagina, the sponge is moistened with water in order to activate the active ingredients. After intercourse, the sponge should be in the vagina for at least six hours (it can be left for no more than 30 hours). The contraceptive effect of the sponge develops due to the fact that it mechanically prevents sperm from entering the uterus, and also, releasing chemical components, destroys sperm. Do not reintroduce a once used sponge!

Popular drugs

Spermicidal agents are presented on the pharmaceutical market, which contain various active ingredients. The most commonly used spermicidal substances are benzalkonium chloride, nonoxynol-9, octosinol. The active ingredients, together with the base, envelop the mucous membranes of the vagina, cause thickening of cervical mucus, thereby preventing the penetration of sperm into the uterus. At the same time, the active ingredient inactivates the sperm, depriving them of the ability to fuse with the egg.

According to this scheme, the following drugs operate, presented in pharmacies:

• Spermicidal gels and creams - Benatex, Pharmatex, Pharmaginex.
• Tablets and suppositories - Erotex, Benatex, Pharmatex, Contratex, Patentx Oval.
• Aerosols - Dettol, Delfin.

Often the question arises about the composition of spermaceti face cream, which can also be found on drugstore shelves. Many women believe that it has a connection with spermicidal drugs. This is a misconception that spermaceti cream contains spermaceti - a wax-like substance that is extracted from the spermaceti sac of a sperm whale. Previously, it was believed that spermaceti is the sperm of an animal, hence the name of the substance and different opinions about the composition of the cream. In fact, the sperm bag provides buoyancy to the sperm whale and takes part in ultrasonic echolocation.

Spermaceti has excellent lubricating and moisturizing properties, it has long been used for the manufacture of creams and ointments, lipsticks, suppositories. Spermaceti cream is used as an anti-inflammatory and regenerating agent, it is great for skin prone to dryness and irritation.

This cream is used in winter to protect the skin of the face and hands from chapping and frostbite. Seeing spermaceti cream on the shelves of a pharmacy or store, you can safely purchase it, as this tool will come in handy in every home.

Barrier methods of contraception can be defined as preventing an unwanted pregnancy by preventing semen from entering the vagina or cervix by chemical or mechanical means, or a combination of both.

None of the currently proposed methods of birth control can be considered ideal for all life situations. Of the variety of contraceptive methods proposed, only condoms and spermicides (vaginal tablets, creams, suppositories, tampons) can be included in any distribution system. They can be the optimal contraceptive for any couple in certain circumstances at one time or another in life.

Female methods:

• female condom;
• diaphragm;
• cervical contraceptive cap;
• spermicidal foam;
• spermicidal suppositories and tablets;
• spermicidal creams and gels;
• sponges, tampons.

Male method:

• male condom.

Condoms

Despite the fact that at this time there are a number of more effective modern methods of contraception, the use of condoms remains very important, as they are one of the few contraceptives that can prevent the transmission of HIV infection and sexually transmitted diseases.

The vast majority of modern condoms are made of a special rubber - latex.

Condoms vary in size. The most common condoms coated with a special lubricant are about 170 mm long. and a diameter of about 52 mm. To prevent root syphilis, some companies produce larger condoms - 200 mm long, 56 mm wide.

Certain brands of condoms contain spermicide when 0.5 g of nonoxynol-9 spermicide is added to the lubricant. The lubricant is distributed over both the inner and outer surfaces of the condom, making it easier to put on the penis and preventing increased friction and tearing during intercourse.

It is the use of a condom as a means of preventing unwanted pregnancies that makes it possible to actively involve men in family planning.

It should be noted that some countries use a condom for women. It is longer and wider than the male. Using it, a woman does not depend on a man and is more confident about her health.

With the correct use of condoms, their contraceptive effect is quite high. For persons using this type of protection against unwanted pregnancy, "contraceptive failure" is about 10.5%.

The male condom is a thin sheath, usually made of rubber (latex), and can be treated with spermicide for added protection. The condom is put on the penis when it is erect.

Condoms vary in shape, color, lubrication, thickness, material composition, and spermicide addition. Designed for genital, oral, anal intercourse.

Mechanism of action:

• prevents sperm from entering the female reproductive organs;
• prevents the transmission of microorganisms of sexually transmitted diseases and HIV infection.

The advantages of the method:

• sold without a prescription;
• widely available (it is preferable to purchase products in pharmacies where storage conditions are strictly observed);
• immediate effect;
• does not affect breastfeeding;
• there is no health risk associated with the method;
• can be used as a safety method in parallel with other contraceptives;
• no medical examination is required before use;
• inexpensive method;
• promotes the involvement of men in family planning;
• one of the few methods that protect against sexually transmitted diseases;
• helps to reduce the risk of developing cervical cancer;
• during intercourse in men, the period before ejaculation is lengthened;
• can be used in the treatment of immunological forms of infertility (within 3-6 months), to prevent the ingress of sperm antigens into the vagina;
• can be used when a woman has allergic reactions to seminal fluid and / or sperm of a sexual partner;
• can be used to improve erection in men with relative erectile dysfunction (the condom ring acts as a weak tourniquet).

Disadvantages of the method:

• average efficiency up to 89% or more during the first year of use;
• contraceptive effectiveness depends on the willingness of the couple to follow the instructions;
• it is necessary to have adequate conditions for storing condoms at home;
• constant use of condoms can slightly reduce the sensitivity of the penis, thereby making it difficult to maintain an erection;
• a condom or spermicide included in the lubricant can irritate the genitals of both men and women;
• you must have an adequate supply of condoms before intercourse.

Method suitable:

• men who want to take part in family planning;
• couples who need a contraceptive method immediately;
• couples who need a safety method;
• couples who have rare sexual intercourse;
• groups at increased risk of contracting sexually transmitted diseases.

Method not suitable for couples:

• in which one of the partners (or both) is allergic to the materials from which the condoms are made;
• who want to use a method other than sexual intercourse;
• in which pregnancy poses a serious danger to the woman's health and it is necessary to select the most highly effective contraceptive method.

Instructions for use:

• use a condom every time you have intercourse;
• use a water-based spermicide condom (Pharmatex) for maximum effectiveness and protection (the so-called "double Dutch" method of protection against pregnancy);
• do not open the package with your teeth or with sharp objects, so as not to damage the integrity of the condom;
• the condom must be put on the penis in a state of erection before it is inserted into the woman's vagina, since pre-ejaculatory semen contains active sperm;
• if the condom does not have a reservoir at the end, a 1-2 cm cavity should be left at the end for sperm;
• after ejaculation, holding the base (ring) of the condom, remove the penis from the vagina while it is still erect. This prevents the condom from slipping and getting sperm on the woman's genitals;
• each condom should only be used once;
• always have a supply of condoms available. Do not store them in a warm place, as this destroys the material, which can lead to a violation of the integrity of the condom during use;
• do not use a condom if its packaging is torn or if the condom looks damaged or brittle;
• do not use mineral oil, edible fat, baby cream or petroleum jelly to lubricate the condom - this will quickly destroy the condom material. If lubrication is required, use saliva, vaginal, secretion, or lubricant.

Diaphragms

This type of pregnancy prevention is less effective than condom use because of the higher chance of inaccurate diaphragm use. At the same time, the combination of the use of a diaphragm with spermicides significantly increases the effectiveness of this method and the degree of protection against sexually transmitted diseases.

Modern diaphragms are made of rubber and latex. They differ in size, which is determined by the diameter of the rim in millimeters.

There are four main types, depending on the structural features of the rim:

• flat spring rim diaphragm;
• spiral spring diaphragm;
• arcuate spring diaphragm;
• diaphragm with a rim in the form of a bridge.

The flat spring rim diaphragm is used for nulliparous women with good vaginal muscle tone and is available in various sizes, from 50 to 90 mm. It is convenient for a woman as it can be inserted with a special instrument. For installation, the diaphragm is pre-lubricated.

A coil spring rim diaphragm is comfortable for most women with moderate vaginal muscle tone. It is also convenient for insertion using a special instrument. There are sizes from 50 to 95 mm.

The bow spring diaphragm is characterized by a strong spring force rim, which makes it highly recommended for most women. For introduction, the product is folded into an arc. Due to the tightness of the rim, this type of contraceptive can be used by women with reduced tone of the vaginal muscles, with recto- and cystocele. Diaphragms range in size from 55 to 95 mm.

The diaphragm with a rim with a wide bridge has a flexible rim up to 1.5 cm wide that connects to the inner edge of the rim. The border is designed to maintain spermicide and better contact with the vaginal walls.

The selection of the type of diaphragm for women, training in its introduction must necessarily be carried out by a medical professional of the family planning service. In this case, the individual anatomical features of each specific patient should be taken into account. The technician should also have a set of special rings that help to find the optimal size.

The diaphragm is inserted into the vagina so that the back of the rim is in the posterior fornix of the vagina, and the front is tightly covering the cervix just behind the pubic bone. Thus, the dome of the diaphragm covers the cervix, and the spermicidal paste or gel placed inside the dome before the introduction of the diaphragm contacts the surface of the cervix. The diaphragm, if desired, can be inserted 6 hours before sexual intercourse.

The contraceptive effect of the diaphragm is determined partly by its barrier function to prevent sperm from entering the cervix and partly by its function as a reservoir of spermicide. The presence of a spermicidal agent in the dome of the diaphragm is essential to achieve maximum contraceptive action.

The efficiency of using various modifications of diaphragms ranges from 82 to 86%.

Cervical caps

Compared to other contraceptives, they are not widely used. They are made from latex rubber. There are currently three types of contraceptive caps: a recessed hollow cap with a rim (or “neck cap”), a Vimule cap, and a domed cap.

The soft rubber cap of the Prentif, deepening with the rim, has a thimble-like shape and tightly covers the cervix. It is available in four sizes with an inner diameter of 22.25.28 and 31 mm. respectively. This cap covers the entire length of the cervix. Of all these types of caps, this is the most common.

The Vimule cap is bell-shaped with a widened open end. It is produced in three sizes: with an outer diameter of 42, 48 and 52 mm, respectively. This cap also directly covers the cervix, but its open end also covers part of the vaginal fornix. The Vimule cap is more comfortable than the recessed rimmed hollow cap when the cervix is ​​irregular, too short or too large to fit the largest recessed rimmed hollow cap to fit snugly. In terms of prevalence, the Vimule cap is the second most popular.

The domed cap is relatively shallow. It is produced in five sizes - from 50 to 70 mm. (outer diameter), with each subsequent dimension by 5 mm. more than the previous one. It has the shape of a wide, flat dome and resembles a diaphragm. It is made of a material that is heavier than the diaphragm and has no spring in its rim.

When in place, it covers the upper end of the vagina, including the cervix and fornices. It is held in place primarily by the walls of the vagina, not by sticking to the cervix.

Mechanism of action: prevents sperm from entering the uterus and fallopian tubes, serves as a container for spermicide.

Advantages of diaphragms and caps:

• have an immediate effect;
• the method is not associated with sexual intercourse (can be entered 6 hours before sexual intercourse);
• there are no systemic side effects;
• inexpensive method;
• provides protection against sexually transmitted infections, especially when using the spermicidal cream "Pharmatex" containing benzalkonium chloride, which even destroys HIV infection.

Disadvantages of diaphragms and caps:

• for initial and postpartum fitting, a gynecological examination by a qualified health worker is required;
• should not be removed within 6 hours after intercourse;
• in some cases does not protect against sexually transmitted infections;
• for greater efficiency, you should study and follow the instructions;
• large diaphragm and cap can interfere with (interfere) with quality sexual intercourse;
• the diaphragm and cap may move during intercourse;
• they must be washed and stored in compliance with all conditions, otherwise the properties of the material deteriorate;
• a woman should clearly know the expiration date of the diaphragm or cap and the criteria for their replacement;
• the average efficiency of methods using spermicide is 82-92% during the first year of use.

The diaphragm and cap are safe contraceptives. However, when using them, side effects:

• allergic reactions of the skin and mucous membranes to rubber or to a spermicidal substance in a woman or her partner;
• If the diaphragm or cap remains in the vagina for too long, then a profuse discharge with an unpleasant odor appears;
• if the diaphragm is poorly washed and stored in unhygienic conditions, candidal colpitis may develop;
• as a result of the pressure of the rim of the diaphragm on the urethra, recurrent cystitis may develop;
• there have been cases of toxic shock syndrome in both menstruating and non-menstruating women who used the diaphragm.

A causal relationship between diaphragm use and the development of toxic shock syndrome has not been established. However, it is recommended not to leave the diaphragm or cap in the vagina for more than 24 hours.

If there is a suspicion of toxic shock syndrome, the patient should be referred to a hospital that has intravenous fluids and antibiotics. In the presence of a high temperature (> 38 ° C), a rehydration agent and a non-narcotic analgesic are also recommended.

The diaphragm and cap can be used by:

• women who prefer not to use (or have contraindications) hormonal methods (for example, women who smoke over 35);
• women who do not want or who are not shown to use an IUD;
• breastfeeding mothers who need inexpensive contraception;
• couples who have rare sexual intercourse;
• women whose partners do not want to use condoms and who want protection from sexually transmitted diseases;
• couples who need an additional safety method.

Diaphragm and cap not shown:

• women whose age, number of births in history, or health problems make pregnancy extremely dangerous (in this case, the specialist helps to choose an alternative highly effective method of contraception);
• women with repeated urinary tract infections;
• women who experience difficulties or inconveniences in connection with the application of this method;
• women with pronounced cystocele or rectocele;
• couples wishing to use a different, more highly effective method of contraception;
• women with genital abnormalities.

Instructions for using the method:

• use a diaphragm or cap during each intercourse;
• empty your bladder and wash your hands before use;
• check for holes in the diaphragm or cap by pulling on the rubber and looking at it or filling it with water;
• squeeze a small amount of spermicidal cream (eg Pharmatex) into the diaphragm cup or cap. Bring the edges of the diaphragm together;
• the diaphragm or cap can be inserted in one of the following positions:

One leg is lifted onto a chair or toilet seat;

Lying on your back with legs bent at the knees;

Squatting.

• taking one of the positions listed above, spread the edges of the vagina;
• insert the diaphragm or cap of cream deep into the vagina and push the anterior edge behind the pubic bone;
• insert your finger into the vagina and feel the cervix through the rubber to make sure it is completely closed;
• the diaphragm or cap must be inserted into the vagina no earlier than 6 hours before intercourse. If intercourse takes place later than 6 hours later, it is necessary to introduce an additional portion of spermicide into the vagina;
• after the last sexual intercourse, the diaphragm or cap remains in the vagina for at least 6 hours and no more than 24 hours. (Douching is not recommended at any stage);
• remove the diaphragm or cap by hooking it / his finger over the front edge and pulling it out;
• after use, they are thoroughly washed and dried before being put into the box.

These are chemicals that inactivate or kill sperm in the vagina before they can enter the upper female genital tract.

Modern spermicides generally have two components: sperm-damaging chemicals and a base (carrier).

Vaginal spermicides

Types and names	Spermicidalagent	Time before the onset and duration contraceptive effect
Tampon, sponges Tampons "Pharmatex"	Benzalkonium chloride	Contraceptive protection comes after the introduction, efficiency retains 24 hours
Delphin Emko Koromex Patentex	Nonoxynol-9	Contraceptive activity is immediate, remains effective for up to 1 hour
Creams and gels Conceptrol Delphin Ramsey Rendell Koromex Ortho-Ginol Alpagel "Pharmatex"	Octoxynol Benzalkonium chloride	Contraceptive protection immediate. Effectiveness maintained for 1 hour when used alone; combined with diaphragm or cap, effective for up to 10 hours
Candles and pills "Pharmatex" - candles "Pharmatex" - tablets Ovules Neo-sampuun Enkda Patentike Rendell Semicide A-gen-53 Spi-a-gen	Benzalkonium chloride Menfegol Nonoxynol-9 Polysaccharide ester (enzyme inhibitor) in combination with nonoxynol-9	Contraceptive protection occurs within 5-10 minutes after insertion into the vagina, up to 3-4 hours. Remains effective for no more than 1 hour

Typically, spermicides differ in the type of carrier they contain and are available as:

• aerosols (foam);
• pastes, creams;
• gels;
• vaginal tablets;
• suppositories;
• soluble films;
• substances used to lubricate condoms;
• sponges, tampons.

The role of the spermicidal carrier is to ensure that the chemical is dispersed into the vagina by enveloping the cervix and holding it in place so that no spermatozoon escapes contact with the spermicidal ingredient and its detrimental effects.

When using creams and gels, both their independent use and combination with a vaginal diaphragm or a cervical cap are provided.

Spermicides are also used with condoms, which provides a more pronounced contraceptive effect, and also serves as reliable protection against sexually transmitted diseases.

Douching with spermicides after intercourse is not a reliable contraceptive method, since it does not exclude the possibility of sperm entering the cervical canal in the interval between ejaculation and subsequent douching.

The mechanism of action of spermicides is the destruction of the sperm membrane, which sharply reduces their mobility and the ability to fertilize an egg.

Vaginal tablets, tampons and suppositories are easy to store and transport. The start time and duration of action are given in the table above.

A spermicidal gel is usually only used in combination with a diaphragm or cap.

Benefits of spermicides:

• easy to use;
• there is no health risk;
• there are no systemic side effects;
• effective immediately (foam, cream, tampon);
• do not affect breastfeeding;
• can be used as a safety method in parallel with other methods of contraception;
• tampons, creams act immediately after injection;
• additional hydration during intercourse;
• do not require medical examination before use;
• sold without a prescription;
• are protection against sexually transmitted diseases, including HIV infection.

Disadvantages of spermicides:

• average efficiency up to 85% during the first year of use;
• for the effectiveness of the method, you need to know and clearly follow the instructions;
• tablets and suppositories are injected 5-10 minutes before intercourse and are effective within 3-4 hours;
• it is impossible to use alkaline soap before and after the application of spermicides (the foaming agent "Pharmatex" is recommended for hygienic care).

• women who do not want to use or who are not shown hormonal methods (for example, women who smoke over 35 years old);
• women who do not want or who are not shown the use of intrauterine devices;
• women who wish to protect themselves from sexually transmitted diseases;
• couples who need temporary contraception for the period of choosing another method;
• couples in need of a safety method;
• couples who rarely have intercourse.

Spermicides are contraindicated:

• women whose age, the number of births in the anamnesis or health problems make pregnancy extremely dangerous;
• women who have difficulty using this method or discomfort;
• those who are allergic to spermicides.

Instructions:

• it is necessary to inject a spermicide before the start of each intercourse;
• after the introduction of a vaginal tablet, suppository or film, you need to wait 5-10 minutes, when using tampons, creams, aerosols (foam), no waiting is required;
• it is necessary to follow the recommendations of the spermicide manufacturer for the correct storage and use of each drug;
• it is necessary to inject an additional dose of spermicide before each repeated intercourse;
• for the cervix to be completely closed, it is very important to inject the spermicide deep into the vagina;
• for intimate hygiene when using spermicides, take only running water or a foaming agent "Pharmatex".

Aerosol (foam)

• shake container 20-30 times before use
• put the applicator on the valve of the container, then fill it with foam
• in the supine position, insert the applicator into the vagina so that its end touches the neck, press the trigger and release the foam, the effect occurs immediately
• after use, the applicator must be washed with warm water and soap, rinsed and dried, for ease of washing it must be disassembled, the applicator is intended only for individual use.

Vaginal tablets and suppositories (suppositories)

• take the vaginal pill or suppository out of the package;
• lying on your back, insert it deep into the vagina until it touches the cervix;
• wait 5-10 minutes before having sexual intercourse.

Cream

• for the introduction of a contraceptive cream, squeeze it into the applicator before filling, insert it into the vagina until it touches the cervix, press the tube and release the cream, do not wait for the action to start - the effect occurs immediately;
• after use, disassemble the applicator, wash with warm water and soap, rinse and dry;
• do not let anyone else use your applicator.

Sponges (tampons)

It is a small cushion-shaped polyurethane sponge containing benzalkonium spermicide chloride.

The sponges are available in one size and sold without a prescription. Before use, it is inserted deep into the vagina. Once inserted into the vagina, the sponge provides continuous protection for 24 hours, so no further action is required if intercourse is repeated during this time. Discard the sponge after use.

Mechanism of action:

• The sponge prevents sperm from entering the woman's upper reproductive tract (uterus and fallopian tubes) and serves as a container for spermicide.

The effectiveness of the contraceptive action of the sponges does not exceed 85-90% during the first year of use.

Advantages of sponges:

• have an immediate effect;
• do not affect breastfeeding;
• the method is not associated with sexual intercourse (can be administered 2-6 hours before sexual intercourse);
• no systemic side effects;
• the method has no health risk;
• delay menstrual blood during menstruation;
• protect against the development of cervical dysplasia (precancerous condition);
• provide partial protection against sexually transmitted diseases and HIV infection.

Disadvantages of the method:

• sometimes the sponge is irritating;
• sponge displacement may occur;
• sometimes vaginal dryness appears due to the absorption of secretions;
• the sponge should be in the vagina for at least 2-4 hours after intercourse;
• remember to remove the sponge.

The use of the sponge is shown:

• women who do not want or who are not shown hormonal methods (for example, women who smoke over 35 years old);
• women who do not want or cannot use an intrauterine device for a number of reasons;
• breastfeeding mothers in need of contraception;
• women who want to avoid contracting sexually transmitted diseases;
• couples for the period of selection of another contraceptive;
• couples who need an additional safety method;
• couples who have rare sexual intercourse.

The use of a sponge is contraindicated:

• women whose age, the number of births in the anamnesis or a health problem make pregnancy extremely dangerous;
• women suffering from inflammatory diseases of the genitals;
• women who have difficulty or discomfort when using this method;
• women with uterine prolapse (prolapse of the uterus into the vagina);
• women with a history of toxic shock syndrome;
• women with vaginal stenosis (narrowing of the vaginal canal);
• women with genital abnormalities;
• couples in need of a more highly effective method of contraception;
• couples wishing to use a method other than intercourse.

Each woman has the right to choose the most suitable type of contraception for her. But, in order to make the right choice, you need to have an idea of ​​the main existing contraceptives. Earlier we already wrote a review article about modern contraceptives. This material will be completely devoted to such a contraceptive as spermicides.

What are spermicides?

Spermicides are a type of chemical contraception. In most of them, the main active ingredient is "nonoxynol" or "benzalkonium chloride", which has a destructive effect on spermatozoa. Some species contain mercury, and their use is highly undesirable unless there is a compelling, justified reason. Spermicides consist of a base that allows the drug to spread well into the vagina and a chemical that reduces the activity or kills the sperm.

Advantages and disadvantages

Pros. It is very convenient that spermicides can be used at any age, as well as during breastfeeding and after childbirth. They can be purchased without a prescription at almost any pharmacy. Using spermicides not only helps you avoid unwanted pregnancies, but protects against a number of sexually transmitted diseases. They do not contain hormones, and practically do not harm health, which, of course, favorably distinguishes it from other contraceptives. In addition, they can be used on an ongoing basis and combined with other types of contraception.

Minuses. The disadvantage of this method of contraception is its low efficiency. In the event that pregnancy occurs, when using spermicides, the risk of developing pathology in the fetus increases significantly, and most likely, the doctor will recommend you to have an abortion. Yes, and the introduction of the drug into the vaginal cavity, immediately before sexual intercourse, can not be called convenient. In addition to all this, there is a risk of an allergic reaction to one of the components of this remedy.

What spermicides are there?

For your convenience, spermicides are available in the form of candles, foams, jellies and tablets, and you can choose which type you prefer. Below is a table of the most common types of spermicides.

Name	Active substance	Release form
Pharmatex	Benzalkonium chloride	Capsules, tablets, suppositories, cream, tampons, paste
Erotex	Benzalkonium chloride	Candles (with the scent of rose, lavender, lemon)
Sterilin	Nonoxynol	Candles
Patentex	Nonoxynol	Candles
Conceptrol	Nonoxynol	Candles
ABF	Nonoxynol	Film

Due to its low efficiency, you should not use this method of contraception as the main type of protection. Although, with rare sexual intercourse, as well as women at an age when the risk of pregnancy is low, this method of contraception will be ideal. Spermicides can also be used during breaks when taking your primary contraceptive, for example if you accidentally forget to take another pill.

How to use spermicides correctly

Before use, be sure to read the instructions for use and wash your hands.

When using tablets and candles.

Gently, as far as possible, insert the candle into the vagina so that it is close to the cervix, or located directly on it. Be sure to wait, only after 10-15 minutes, the candle will completely dissolve and begin to work. By the same principle, tablets can be used.

When using foam.

To begin with, it is necessary to thoroughly shake the bottle with the drug. After that, fill the applicator with foam and insert it into the vagina as deep as possible. Inject the foam and remove the applicator. When using spermicides in the form of foam, there is no need to wait, the drug takes effect immediately after administration. The applicator must be washed with soap after each use.

When using cream or jelly.

Dispense, into the applicator, the required amount of cream or jelly from the tube. Insert the applicator as deep as possible into the vagina and insert its contents inside. Remove the applicator and wash it. Sexual intercourse can be started immediately after the administration of the drug.

When using film.

The spermicidal film must be inserted into the vagina to the maximum depth. When using it, it is important to strictly follow the attached instructions. After the introduction of the film, it is worth waiting 15 minutes for the drug to begin to work, which will last for an hour.

When using a sponge.

The sponge is both chemical and mechanical contraceptive. It is installed in front of the cervix, just before intercourse, and provides protection against sperm and other microorganisms. When using it, there is no need for additional injection of spermicides with each subsequent sexual intercourse. It must take at least 6 hours before the sponge can be removed. The spermicidal sponge is disposable and, once removed, is not recyclable.

Remember! That with each new sexual intercourse, spermicide must be applied again. Also, it is necessary to use spirimcid, and during menstruation.

You can take a shower no earlier than 6 hours after intercourse, otherwise, the effectiveness of chemical contraception is significantly reduced.

Spermicides are one of the methods of chemical contraception and are substances that effectively destroy sperm cells. The effectiveness of spermicides as a contraceptive is low. Of the 100 women who used spermicides as a means of protection against unwanted pregnancies during the year, 18-30 became pregnant. Therefore, to increase the level of reliability, spermicides are recommended to be used in combination with other methods of contraception.

The contraceptive effectiveness of spermicides largely depends on the correctness of their use and compliance with the instructions attached to them.

The principle of action of spermicide.
The new generation of spermicides consists of two components: a chemical that adversely affects the sperm, and a base that is responsible for spreading the spermicide into the vagina. The base envelops the cervix in such a way as to prevent sperm from contact with spermicide. As a rule, the active potent substance that is part of most spermicides is nonoxilone-9, which, in fact, kills spermatozoa. But instead of it there may be other substances with a similar effect. These include: benzalkonium chloride, octoxylon, menfegol. Mercury compounds were previously used as spermicides, the use of which was not entirely desirable due to possible complications, so today they have been abandoned.

As a contraceptive, spermicides can be used by women of any age. In addition, this method of contraception is allowed to be used after childbirth, abortion, and also during lactation.

Today spermicides have several forms of release: cream, foam, gel, foaming tablets and suppositories, spermicidal condoms, melting suppositories, soluble films, contraceptive sponges. Differences in shape suggest differences in spermicide use.

Gels, creams and foams.
Creams and gels can be used alone or in combination with a vaginal diaphragm or cervical cap. Due to its high contraceptive effectiveness, the foam can be used separately. The action of creams and gels begins from the moment they are inserted into the vagina and lasts for an hour. When spermicidal creams or gels are used in combination with a diaphragm or cervical cap, the period of their action is extended to six hours. In addition, the contraceptive effect also increases. Gels, creams and aerosol foams can be produced for a single use or combined use with a diaphragm or caps. Foam application requires a dedicated aerosol container.

Spermicidal suppository pills.
Spermicidal suppositories can be used alone or in combination with a condom. Spermicidal suppositories and tablets begin their effect only 15 minutes after their introduction into the vagina, therefore, the onset of coitus is possible only after 15 minutes after the introduction of the contraceptive. Incomplete dissolution of a tablet or suppository significantly reduces the contraceptive effect, in addition, it can cause an unpleasant sensation during intercourse. The contraceptive effect of spermicidal suppositories and tablets lasts for an hour.

Spermicidal condom.
Contraceptive manufacturers produce special latex condoms treated with spermicide.

Soluble film.
Single-use dissolving spermicidal films can be used alone or in combination with a diaphragm. When using it, you should strictly follow the instructions attached to it. The spermicidal film should be injected as deep as possible into the vagina. The film begins to act in the same way as a cream or suppositories, 15 minutes after its introduction. The vaginal film has a contraceptive effect within an hour.

Contraceptive sponges.
Contraceptive sponges are a contraceptive method that combines mechanical and chemical methods of contraception. The contraceptive sponge protects the cervical canal from the ingress of sperm into it, retaining it in the sponge while simultaneously releasing the spermicidal substance contained in it. Typically, spermicidal sponges are made of polyurethane and impregnated with nonoxylone-9 or benzalkonium chloride. Its use eliminates the need for additional administration of spermicide during repeated intercourse.

The sponges have a sealed container that provides it with the necessary moisture. It should be introduced immediately before intercourse. A spermicidal sponge is inserted into the vagina and is located in front of the cervix, which provides some protection against the penetration of any microorganisms into the cervix, and as a result, reduces the risk of diseases of the pelvic organs and the development of pathology of the cervix.

The sponge should not be removed from the vagina immediately after sex, it is recommended to wait at least six hours to be more confident in the loss of sperm viability. The sponge can only be used once, as washing it removes a huge amount of spermicide, which greatly reduces its effectiveness. The contraceptive sponge can be inserted into the vagina up to 24 hours before sexual intercourse and left there for up to thirty hours.

Benefits of spermicides:

• possibility of permanent use;
• do not contain hormones in their composition;
• can be used during breastfeeding, since their use has only a local effect;
• are a simple and easy-to-use tool;
• reduces the likelihood of contracting STDs in combination with other methods of contraception (the active component of spermicides kills gonococci, Trichomonas, genital herpes virus, treponema pale), but does not completely protect against them;
• dispensed without a doctor's prescription;
• their use is absolutely harmless;
• have moisturizing properties, which is important when there is a lack of natural lubrication;
• can be used as emergency contraception when a condom breaks, only the use of spermicide should be very quick;

Disadvantages of spermicides:

• most spermicides require adherence to a certain time before intercourse;
• hygienic restrictions, that is, you cannot use the shower before the time indicated in the instructions for this spermicide;
• the presence of side effects in the form of spermicide allergy and skin irritation.

In cases of side effects (skin irritation, allergies), you should go for a consultation with a doctor and it may be necessary to change the method of contraception.

The effectiveness of the use of spermicides can be reduced due to incorrect administration of these funds, a history of toxic shock syndrome, as well as abnormalities in the development of the genitals that prevent the correct placement of spermicides.

How to inject spermicide?
First you need to know exactly how much spermicidal agent you have left, since each sexual intercourse requires a new dose of the agent. It is best to have spare packaging on hand. Before using spermicide, you should carefully study the instructions attached to it. In addition, you should wash your hands thoroughly with soap and water.

When using a suppository or pill, immediately after removing from the package, it should be inserted as deeply as possible into the vagina along the back wall so that the suppository or pill is located on the cervix or very close to it.

When using foam, shake the bottle vigorously before using it. Then fill the applicator with foam and insert it as deep as possible into the vagina, press the plunger to introduce the foam. Then remove the empty applicator and wash it with soap and water. The foam starts acting immediately after it is injected, so there is no need to wait.

If you are using a cream or gel, you must squeeze it into the applicator and insert it deep into the vagina. Then press the plunger of the applicator and squeeze the gel or cream into the vagina. After that, the applicator is also removed and washed thoroughly. This is how the cream or gel begins to act immediately after administration, no waiting time is required.