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    What is the birth control sponge? And how does it work?

    What is the birth control sponge? And how does it work?
    Updated 14 March 2022 |
    Published 04 December 2019
    Fact Checked
    Dr. Jenna Beckham
    Medically reviewed by Dr. Jenna Beckham, Obstetrician and gynecologist, WakeMed, North Carolina, US
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    If you’ve never heard of the birth control sponge then our guide will get you up to speed fast

    You could easily be forgiven for not being too sure what the birth control sponge is, because it’s definitely less well known than other contraceptive methods, like condoms or the pill.

    If you’re used to only using a sponge for washing dishes, let us enlighten you. Our guide will tell you all you need to know about the birth control sponge, from what it is and how to use it to where to get it and how effective it is for protecting you from unplanned pregnancy.

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    What is the birth control sponge?

    The birth control sponge, or contraceptive vaginal sponge as it’s sometimes called, is a small, round sponge made from soft, squishy polyurethane foam. It looks a bit like a donut with a fabric loop to make it easier to remove.

    How does the birth control sponge work?

    Think of inserting the sponge like you would a tampon. The difference is that you place the sponge deep inside your vagina before you have sex, and it covers your cervix, acting as a barrier to help block sperm and prevent pregnancy. 

    For added protection, the sponge also contains spermicide, a substance that kills or immobilizes sperm cells, to stop them from reaching the egg.

    That said, the sponge doesn’t protect you from sexually transmitted infections (STIs). In fact, sponges can actually increase your risk of picking up an infection thanks to an ingredient in the spermicide that can irritate your vagina and make it easier for germs to pass from one partner to another. So, double up your protection from unplanned pregnancy and STIs with a condom for safer sex.

    One very important thing to note is that sponges should never be taken out and reused. But, once in place, each sponge can be left in for up to 30 hours. That means you can have sex as much or as little as you like in that 24-hour window — you just need to make sure you keep the sponge in place for six hours after the last time you have sex (up to a maximum of 30 hours), so it can work its magic. You should never leave a sponge in your vagina for more than 30 hours

    Benefits of using the birth control sponge

    There are a few key benefits of the birth control sponge, the main one being that you only need to use it when you have sex. So it’s a good option for those of us who are too busy (or forgetful) to take a pill every day or who don’t want to commit to a long-term contraceptive method

    Another plus is that it doesn’t contain hormones, so if hormonal contraception isn’t a good fit for you for whatever reason (e.g., you’re breastfeeding), then the sponge could be an option worth considering.

    You can also insert and remove the sponge yourself at home — although we’d recommend speaking to your health care professional first so they can answer any questions you might have.  

    Remember that although the sponge doesn’t require medical prescription or fitting, you should buy it from a pharmacy or family planning clinic so you know what you’re using is safe.

    How effective is the birth control sponge?

    When you’re weighing up whether the birth control sponge is the right form of contraception for you, there are a few things to consider.

    The two biggest factors that can impact the sponge’s effectiveness to prevent unplanned pregnancy are:

    • Whether you’ve inserted it correctly
    • Whether you’ve previously had a vaginal birth

    Unlike condoms and the pill, which are pretty straightforward and convenient to use, inserting the birth control sponge correctly can take a bit of getting used to — and this impacts how effective it is. With typical use, the sponge is:

    Why does a previous vaginal delivery make a difference? Well, there’s some evidence that a vaginal birth can change the shape of the cervix so the sponge no longer sits flush against it. This can allow sperm to pass through.

    Remember that no form of birth control is 100% effective, but the sponge ranks lower than perfect use of condoms (98%), the contraceptive pill (99%), and IUDs (99%) for successfully preventing pregnancy. That might be why it has become a less popular choice in recent years.

    Where can you buy the birth control sponge? Is it still available?

    Birth control sponges are also harder to find these days. They’ve been discontinued in some countries like the U.K.

    In the U.S., there’s now just one brand of sponge available: the Today Sponge. You can pick up a pack of three without a prescription or proof of age for around $15 at a pharmacy. But, at the time of writing, the Today Sponge is out of stock and not currently in production

    Outside of the U.S.? Speak to your health care provider to find out what birth control options are available in your area. 

    How do you use the birth control sponge?

    You can insert the birth control sponge up to 24 hours before you have sex. Because it’s the main barrier to protect your cervix from sperm, it’s really important to insert it the right way. These easy steps might help:

    • Take the sponge out of its packaging with clean hands. Certain brands must be moistened with approximately two tablespoons of water to activate the spermicide, whereas other sponge brands come ready to use, so just check the instructions to determine whether you need to wet your sponge.
    • Gently squeeze out any excess water. The sponge should feel wet, foamy, and lathery before you pop it in.
    • Fold the sides of the sponge up, keeping the indented side of the sponge facing up, with the loop facing down so you can easily find the loop when you want to remove it.
    • Get yourself into a comfortable position, as if you were inserting a tampon or menstrual cup.
    • As you insert the sponge into your vagina, the indented side should face up — if you were to look, you could see the fold you made. The loop side should be facing down.
    • Slide the sponge as far up into your vagina as possible. When the sponge is in place, it will unfold and cover your cervix.
    • Gently slide a finger around the edge of the sponge to determine whether it’s properly blocking your cervix.

    You might feel a little nervous or unsure the first time you use the sponge, so we’d suggest practice before you actually have sex, so you feel confident when the time comes.

    Leaving it in

    One of the benefits of the birth control sponge is you can have sex as many times as you wish for up to 24 hours after you’ve inserted your sponge, and you don’t need extra spermicide for each time you have sex. Just remember to leave it in for six hours after the last time you have sex (no more than 30 straight hours in total).

    Removing it

    Here are a few tips you might find useful while removing the birth control sponge: 

    • Once you’re ready to remove the sponge, wash your hands and hook a finger around the fabric loop.
    • If you can’t reach the sponge easily, push with your vaginal muscles as you grab it.
    • Then, simply pull the sponge out and put it in the trash. Don’t flush a birth control sponge down the toilet.
    • You should never reuse a contraceptive sponge.

    When to avoid the contraceptive sponge

    Although you don’t need a medical prescription to buy the birth control sponge, there are certain situations which might mean it’s not the best form of contraception for you. These include:

    • If you’ve had toxic shock syndrome (TSS) in the past (TSS is a rare, sudden, and very serious condition that occurs when a bacteria called Staphylococcus aureus releases toxins into your blood. Read more about TSS here.)
    • If you’re at a high risk of contracting HIV or another STI
    • If you have your period or currently have vaginal bleeding
    • If you’re not confident that you’d be able to use the sponge correctly or consistently, or if you have sex three or more times per week
    • If you’ve recently given birth or had an abortion or miscarriage in the last 6 weeks
    • If you regularly have frequent urinary tract infections (UTIs)
    • If you’re allergic to polyurethane or spermicide (nonoxynol-9)

    Your health care provider is the best person to advise you, so if you’re unsure about any of the above, we’d suggest making an appointment to discuss whether the contraceptive sponge is right for you.

    Birth control sponge: Things to consider

    Just like any other type of medical product and form of contraception, there are some small risks associated with using the birth control sponge:

    • Toxic shock syndrome: The risk of developing TSS increases if you leave the sponge inside your body for longer than 30 hours in total. Initial symptoms include chills, fever, malaise, skin rash, headache, vomiting, diarrhea, and muscle pain, among others. If you suspect that you’ve developed TSS, you should seek medical attention immediately.
    • Vaginal dryness: Sometimes the components of the sponge can cause dryness and irritation. Some people find that the sponge also absorbs their natural lubrication and makes sex uncomfortable; try using a water or silicone-based lubricant if this happens.
    • UTIs or yeast infections: Using the sponge increases the risk of getting a UTI or yeast infection.
    • Difficult removal: It’s usually easy to remove a birth control sponge. However, if it breaks into pieces that you can’t retrieve, you may need to seek medical attention. Leaving in pieces of the sponge can increase your risk of TSS or cause an infection.

    The birth control sponge: The takeaway

    The birth control sponge has both pros and cons, and there are several factors that you need to take into consideration before deciding whether it’s right for you.

    This method can be a good choice for people who can always use it correctly, haven’t given birth, and don’t want to use hormonal or long-term contraceptive methods. However, the sponge may not be for you if you’ve given birth, have sex frequently, are at higher risk of contracting an STI, or don’t think you’ll be able to use it correctly every time you have sex.

    Although the birth control sponge doesn’t contain any hormones, it still carries certain risks, so it’s always worth talking to your health care provider before choosing your birth control method. They can help you make sure that you’re making the best choice for your body and your health.

    References

    “Contraceptive Sponge.” Mayo Clinic, 11 Aug. 2021, www.mayoclinic.org/tests-procedures/contraceptive-sponge/about/pac-20384547.

    Kuyoh MA, Toroitich-Ruto C, Grimes DA, Schulz KF, Gallo MG. “Sponge versus diaphragm for contraception.” Cochrane Database Syst Rev. 2002;(3):CD003172. doi: 10.1002/14651858.CD003172. Update in: Cochrane Database Syst Rev. 2013;5:CD003172. PMID: 12137678.

    Kuyoh MA, Toroitich-Ruto C, Grimes DA, Schulz KF, Gallo MG. “Sponge versus diaphragm for contraception.” Cochrane Database Syst Rev. 2002;(3):CD003172. doi: 10.1002/14651858.CD003172. Update in: Cochrane Database Syst Rev. 2013;5:CD003172. PMID: 12137678. 

    “Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap.” ACOG, Mar. 2018, www.acog.org/womens-health/faqs/barrier-methods-of-birth-control-spermicide-condom-sponge-diaphragm-and-cervical-cap?utm_source=redirect&utm_medium=web&utm_campaign=otn.

    History of updates
    Current version (14 March 2022)
    Medically reviewed by Dr. Jenna Beckham, Obstetrician and gynecologist, WakeMed, North Carolina, US
    01 December 2019
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