Vegas vaginas and the contraceptive sponge

A Today vaginal contraceptive sponge

The photo: The Today vaginal contraceptive sponge hanging from an orchid by its ribbon removal loop. Today is a soft, disposable polyurethane foam sponge containing 1000 mg of the spermicide Nonoxynol 9 (N9) and is slightly less than two inches in diameter. The Today sponge while recommended for only 24 hours of continuous wear was originally approved for a 48 hour continuous wearing interval. However, wearing a sponge continuously makes it more likely that the wearer may become allergic to the N9 spermicide and that the sponge will develop an odor. The concave side fits over the cervix and the manufacture says it is effective protection for an unlimited number of acts of intercourse during the approved wearing interval making it ideal for a teen get-away weekend with a spongeworthy man..

Sponge pregnancies: For women who have given birth the contraceptive sponge failure rate is very high (20%) even when used perfectly so is not a good alternative. However, for a young woman who hasn’t been pregnant and has the willpower to use it consistently and correctly the Today vaginal contraceptive sponge can be an attractive birth control alternative if hormonal contraceptives; diaphragms and caps or a LARC method do not suit in her circumstances.  Walmart currently has a three count box advertised for less than eleven USD or about $3.33 each for 48 continuous hours of protection which is pretty good if you are going on a very spontaneous weekend with a new love interest. Of course it provides no STI protection, but does offer some thrust buffering if the man is large and frequently hits the cervix and it is readily available in most pharmacies w/o an Rx.

Bea has had some St Lucy’s girls to our home for weekend sleepovers with escort trainees for entertainment as an ice breaker for new girls entering the prep school during the spring semester. I was surprised to learn that several of the new girls, all Bea’s age, were using the sponge for protection.  There is no danger of contracting STIs on the sleepovers as the escorts and students have all been screened, but the likelihood of them using the sponge correctly at that age isn’t very good. So I made sure they all took the EC pill ella before they left for school the following Monday.  There is some risk but it was a major bonding experience for everyone involved. And I talked with their sexual health counselor at school to see if the girls can’t be convinced to switch to IUDs.

The sponge’s effectiveness: Source: Trussell J. Contraceptive efficacy. In Hatcher RA, Trussell J, Stewart F, Nelson A, Cates W, Guest F, Kowal D. Contraceptive Technology: Eighteenth Revised Edition. New York NY: Ardent Media, 2004.

Failures (unplanned pregnancies) per 100 women during the first year of use.

Parous women     Typical use (not always consistently or correctly) 32%         

      Perfect use (Always used consistently and correctly) 20%

Nulliparous women    Typical use (not always consistently or correctly) 16%         

 Perfect use (Always used consistently and correctly) 9%

Proper use means thoroughly wetting the Today Sponge with tap water before insertion, leaving it in place for six hours after the last act of intercourse, and having it in place every time intercourse occurs. The Today contraceptive sponge does not protect against STIs and should not be used during the woman’s menstrual period or for contraceptive protection during underwater sex. However, it is said to be safe to wear during bathing and while swimming.

Vegas vaginas and the contraceptive sponge: We are seeing a spike in sponge pregnancies coming in to our clinic for blood tests and terminations. That seems to be related to holiday (three day) weekends where the users are trying to stretch a single sponge to a continuous wearing interval of three days, 72 hours. Assuming that all other requirements had been met that leaves them in uncharted territory (as far as the sponges efficacy goes) for the last 24 hours and they are far more likely to have an allergic reaction to the continuous N9 released against delicate vaginal tissue. The scent of a sponge left inserted for three days is pretty ripe, but that is just from the interaction of the polyurethane foam with the wearer’s natural secretions and her partner(s) semen a reaction that occurs with diaphragms and cervical caps left inserted for too long as well.

Birth control hormones, copper IUDs and divorce: Our clinic is beginning to see a pattern in some patients who were recently married (in the past three years), who had been on hormonal contraceptives since their teens and who had come off hormones to get pregnant. The pattern is that the women are coming in for a ParaGard copper IUD before conceiving and having the strings removed so their husbands can’t tell they have An IUD inserted.

I’ve spoken to several of them and they have a common story; that when they came of contraceptive hormones each found they had married the wrong man, meaning that he wasn’t masculine enough for her. All are preparing themselves to divorce their husbands and while hormone free are searching for a more masculine and ruggedly compatible man. I’m not saying this is common, but it does fit with a study that was published last year which found that women who met their partners while they were on hormonal contraceptives chose less masculine men than those who were cycling naturally.