Contraception with spermicidal drugs. How spermicides work and how to use them correctly Spermicidal gels names

Spermicidal lubricant is one of the ways to protect against unwanted pregnancy. How to use it? What are its features?

What is spermicidal lubricant?

Today, sex is needed not only for procreation. This is a manifestation of love and passion. Many couples who do not want to have children yet use spermicidal lubricant to protect against unwanted pregnancy. This method is simple and painless.

The product immobilizes and destroys sperm. But this is not only a contraceptive. Spermicidal lubricant also improves the glide of the penis (i.e. acts as a lubricant). Many substances have a similar effect. The drug also acts on bacilli, staphylococci and other “harmful” and opportunistic bacteria. That is, in addition to the fact that spermicide destroys the heads and flagella of sperm, it provides some protection against STIs. The product is available both as a lubricant and in the form of creams, suppositories, tablets, tampons and capsules.

How to use spermicides?

All products are introduced into the vagina as close to the cervix as possible. Depending on the form of release, the drug must be used a certain time before sexual intercourse. Creams and gels usually work immediately after administration. Suppositories and capsules usually dissolve within 5-10 minutes. The tablets take longer to work. Before using a specific product, you should carefully study the instructions.

One of the very popular ones is spermicidal sponges, which provide two levels of protection at once. Special impregnation kills sperm. Also, due to the fact that the sponge is located right next to the cervix, a certain mechanical barrier is provided. In addition, the product absorbs ejaculate, which also affects the effectiveness of the method.

First, the sponge must be moistened with water, then inserted into the vagina so that it covers the cervix. Conveniently, spermicides in other forms of release are suitable only for one-time use. That is, when the act is repeated, you need to administer an additional dose of the drug. Considering that creams and suppositories have a strong moisturizing effect, and there are sperm residues in the vagina, a woman may experience discomfort after repeated administration of the drug. The sponge is enough for several acts within 24 hours.

Condoms with spermicidal lubricant

It is no secret that condoms are a very effective method of barrier contraception, which reliably protects against both pregnancy and STDs. But sometimes (often due to improper use) the condom can break. If you have been using regular condoms, you will most likely need to use some to prevent pregnancy.

But if you choose contraceptives with which the spermicidal lubricant 9-nonoxynol is used, the likelihood of fertilization is extremely low. The product immobilizes sperm and destroys them, therefore, even if you are provided with protection. Of course, a 100% guarantee is impossible. If pregnancy is extremely undesirable, you still need to take appropriate measures.

Natalia Zlenko

Modern contraception is quite diverse. If a few years ago women used mainly hormonal drugs, today products with spermicides are more popular.

They are not used as the main means of protection against unwanted pregnancy, but serve as a reliable additional measure. The most popular spermicidal lubricant is in the form of a cream or gel. There are also many condoms sold with spermicide.

Contraceptives with spermicides

Spermicidal contraceptives are chemicals that have a harmful effect on sperm within 60 seconds after they enter the vagina.

Spermatozoa are very motile. They are able to enter the fallopian tubes within 2 minutes. Conception in this case can be avoided only with the help of emergency contraception or by taking hormonal medications.

It is not recommended to use spermicidal contraceptives as the main type of protection, since without other means they are not effective enough (no more than 80%). To increase the reliability of protection, they can be combined with hormonal drugs. It is also worth finding out which condoms contain spermicidal lubricant.

Advantages and disadvantages of spermicidal contraceptives

All spermicidal contraceptives (suppositories, gels, foams, tablets and soluble films) have common advantages and disadvantages. Such means should be used as an additional measure of protection.

Spermicidal contraceptives:

• easy to apply;
• do not disrupt hormonal levels;
• reduce the likelihood of developing sexually transmitted infections;
• can be used as a lubricant;
• There is no need for a doctor's prescription to purchase;
• can be used during pregnancy and also during lactation.

Such advantages ensure the high popularity of contraceptives with spermicides. The most popular is spermicidal gel lubricant.

Flaws :

• spermicidal contraceptives are not suitable as the main means of protection;
• many drugs need to be administered 10 minutes before sexual intercourse;
• some drugs cause an allergic reaction;
• You can go to the bathroom after sexual intercourse only after a certain time has passed.

The use of spermicides as the main protective measure often does not give positive results. You can also use condoms with spermicidal lubricant.

Gel, foam, jelly

Aerosol foam is highly effective (up to 95%), so it is often used as the main protective measure. For its comfortable use, it is worth purchasing a balloon and an applicator.

Gels and creams are packaged in tubes. Apply such products with your finger or applicator. Many people use spermicidal gel as a lubricant. Such products begin to act almost immediately after application. The contraceptive effect lasts no more than an hour. If a cap or diaphragm is used together with them, the protective effect is extended to 6 hours. In this case, the contraceptive effect is noticeably enhanced.

Gels are used as an additional lubricant to moisturize a dry vagina. The lubricant perfectly moisturizes the mucous membrane and also enhances the effect of using other contraceptives. The effectiveness of various creams and gels is 82%. To decide on the choice of contraceptives, you should also find out which condoms with spermicidal lubricant are sold in stores.

One of the popular ones is Contex Opium lubricating gel, packaged in 100 ml bottles. The drug is produced in the Czech Republic. The gel contains water, nonoxynol-9, as well as various flavors and lactic acid and glycerin components.

The spermicide nonoxynol-9 reduces sperm motility. Thanks to its presence in the composition, the risk of pregnancy is significantly reduced.

Features of application:

• it is necessary to squeeze out the gel and apply it to the erect penis;
• the product can also be used to lubricate the vagina;
• Contex lubricating gels do not damage latex, which allows them to be used with all condoms;
• It is not recommended to use the product during anal sex.

You should not use gel lubricant as the main means of contraception. In addition, it is not used more than once a day.

Condoms

When using protective agents with lubricants, no additional compounds are required. When using regular condoms, special preparations must be applied to increase slip.

Condoms with spermicidal lubricant are much more expensive than conventional products in this category. In the absence of lubricant, the partner may feel discomfort.

Spermicide can slow down the movement of sperm and even cause their death, which increases protection against unwanted pregnancy. This is quite relevant in case of a break or slippage of the condom.

Spermicide does not have a hormonal effect, so there are no side effects from its use. The contraceptive effect only increases. Using a condom without a special spermicidal lubricant does not completely eliminate the risk of conception if it is damaged.

Durex produces several lines of condoms with spermicide in the lubricant:

1. Enhanced Pleasure – have a unique anatomy, which allows each partner to receive more natural sensations. Spermicidal lubricant is sold in packs of 3 or 12 pcs.
2. ExtraSensitive - fairly thin products that increase the sensitivity of partners. Spermicides are sold in packages of 3, 12 and 24 pcs.
3. HighSensation – a series with ridges is available. Durex spermicidal lubricant is available in packs of 3 or 12.
4. IntenseSensation – products are equipped with pimples. This increases the brightness of sensations. Packs of 12 pcs. may contain spermicidal lubricant. This must be clarified when purchasing.
5. NaturalFeeling – have a classic shape, sold with spermatic lubricant.
6. UltimateFeeling – the thin products have ridges applied to them, allowing both the partner and the partner to experience unique sensations. Packs of 3, 12 and 24 pieces contain spermicides.
7. UltraComfort - products have an increased size and are easy to remove from the packaging. The lubricant is available in packs of 3 and 12 pcs.

To determine the presence of spermicides in the lubricant of a condom, it is necessary to examine the packaging. If the spermicide Nonoxinol-9 is in the list of components, then partners are provided with additional protection from infections and unwanted pregnancy. Condoms without spermicidal lubricant do not have this degree of protection.

The problem of effective contraception is relevant for many. Popular hormonal drugs have a lot of contraindications and side effects and are not suitable for many women. Alternative contraceptives popular in the West include spermicides. What kind of drugs are these, who are they suitable for and how can they protect against unwanted pregnancy?

Spermicides are chemical-type contraceptives used only locally. Products containing spermicides can be produced in the form of creams, gels, jellies, vaginal suppositories, aerosol foams, and sponges. Initially, citric acid, vinegar or lemon juice were used for this purpose, which were ineffective. In modern conditions, surfactant chemicals (benzalkonium chloride, nonoxynol-9, octoxynol-9, menfegol, etc.) are used as active components of spermicides.

Phenyrttudic acetate, which is dangerous to the health of patients, is almost never used in spermicides.

The destructive effect of spermicides on sperm lies in their properties:

• impair mobility;
• prevent penetration into the egg for fertilization;
• destroy the sperm membrane.

The active substance of spermicides destroys sperm in a very short time. This is due to the need for sperm to penetrate the fallopian tubes through the cervix in 90 seconds.

What are the capabilities of spermicides in the field of protection against unwanted pregnancy?

Benefits of spermicide products

Such advantages are the properties of products with spermicides in the form of:

• maintaining hormonal levels;
• simplicity and possibility of use at any age;
• minimum side effects;
• protection against sexually transmitted infections (gonorrhea, syphilis, trichomonas);
• reducing the risk of many cervical pathologies (especially in combination with barrier methods of contraception);
• possibility of occasional use, without the need for regular use;
• excellent moisturizing effect on the vagina and the possibility of use as lubricants;
• safety for the body (as opposed to hormonal drugs) for women with concomitant diseases;
• reducing the risk of becoming pregnant if the condom is damaged;
• safe for use during breastfeeding, since the active substances cannot pass into breast milk or blood;
• the ability to become pregnant at any time after stopping the drug;
• affordability.

Pearl index

Despite all the advantages of these non-hormonal contraceptives, their independent use is considered insufficiently effective: the Pearl index (percentage of effectiveness) of spermicides ranges from 18 to 29. This is the number of failures that can occur in a year with the regular use of these products per 100 women. Therefore, to achieve a good effect, it is necessary to supplement this method with others (cervical cap, diaphragm or oral contraceptive methods).

When supplemented with other methods of spermicide, the pregnancy rate is about 6%. And this is already a pretty good indicator. And if you combine this method with the use of a condom, this combination can reach 98% effectiveness.

This combination (spermicide + condom) is considered a double Dutch method of contraception, recommended for women who do not have a permanent sexual partner and do not have regular sex. The Dutch method also perfectly prevents STDs.

You can combine the use of spermicides with oral hormonal drugs.

The combination of spermicides with hormonal agents is especially indicated in the following cases:

• starting to take hormonal medications (the effect of taking them will accumulate no earlier than two weeks);
• missed more than 12 hours of taking a hormonal drug due to the need for additional protection that day (condom, spermicide);
• missed more than 24 hours of taking a hormonal drug, when sexual intercourse becomes unprotected and requires additional contraception throughout the entire cycle.

In addition to use with hormones, spermicides give a fairly high chance of not getting pregnant in combination with:

• condoms;
• interrupted sexual intercourse.

Who is most often prescribed non-hormonal contraceptives?

You can use these non-hormonal contraceptives on your own, but it is better to get competent advice from a doctor. After all, although these non-hormonal agents act locally, they are not suitable for everyone.

If spermicides are used incorrectly, the contraceptive effect of their use can lead to pregnancy. The worst thing is that leaving such a pregnancy will be dangerous: after toxic effects on sperm, there is a high risk of giving birth to weakened children or with the presence of serious pathologies.

Most often, gynecologists prescribe spermicides to patients in the following cases:

• rare sexual intercourse;
• allergic reaction to latex condoms;
• contraindicated use of hormonal contraception;
• impossibility of inserting an intrauterine device;
• endocrine pathologies (thyroid diseases, diabetes mellitus, etc.);
• breastfeeding;
• premenopausal period, when periods are irregular and the risk of becoming pregnant is less pronounced;
• a number of gynecological diseases (for example, large fibroids).

Disadvantages of spermicides

The main disadvantage of non-hormonal contraceptives is their low effectiveness and the need to supplement this method with a more reliable one.

Their other disadvantages are the features of spermicides:

• Provoke allergic reactions to active substances (usually nonoxynol-9). It causes sores or itching on the genitals (penis or vagina). Disturbance of the mucous membrane can lead to an increased chance of contracting HIV during sex from an infected partner.
• Spermicides are inappropriate for some types of sex (for example, oral or anal), interfering with sex itself or its foreplay, and therefore are not suitable for use;
• The need to plan the beginning of sexual intercourse minute by minute;
• Inconvenience due to the need to carry medications 10-15 minutes before having sex;
• Increased vaginal discharge after use. Water procedures (douching, showering) should not be used earlier than 6-8 hours after sexual intercourse. This time is necessary for spermicides to be fully effective. Otherwise, the active substances will be washed out ahead of schedule and will not be able to prevent pregnancy.
• There is an increased risk of contracting HIV/AIDS from a sick partner when using nonoxynol-9 in this type of product.
• The use of any detergent before and after the administration of spermicides will neutralize their effect. Therefore, for hygiene during this period, only clean water is permissible. Recently, gels for intimate hygiene have appeared that are approved for use when using spermicides.
• Possibility of developing dysbacteriosis with long-term use due to disruption of vaginal microbiocenosis.
• The occurrence of pregnancy while taking spermicides, which is dangerous to leave, since chemicals double the risk of deformities. This forces women to make the unpleasant choice of having an abortion.

Some couples are unable to use spermicide products due to reactions to their use that include severe burning, irritation, or itching in both the partner and partner.

By the way, douching is not a method of contraception, even if spermicides are added to the solution.

Contraindications

Like any drugs, spermicides have a number of conditions in which their use is contraindicated.

Absolute contraindications for spermicides are associated with:

1. anatomical anomalies or features (usually vaginal) that prevent the normal distribution of the drug;
2. severe side effects or allergic reactions to the spermicide component;
3. acute inflammation of the external genitalia;
4. development of toxic shock when used;
5. during menstruation or in case of bleeding (for tampons or sponges);
6. earlier than six weeks after birth.

You should not use these non-hormonal drugs for cervical erosion due to the following factors:

• violations of the vaginal microflora;
• damage to the epithelium of the mucous membrane of the vagina and cervix (usually nonoxynol-9) by the active substances of the drug;
• irritating effect on the mucous membrane of the cervix;
• destruction of lysozyme (a vaginal enzyme) with its antibacterial effect.

Such spermicide exposure factors may contribute to the worsening of erosion.

Types of spermicides

Spermicides are most often used in the form of:

1. Convenient and familiar to women vaginal suppositories, which dissolve after insertion into the vagina under the influence of body temperature and form a spermicidal layer in the vagina.
2. Foaming tablets used to be taken into the vagina before sexual intercourse, but require a certain time to dissolve;
3. Sponges soaked in spermicide. This is a convenient form that is inserted into the vagina. Sexual contacts will be protected immediately after insertion of the sponge.
4. In the form of a gel, foam or jelly, since sexual intercourse can begin immediately after their administration, without requiring waiting for the drug to dissolve.
5. Soluble films, used less frequently due to the need to wait after their introduction until complete dissolution of at least 15 minutes.

Popular types of spermicidal contraceptives

Spermicides can have many forms of use: gels, creams, jellies, tablets, sponges, sprays, foams, condoms. They are based on two substances: inert and active. All forms of product release are used only locally, for insertion into the vagina before sexual intercourse.

It is very convenient that spermicides are available in different forms, giving each couple the opportunity to choose the composition that is most convenient for them.

The most popular spermicides currently available are Pharmatex spermicides, produced in the form of suppositories, pastes, creams, tablets or tampons. Among the products of other manufacturers, spermicides from Sterilin, Conceptrol, Benatex, Patentex, Erotex are popular. Most often, spermicides are produced in the form of:

• foam or jelly (Delfinon, Patentex, Emko Coromex);
• vaginal suppositories (Pharmatex, Erotex, Contratex, Patentex Oval);
• vaginal tablets (Benatex, Gynecotex, Traceptin);
• cream (Pharmatex);
• foaming tablets (Pharmatex);
• foaming suppositories (Pharmatex, Erotex);
• soluble films (Pharmatex);
• vaginal tampons (Pharmatex);
• sponges (Pharmatex).

Features of application

Let us consider the main features of the use of various spermicidal agents.

Vaginal suppositories and tablets

Vaginal suppositories or soluble tablets must be combined with the use of a condom. This combination gives the maximum protection effect. The suppositories are inserted as deep as possible into the vagina, closer to the back wall. After administration, it is better for a woman to lie down for 10-15 minutes. The effect of suppositories or tablets occurs no earlier than 15 minutes after administration, when the drugs are completely dissolved in the vagina.

For vaginal suppositories, the applicator included in the kit is used. Incomplete dissolution of suppositories or tablets leads to a decrease in the contraceptive effect of the drugs and discomfort during intimacy. The duration of the contraceptive effect when using suppositories or tablets does not exceed one hour. Repeated sexual contacts require re-taking suppositories or tablets and leaving them for 15-20 minutes after that.

The tablets are convenient to use, but may cause a burning sensation in some patients during their administration and dissolution. These sensations go away quickly and do not require discontinuation of the drug. The contraceptive effect occurs no earlier than 15 minutes after administration and lasts about an hour, requiring repeated use for further sex.

Gel, foam, cream

The use of cream, jelly, foam or gel requires strict adherence to the instructions for their use. Their use is allowed only on clean mucous membranes. It is better to combine these products with cervical caps or diaphragms. These products do not require additional time to dissolve in the vagina and perfectly moisturize the mucous membrane. The most effective type of spermicide is foam; other products (jelly, cream, foam) have an effectiveness of no more than 82%. The foam can be used without other additional means of contraception. Before use, shake the foam and fill the applicator with it. After an hour of having sex, you must repeat the use of the product.

The use of soluble films requires certain skills and exhausts its effect after an hour, requiring repeated administration. This type of means is rarely used. The introduction of foam requires a 15-minute wait before sex. Even with the additional use of other barrier means (condom), their effectiveness is no more than 82%.

Sponges and condoms with spermicides

The sponges are very convenient to use, as they have a long-lasting effect after administration (up to 24 hours). They are a polyurethane pad impregnated with an active substance containing spermicide. The sponges interfere with the passage of sperm, covering the cervix. When used correctly, the contraceptive effect of the sponge is 87%. These types of spermicides provide dual (chemical and mechanical) protection for sperm penetration. The sponge should be removed no earlier than 6 hours after sexual intercourse.

Condoms with spermicide have long been considered more powerful than regular condoms. But recently it has become clear that contact with latex and aromatic compositions destroys spermicidal substances. Such condoms are prohibited for use during anal sex. Therefore, it is currently recommended to use regular condoms with lubricant containing spermicide.

Spermicides are chemicals that inactivate sperm in the vagina and prevent their passage into the uterine cavity.

The safety and possibility of using spermicides for a long time, their ease of use and relatively high efficiency, confirmed by numerous foreign clinical studies, in most cases determine the recommendations of doctors and the inclination of patients in choosing contraceptives.

Mechanism of action

Modern contraceptives, in accordance with the criteria of the World Health Organization, should not only prevent the development of unplanned pregnancy, but also be able to protect against sexually transmitted diseases.

Chemical contraceptives have not only a preventive, but also a therapeutic effect. The most pronounced antiviral and antibacterial activity among these substances is characteristic of benzalkonium chloride. In cases of its use, there is no need for additional use of other antimicrobial drugs for the treatment of nonspecific vaginosis, which can be caused by streptococcus, staphylococcus, corynebacterium, and yeast. Statistics from a large number of studies indicate a 23-65% reduction in the number of inflammatory diseases and sexually transmitted infections.

At the same time, these drugs destroy lysozyme and, having a powerful antiseptic effect that lasts for about one day, sharply disrupt the normal ratio of microorganisms (biocinosis), preventing the development of pathogenic bacteria and yeast in the vagina of healthy women.

With frequent and regular use, they can even lead to sterility in the vagina due to the death of lactobacilli, which provide an acidic environment that is unacceptable for bacterial microflora. As a result of their use, within a day, pathogenic microflora begins to successfully multiply in the genital tract, and inflammatory processes develop in the mucous membrane of the vagina and cervix.

Names and uses of spermicides

"Pharmatex" - available in various forms (capsules, tablets, cream)

Modern drugs are manufactured by various pharmaceutical companies under different names and with different active ingredients:

• "Pharmatex" - with benzalkonium chloride or nonoxynol-9 as an active ingredient;
• "Allagel", "Benatex" and "Erotex" - with benzalkonium chloride;
• "Conceptrol", "Patentex", "Dolphin" and "Emuco Coromex" - with nonoxylon-9;
• "Neo-sampun" - with mengefol.

The duration of action and method of administration of the drug depend on the pharmacological forms of release, mainly related to the type of carrier. Female spermicides are available in the following forms:

• Vaginal foaming suppositories and tablets, as well as capsules and melting tablets. Capsules provide contraceptive protection for 4 hours, the rest - 1 hour. They are inserted into the vagina along the back wall in a supine position 10-15 minutes before the start of sexual intercourse.
• Jelly and creams, the contraceptive effect of which lasts about 1 hour, and in some of them longer, are also administered in the supine position using a special applicator. In addition, they can be used together with mechanical barrier means (diaphragm, cervical cap), which increases the duration of the pregnancy protection effect to 6 hours.
• Aerosol foams - the action begins immediately after administration, so there is no need for a time interval after their administration. The duration of action lasts up to one hour.
• Vaginal cream - available in tubes with a dosing device and administered 10 minutes before intercourse.
• Dissolving films approximately 5 cm long. They are available in sterile portable packaging and are convenient to use, but require skill in deep insertion and an interval of 15 minutes after administration. Their duration of action is from 1 to 2 hours.
• Sponges and tampons soaked in spermicide. The mechanism of their action is combined - the creation of a mechanical barrier to the migration of sperm and the release of a chemical agent. Their effect begins immediately after administration and lasts for 1 day, which eliminates the need for additional use during repeated sexual acts.

To prevent a decrease in their effectiveness, it is prohibited:

• 2 hours before the start of sexual intercourse and for 2 hours after it, use soap when toileting the external genitalia, since it destroys the active substance even in small quantities; for these purposes, it is necessary to use only clean water without hygiene products;
• douche even with clean water within 2 hours after sexual intercourse;
• take general water procedures before it (bathing in a bathtub, pond, etc.) with the drug already administered;
• use spermicides against the background of vaginal use of other drugs (anti-inflammatory treatment, etc.).

Regardless of the pharmaceutical form, except for tampons and sponges, a repeat dose of spermicide must be administered before each sexual intercourse. The frequency of use depends on the number of sexual acts and individual tolerance to the drug. Each means of protection, depending on its composition, may have its own characteristics of use and duration of action, which should be indicated in the attached instructions.

Vaginal suppositories and gels must be inserted deep enough

There are no specific male spermicides as such. Condoms for men are produced that are treated on the inside or outside with nonoxynol-9 and have a short shelf life. Even a slight excess of the latter contributes to the destruction of the latex product by the chemical, as a result of which the protective properties of the product are largely lost.

Back in 2001, the World Health Organization published a number of scientific studies, based on which it was concluded that there are no differences in the quality of protection and the degree of protection against infections between treated and regular condoms. The combined use of male condoms and vaginal chemical contraceptives significantly reduces both the risk of unplanned conception and the risk of contracting sexually transmitted infections.

Some doctors recommend combining spermicides and PPA (coitus interruptus), explaining this as a kind of double protection, supposedly guaranteeing 100% protection against conception. This statement is completely unconvincing, because if spermatozoa do end up in the vagina during PPA, then the degree of the chemical effect of the contraceptive does not depend on their number.

In any case, there are no such recommendations in the scientific literature, especially since PPA itself has a very negative impact on a man’s health. It is much more expedient to combine mechanical barrier contraceptives with spermicidal preparations, which guarantees 98% protection against unwanted pregnancy.

The use of spermicides during pregnancy and breastfeeding, their effectiveness

As a result of the studies, the following effects of spermicides on pregnancy and breastfeeding were established:

1. In the population of ordinary consumers, not everyone and does not always adhere to the rules of chemical contraception. The probability of conception during the first year of using drugs of this series, that is, the effectiveness of spermicides, is quite low and reaches 21-25%. If you strictly follow the instructions for their use, the risk of pregnancy is much lower and averages 3%. This figure is quite comparable to statistics on the use of hormonal contraception.
2. The use of modern products containing benzalkonium chloride and other surfactants during pregnancy does not have any harmful effect on the fetus, including a teratogenic effect. However, the irritating effect of chemical ingredients can sometimes provoke contraction of the pregnant uterus and lead to miscarriage or premature birth.
3. Special spermicides for nursing mothers are not produced, since the constituent components of existing drugs do not have a systemic resorptive effect, due to the lack of ability to be absorbed into the blood and pass into breast milk.

Advantages and disadvantages

The main advantages of modern spermicidal preparations are the possibility of using:

1. In combination with other means of contraception, including mechanical barrier ones (condoms, caps, diaphragms).
2. In cases where there are contraindications for the use of combined oral contraceptives or an intrauterine device, as well as the woman’s reluctance to use them for any other reasons.
3. If necessary, temporary contraception in case of a break in the use of the above means.
4. For irregular sexual intercourse, when the use of permanent means does not make sense.
5. At risk of contracting sexually transmitted diseases. In these cases, the combination of spermicides with a condom is more reliable.
6. During any period of a woman’s sexual activity, including adolescence, during breastfeeding, and during perimenopause.
7. As lubricants, due to its good moisturizing effect.

The most important disadvantages:

• the need to learn the correct insertion and maintain an interval between insertion and the beginning of sexual intercourse of up to 15 minutes (when using most forms - suppositories, capsules, tablets, films, creams);
• the need for repeated injections before each sexual intercourse, with the exception of aerosol foam, sponges and tampons;
• delayed carrying out a full hygienic toilet of the vagina and external genitalia;
• the possibility of allergic reactions and side effects - itching and irritation of the mucous membrane of the vagina, cervix and skin of the penis.

Contraindications for use

It is undesirable to use spermicides due to the following factors:

• irritating effect of chemicals on the mucous membrane of the cervix;
• destruction of epithelial cells of the mucous membranes of the cervix and vagina, which is especially characteristic of drugs with the active component nonoxynol-9;
• destruction of lysozyme, which has anti-inflammatory properties;
• violation of biocenosis in the vagina.

This mechanism of action of chemical contraceptives contributes to the formation or worsening of the erosive process in the cervix.

In addition, absolute contraindications to their use are:

1. Allergic reactions or severe side effects to a particular spermicide during previous use.
2. Anatomical features and vaginal abnormalities that prevent the uniform distribution of the substance or the placement of the sponge or tampon.
3. Previous development of toxic shock syndrome (contraindicated only for sponges and tampons).
4. Acute inflammatory processes in the area of ​​the external genitalia.
5. Until the end of the six-week postpartum period.
6. The presence of menstruation, bleeding or discharge mixed with blood (for sponges and tampons).

It should be remembered that the correct use of spermicidal preparations provides sufficiently high contraceptive results and protection against sexually transmitted infectious diseases, but is not a complete guarantee of eliminating the risks of infection.

Along with all the usual and well-known methods of contraception, such as the use of condoms, there are many other, less popular, but no less effective methods. One such method is the use of spermicides. This article is intended to introduce you in more detail to this method of contraception and tell you about all the advantages, disadvantages and different types of spermicides.

What are spermicides

Spermicides are substances that can lead to the destruction of the cellular structure of sperm during their contact. Spermicides, in addition to their main function (prevention of unwanted pregnancy), also exhibit a number of other properties, among which it is worth highlighting antiprotozoal, antifungal and antiviral.

Did you know? One of the most unreliable, but at the same time the most popular, methods of contraception is the calendar method. Due to the phenomena of false ovulation and the fluctuating cycle of most women, it is not able to predict “safe” periods with high accuracy.

Spermicides are excellent antiseptics, so in some cases they are used to disinfect various surfaces and primary disinfection of household items. The most famous and first synthesized substance of this group is benzalkonium chloride, obtained in 1935 by the German bacteriologist Gerhard Johannes Paul Domagk.

How do spermicides work?

The principle of their action is based on the destruction of sperm membranes, the natural result of which is the limitation of their mobility, as a result of which they can no longer reach the egg and fertilize it. From the moment of contact of the active substance of the spermicide until the complete destruction of the cell wall of the sperm, no more than 60 seconds should pass, or better yet less.

Important! Spermicides do not guarantee 100% protection against pregnancy and cannot prevent pregnancy if used after sexual intercourse, therefore it is recommended to carefully study the instructions for each drug before using it directly.

Use in the fight against unwanted pregnancy

The effectiveness of spermicides can be measured using the Pearl index, which is 18-24 for this class of contraceptives. In practice, this means that, despite the use of this technique, 18-24 women out of 100 became pregnant. For comparison, the Pearl index when using combined oral contraceptives is 0.1-0.9, and when using condoms - about 12.

However, it has been proven that this class of substances can significantly increase its effectiveness if used in combination with other contraceptives. For example, a combination of spermicides with condoms gives us a Pearl index of 2, and in the case of a combination of spermicides with oral contraceptives, the probability of becoming pregnant decreases to 0.01. The method of combined use of such drugs with other methods of contraception is called the double Dutch method.

In general, the effectiveness of this technique depends on the woman’s desire and ability to follow a number of simple rules, which may vary depending on the dosage form of a particular spermicidal drug and are always set out in the instructions for use attached to it.
The use of spermicides in combination with condoms works very well for those representatives of the fair sex who are in search of a permanent sexual partner and have sexual intercourse quite irregularly. Due to the antimicrobial, antiviral and antifungal properties exhibited by these drugs, it is also possible to use them as drugs for the prevention of various sexually transmitted diseases.

Did you know? You should not use Vaseline, like other creams that contain various fats, for additional lubrication, since they can reduce the strength of latex.

Advantages and disadvantages of spermicides

In addition to the advantages and disadvantages of this technique already mentioned above, there are several more significant points worthy of special mention.

Advantages

This method of preventing unwanted pregnancy has the following positive aspects:

1. A fairly easy to learn and accessible method.
2. These products do not contain hormones and do not in any way affect the hormonal balance of the female and male body.
3. They have an exclusively local effect and do not pass into breast milk or the bloodstream.
4. Due to their chemical nature, they have a fairly pronounced moisturizing ability, and therefore can be used as an alternative to lubricants.
5. They significantly reduce the likelihood of contracting many sexually transmitted diseases, but do not completely eliminate this likelihood.

Flaws

But there is also a flip side to the coin and some negative effects of the contraceptive cannot be ruled out:

1. Direct connection between sexual intercourse and the use of the drug. Unlike oral contraceptives, which are used simply according to the schedule, many of the dosage forms containing spermicides must be used 10-15 minutes before sexual intercourse, which introduces the need for an element of contact planning and is not always convenient or possible in principle.
2. After using many spermicides, the use of soap and other detergents is prohibited due to the likely change in their chemical nature and possible loss of activity. For hygienic purposes, it is recommended to use only cool, clean water.
3. Various side effects may occur in the form of dermatitis, irritation, redness, itching, peeling and inflammation of the skin, up to the formation of pronounced skin defects.

Important! If the adverse reactions described above occur, it is recommended to consult a doctor to find out the objective reason for their occurrence and a possible change in the method of contraception.

Main types and forms of spermicides and features of their use

There are many different dosage forms in which certain spermicides are produced.
Separately, it is worth noting condoms coated with spermicidal lubricant. As mentioned earlier, this method of combined contraception is called double Dutch and shows a fairly high efficiency of 98%. However, it is worth noting that this technique shows such a high Pearl index only if the duration of sexual intercourse does not exceed 20-25 minutes. Then it decreases with each additional minute by 2-4%.

Creams and jellies

Among the most popular spermicidal agents in this dosage form in our country, the following should be highlighted:

• "Pharmatex", "Alpagel" - active ingredients - benzalkonium chloride;
• "Conceptrol", "Dolphin" - active ingredient - non-oxylon-9;
• “Ortho”, “Ramses”, “Rendell”, “Coromex”, “Ortho-Gynol” - the active ingredient is octoxynol.

Suppositories and tablets

These dosage forms must be used 10-15 minutes before sexual intercourse. The introduction is carried out in a lying position, it is desirable that the pelvis is in an elevated position during the process. The insertion is carried out along the back wall of the vagina to the depth of a finger. The negative aspect of using these contraceptives is the formation of some foam, which can be visually unpleasant for your partner.

The duration of the candle effect is on average about 4-4.5 hours. The tablets exhibit a slightly shorter active period of action - only about 1 hour, but produce less foam. Below are the main drugs of this dosage form used in our country:

• "Ovelus Pharmatex" - active ingredient - benzalkonium chloride;
• "Neo-sampun" - active ingredient - menfegol;
• "Enkea", "Pharmatex" - active ingredient - non-oxylon-9;
• "Norform" - active ingredient - phenylmercuric acetate.

Foam

Unlike other dosage forms, the effect of these drugs occurs immediately after their administration, so there is no need to wait a certain period of time after their administration. The negative aspect of their use is the relatively short period of time in which they exhibit an active effect - less than an hour.

Important! The spray can must be inserted into the vagina only to a certain point, since there is a possibility of injuring the vaginal mucosa or reducing the effectiveness of the product.

As with the previous forms, to use these means it is advisable to take the Trendelenburg position (lying down, with the pelvic end of the body slightly elevated). Here is a list of the main spermicides produced in our country in this dosage form: “Dolphin”, “Emco Coromex”, “Patentex” - the active substance is non-oxylon-9.

Films

They look like transparent membranes, up to 5-7 centimeters long. They are sold in sterile packages and are quite convenient to use, but their use requires some skill.

The film is inserted in a supine position, with the pelvic end of the body slightly elevated. It is necessary to insert the film as deeply as possible, while trying to position it in such a way that it expands into the vagina as much as possible and covers the largest area.

After inserting the film, you must wait 15 minutes for it to dissolve, otherwise during contact the film may move, as a result of which its contraceptive properties will be reduced, or even fall out of the vagina. The duration of action varies depending on many factors, but on average it is 1-2 hours.

Here is a list of the main spermicides produced in our country in this form:

• "Pharmatex" - active ingredient - benzalkonium chloride;
• "Contraceptin-T" - active ingredient - octoxynol.

Use of spermicides: side effects and contraindications

In addition to the already mentioned side effects in the form of possible allergic reactions and various local irritations, it is also worth mentioning the possible influence of these drugs on the formation of various erosive processes in the vagina, cervix and uterus itself.
The likelihood of a connection between these facts is explained by the following reasons:

• the presence of a local irritating effect of spermicides on the vagina and uterus;
• negative impact on the mucous layer of the epithelium of the vagina and uterus, up to the destruction of individual cells. This phenomenon is especially typical for drugs based on non-oxylon-9;
• preventing natural substances with anti-inflammatory activity, for example, lysozyme, from entering injured areas due to its chemical destruction;
• disruption of the natural balance of bacteria and chemicals in the vagina and uterus;

• the presence of anatomical or functional structural features of the pelvic region that prevent the uniform distribution of the active substance inside the vagina;
• history of toxic shock episodes;
• the presence of acute inflammatory processes of the genitourinary system, as well as the area of ​​the external genital organs;
• early postpartum period, as well as the period up to 6 weeks after its end;
• , vaginal bleeding or the presence of vaginal discharge mixed with blood of any nature;