Contraceptive sponge

Contraceptive sponge
Protectaid sponge, in its plastic tray. It is removed from the tray before use.
Background
B.C. type	Barrier
First use	1983
Failure rates (first year)
Perfect use	Nulliparous:9% Parous:26%
Typical use	Nulliparous:16% Parous:32%
Usage
Reversibility	Immediate
User reminders	?
Advantages and disadvantages
STD protection	No
Benefits	May be inserted 12–24 hours before intercourse
Risks	yeast infection, rarely toxic shock syndrome

The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and Quebec; Protectaid in Canada and Europe; and Today in the United States.^[1] For a while, the Today brand was not being manufactured.^[2] In mid May 2009, Mayer Laboratories, Inc.[1], the distributor of the Today Vaginal Contraceptive Sponge [2]for the US, Canada and the EU, announced the Today Sponge had been re-launched in the United States.^[3]

The sponges are inserted vaginally prior to intercourse and must be placed over the cervix to be effective. To facilitate removal, Today has an elastic band across the sponge; Protectaid has two slots.

Sponges provide no protection from sexually transmitted infections (STIs).

Effectiveness

The manufacturer of the Today sponge reports effectiveness for prevention of pregnancy of 89% to 91% when used correctly and consistently. When packaging directions are not followed for every act of intercourse, effectiveness rates of 84% to 89% are reported.^[4] Other sources cite poorer effectiveness rates for women who have given birth - 74% during correct and consistent use, and 68% during typical use.^[5]

Studies of Protectaid have found effectiveness rates of 77% to 91%.^[6][7]

Studies of Pharmatex have found perfect use effectiveness rates of over 99% per year.^[8] Typical use of Pharmatex results in effectiveness of 81% per year.^[9] Sponges may be used in conjunction with another method of birth control such as condoms to increase effectiveness.

Use

The Today sponge must be run under water until thoroughly wet before insertion.^[4] The Protectaid^[1] and Pharmatex^[9] sponges come ready to use.

Insertion of the sponge requires reaching the cervix and is generally performed by the woman. Intercourse can proceed when it is placed or hours afterwards. The sponge must be left in place for several hours after ejaculation in the vagina (Today and Protectaid recommend six hours, Pharmatex two).^[1]

All sponges must be removed within the time limits specified by the manufacturer - 24 hours for Today and Pharmatex and 18 for Protectaid.^[1]

History

The Today Sponge was introduced in the United States in 1983. The Pharmatex sponge was introduced in France and the Quebec province in Canada in 1984.^[10] The Protectaid sponge was introduced in Canada in 1996, and in Europe in 2000.^[1] All three brands are available outside their normal marketing areas through internet retailers.

The Today sponge actually dates back to 1976 when it was created by Bruce Ward Vorhauer. Vorhauer struggled for 7 years to get the device approved and on the market. Personal money problems forced Vorhauer to sell the entire manufacturing operation to American Home Products, now Wyeth. Almost the entire content of the facility was moved to the Whitehall-Robbins facility in Hammonton, NJ from its original California home. The sponge was removed from the U.S. market in 1994 after problems were found at the facility related to the DI water system. The water system which was originally sized for much larger production could not produce the small amounts of DI water required for this one product and became repeatedly contaminated. Wyeth stopped selling the sponge rather than move production or modify its plant, based on slumping sales and to avoid any further FDA issues.

In 1998, Allendale Pharmaceuticals bought the patents and the complex manufacturing equipment. New FDA standards for manufacturing and record-keeping forced repeated delays (some users started calling it the "Real soon now sponge"), but the Today sponge was finally re-introduced in Canada in March 2003, and in the U.S. in September 2005. In January 2007, Allendale Pharmaceuticals was acquired by Synova Healthcare, Inc.^[11] In December 2007 Synova filed for bankruptcy reorganization;^[12] in 2008 the manufacturing rights to the Today sponge were purchased by Alvogen.^[13] As of 2008^[update], the Today Sponge was not being manufactured.^[2] In mid May 2009, Mayer Laboratories, Inc.[3], the distributor of the Today Vaginal Contraceptive Sponge [4]for the US, Canada and the EU, announced the Today Sponge had been re-launched in the United States.^[3]

Spermicide

Sponges are a physical barrier, trapping sperm and preventing their passage through the cervix into the female reproductive system. The spermicide is an important component of pregnancy prevention; each brand offers a different formula.

The Today sponge contains 1,000 milligrams (mg) of nonoxynol-9.^[14] Protectaid contains 5,000 mg of the F-5 gel, with three active ingredients (6.25 mg of nonoxynol-9, 6.25 mg of benzalkonium chloride, and 25 mg of sodium cholate).^[9] Pharmatex contains 60 mg of benzalkonium chloride.^[1]

Side effects

Some people are allergic to the spermicide used in the sponge. Women who use contraceptive sponges have an increased risk of yeast infection and urinary tract infection. Improper use, such as leaving the sponge in too long, can result in toxic shock syndrome.

In popular culture

Shortly after they were taken off the U.S. market, the sponge was featured in an episode of the sitcom Seinfeld titled "The Sponge". In the episode, the character Elaine Benes conserves her remaining contraceptive sponges by refusing intercourse unless she is certain her partner is "sponge worthy".

Footnotes

1. ^ ^{a b c d e f} "Sponges". Cervical Barrier Advancement Society. 2004. http://www.cervicalbarriers.org/information/sponges.cfm. Retrieved 2006-09-17. 
2. ^ ^{a b} "Where are contraceptive sponges?". Go Ask Alice!. Columbia University. 2009-03-06. http://www.goaskalice.columbia.edu/0395.html. Retrieved 2009-03-06. 
3. ^ ^{a b} "Today Sponge Returns To Store Shelves". Mayer Laboratories, Inc.. 2009. http://www.todaysponge.com/email-consumer. Retrieved 2009-05-14. 
4. ^ ^{a b} "How Well Does Today Sponge Prevent Pregnancy?". Today Sponge. Allendale Pharmaceuticals. http://www.todaysponge.com/howwell.htm. Retrieved 2006-08-17. 
5. ^ Hatcher, RA; Trussel J, Stewart F, et al. (2000). Contraceptive Technology (18th ed.). New York: Ardent Media. ISBN 0-9664902-6-6. http://www.contraceptivetechnology.com/table.html. 
6. ^ Creatsas G, Elsheikh A, Colin P (2002). "Safety and tolerability of the new contraceptive sponge Protectaid". Eur J Contracept Reprod Health Care 7 (2): 91–5. doi:10.1080/713604323. PMID 12201327. 
7. ^ Creatsas G, Guerrero E, Guilbert E, Drouin J, Serfaty D, Lemieux L, Suissa S, Colin P (2001). "A multinational evaluation of the efficacy, safety and acceptability of the Protectaid contraceptive sponge". Eur J Contracept Reprod Health Care 6 (3): 172–82. doi:10.1080/713604234. PMID 11763982. 
8. ^ "Ovule Pharmatex: results of 10 years of research in contraception". Nurs Que 3 (2): 33. PMID 6552435. 
   Serfaty D. "The contraceptive sponge". Entret Bichat Pitie Salpetriere Ther: 225–8. PMID 12340222. 
   Leroy B, Serror R (1979). "Contraception through the use of intravaginal spermicides during the post-partum period". Rev Fr Gynecol Obstet 74 (1): 63–5. PMID 424660. 
9. ^ ^{a b c} "The Birth Control Sponge". Global Health Options. 2004. http://www.g-h-o.co.uk/sponge.htm. Retrieved 2006-10-06. 
10. ^ Menard F (1984). "The health of women and contraception in Quebec". IPPF Eur Reg Inf 13 (1): 18–20. PMID 12178356. 
11. ^ George, John (2007-01-16). "Synova Healthcare finds company worthy of purchase". Philadelphia Business Journal. http://www.bizjournals.com/philadelphia/stories/2007/01/15/daily9.html. Retrieved 2007-01-16. 
12. ^ "Synova Healthcare, maker of contraceptive sponge filed for bankruptcy". http://www.bizjournals.com/philadelphia/stories/2007/12/17/daily28.html. 
13. ^ Staff writer (2008-06-13). "Alvogen buys Today Sponge assets". Pharmaceutical Business Review. http://www.pharmaceutical-business-review.com/article_news.asp?guid=A0C25159-0147-4C9B-9AEE-DF93FF5556AB. Retrieved 2008-07-10. 
14. ^ Best, Kim (2000). "New Devices May Be Easier to Use". Network (Family Health International) 20 (2). http://www.reproline.jhu.edu/english/6read/6issues/6network/v20-2/nt2023.html. Retrieved 2006-10-01. 

External links

• Contraceptive Sponge - American Pregnancy Association
• Contraceptive Sponge - CoolNurse.com
• Spongeworthiness - Salon.com
• The Contraceptive Sponge - DrDonnica.com
• Contraceptive Sponges (Today / Protectaid / Pharmatex) - FAQ thread on Ovusoft.com message boards