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Spermicides, or vaginal chemical contraceptives, come in many varieties, including foams, jellies, creams, and tablets or suppositories. They do not require a prescription and are available at drugstores and family planning clinics. Spermicides should not be confused with feminine hygiene products, often displayed beside them, which have no spermicidal effectiveness.

Spermicides work in two ways: their active chemical ingredient kills sperm, while the material containing this ingredient provides a mechanical barrier that blocks the entrance to the cervix. Because of the individual differences in the many products on the market, the manufacturer's instructions regarding use and effectiveness must be consulted. This information is given in the package insert that comes with each product. These products are not identical in how they are used or in their reliability in preventing pregnancy. In general, foams and suppositories are much more effective than creams or jellies, which should be used only with another method of birth control such as a diaphragm or condom. All spermicides require proper placement in the vagina. If used properly am' regularly, some spermicidal products can be very effective. In several studies, less than five pregnancies occurred for every 100 couples using these methods for one year. Failure rates tend to be about three times higher than this in actual use as a result of inconsistent use of the method and improper following of the manufacturer's instructions. Failures occur when a couple inserts the spermicide in the vagina incorrectly, has intercourse a second time without using more of the product, or overlooks the time limits of product effectiveness. In addition, failures can occur if the spermicide has become outdated; for this reason, users should check the expiration date stamped on the spermicide package prior to use.

Burning or irritation of the vagina or penis occurs in about one in twenty people using spermicides, but this problem can often be alleviated by changing to a different product. Although one study found a higher rate of birth defects in the infants of women who had used a spermicide in the ten months before conception, the researchers stressed that these results were not conclusive, and a more recent investigation found no evidence supporting the existence of such a problem. However, it now appears that women who use spermicides after becoming

pregnant are more likely than other women to have miscarriages.

On the positive side, there is mounting evidence that spermicides provide some protection against sexually transmitted diseases such as gonorrhea and also protect against pelvic

inflammatory disease.

The use of spermicides may require interrupting the spontaneous flow of sexual activity, but insertion can be made a part of sexual play. With spermicidal suppositories, unlike aerosol foams, ten to fifteen minutes must elapse before vaginal distribution of the product has occurred (depending on the brand), and intercourse is "safe" — so these should not be used if you are in a hurry! Vaginal chemical contraceptives may discourage cunnilingus (oral stimulation of the vulva and vagina) because most products do not have a very pleasant taste. Finally, some people find that these products are messy and provide too much vaginal lubrication (one woman described the sensation as "sloshy").


Men's Health Erectyle Dysfunction