Sponge

How They Work; Pros and Cons

Composition

Polyurethane foam device impregnated with spermicide (nonoxyl-9).

Mechanism of Action

Both a true barrier to the sperm as well as toxic to the sperm because of the spermicide present in the sponge.

Dosage

Must be inserted prior to intercourse and should be removed no sooner than six hours after the last coital act. The maximum wear time is 30 hours.

Advantages

1. Offers some protection from sexually transmitted diseases. 
2. No hormonal additives. 
3. Can be used in breastfeeding women. 
4. Permits spontaneous, repeated intercourse up to 24 hours after insertion without changing the device. 
5. Requires no additional spermicide. 
6. Requires no fitting. 

Disadvantages/Side Effects

1. Coitus dependent. 
2. Can be messy. 
3. Can cause irritation or rarely an allergic reaction. 
4. Vaginitis may occur if the sponge is left in too long. 
5. Toxic shock syndrome can occur (extremely RARE). 
6. Cannot be used during menstruation. 
7. May be forgotten and left in place. 
8. Women must be comfortable with insertion as well as assertive enough to insist on the timing of insertion and removal. 
9. Vaginal irritation from spermicide. 

Efficacy

The Pearl index is 13-16 (failure rate for 100 women using this method for one year). The sponge is less effective in parous women.

Contraindications/Poor candidates

1. Women with sensitivities to spermicides. 
2. Women with some physical disabilities, or with neurological impairment, which limits their flexibility to insert and remove the device. 
3. Parous women 
4. Women unable to consistently use the device correctly. 

Follow-up

None required. Patient may benefit from a visit within the first few months of use to discuss side effects as well as overall tolerability.

Note : Not available in USA at this time.