Contraceptive sponge

Contraceptive sponge
Protectaid sponge, in its plastic tray. It is removed from the tray before use.
Background
Type	Barrier
First use	1983
Failure rates (first year)
Perfect use	Nulliparous:9% Parous:20%
Typical use	Nulliparous:12% Parous:24%
Usage
Reversibility	Immediate
User reminders	?
Advantages and disadvantages
STI 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 the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.

Sponges work in two ways. First, the sponge is inserted into the vagina, so it can cover the cervix and prevent any sperm from entering the uterus. Secondly, the sponge is produced with spermicide already inside of it, which is used to prevent the sperm from moving.

The sponges are inserted vaginally prior to intercourse and must be placed over the cervix to be effective. Sponges provide no protection from sexually transmitted infections (STIs).

The manufacturer of the Today sponge reports effectiveness for prevention of pregnancy of 100% when used correctly and consistently. When packaging directions are not followed for every act of intercourse, effectiveness rates of 84% to 89% are reported. Other sources cite poorer effectiveness rates for women who have given birth: 74% during correct and consistent use, and 68% during typical use.

Studies of Protectaid have found effectiveness rates of 77% to 91%.

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

To use the Today sponge, it must be run under water until thoroughly wet, about 2 tablespoons. The water is used as a mechanism to activate the spermicide inside the sponge. No extra spermicide is needed. The Protectaid and Pharmatex sponges come ready to use.

The sponge can be inserted up to 24 hours before intercourse. It must be left in place for at least six hours after intercourse. It should not be worn for more than 30 hours in a row.

The sponge should never be reused once it has been removed after having sexual intercourse.

The devices have had periods of unavailability in some markets since being introduced. All three brands are currently available outside their normal marketing areas through internet retailers.

The Today Sponge was developed beginning in 1976 and introduced in the United States in 1983. Today was removed from the market in 1994 due to manufacturing problems. Following several delays, the Today brand became available again in Canada in March 2003, and in the U.S. in September 2005. After the manufacturer's parent company declared bankruptcy in 2007, production was shut down again, until the new manufacturer, Mayer Laboratories Ltd., reintroduced Today to the U.S. market in 2009.