Spermicide
387814
224895570
2008-07-10T21:58:11Z
TylerPuetz
5684039
Reverted edits by [[Special:Contributions/68.206.249.226|68.206.249.226]] to last version by Sardanaphalus (using [[WP:HG|Huggle]])
{{Infobox Birth control
|name = Spermicide
|image =
|width =
|caption =
|bc_type = Spermicide
|date_first_use = Ancient
|rate_type = Failure
|perfect_failure% = 18
|typical_failure% = 29
|duration_effect =
|reversibility = Immediate
|user_reminders = More effective if combined with a barrier method
|clinic_interval =
|STD_protection_YesNo = No
|periods_advantage =
|benefits = Provides lubrication
|periods_disadvantage =
|weight_gain_YesNo = No
|risks = Genital irritation
|medical_notes =
}}
'''Spermicide''' is a substance that kills [[spermatozoon|sperm]], inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods. Usually, spermicides are combined with contraceptive [[barrier method]]s such as [[diaphragm (contraception)|diaphragm]]s, [[condom]]s, [[cervical cap]]s, and [[contraceptive sponge|sponges]]. Combined methods are believed to result in lower pregnancy rates than either method alone.<!--
--><ref name="simultaneous">{{cite journal |author=Kestelman P, Trussell J |title=Efficacy of the simultaneous use of condoms and spermicides | journal = Fam Plann Perspect | volume = 23 | issue = 5 |pages=226–7, 232 |year=1991| pmid = 1743276 | doi = 10.2307/2135759}}</ref>
Spermicides are unscented, clear, unflavored, non-staining, and lubricative.
==Types and effectiveness==
The most common active ingredient of spermicides is [[nonoxynol-9]]. Spermicides containing nonoxynol-9 are available in many forms, such as jelly (gel), films, and foams. ''Contraceptive Technology'' states that spermicides have a failure rate of 18% per year when used correctly and consistently, and 29% under typical use.<!--
--><ref>{{cite book | first=RA | last=Hatcher | coauthors=Trussel J, Stewart F, et al | year=2000 | title=Contraceptive Technology | edition=18th Edition | publisher=Ardent Media | location=New York | id=ISBN 0-9664902-6-6 | url=http://www.contraceptivetechnology.com/table.html }}</ref>
Menfegol is a spermicide manufactured as a foaming tablet.<!--
--><ref>{{cite web |title=Spermicides: Neo-Sampoon (Menfegol) |work=RemedyFind |url=http://www.remedyfind.com/treatments/77/1301/ |accessdate=2006-10-01 }}</ref> It is only available in Europe.
[[Octoxynol-9]] was previously a common spermicide, but was removed from the U.S. market in 2002 after manufacturers failed to perform new studies required by the FDA.<!--
--><ref>{{cite web |title=Status of Certain Additional Over-the-Counter Drug Category II and III Active Ingredients |work=Federal Register |publisher=Food and Drug Administration |date=May 9, 2002 |url=http://www.fda.gov/ohrms/dockets/98fr/050902b.htm |accessdate=2006-08-18 }}</ref>
The spermicides [[benzalkonium chloride]] and sodium cholate are used in some [[contraceptive sponge]]s.<ref name="CBAC">{{cite web |title=Sponges |work=Cervical Barrier Advancement Society |date=2004 |url=http://www.cervicalbarriers.org/information/sponges.cfm |accessdate=2006-09-17 }}</ref> Benzalkonium chloride might also be available in Canada as a suppository.<!--
--><ref>{{cite web |title=Spermicides (Vaginal) |work=MayoClinic.com |date=August 1997 |url=http://www.mayoclinic.com/health/drug-information/DR202531 |accessdate=2006-10-16 }}</ref>
A common [[urban legend]] suggests that [[Coca-Cola]] or other soft drinks serve as an effective spermicide. This is false.<!--
--><ref>{{cite web |last=Mikkelson |first=Barbara |title=Cokelore (Killer Sperm) |work=Snopes.com |date=November 2003 |url=http://snopes.com/cokelore/sperm.asp |accessdate=2006-08-06 }}</ref>
Lemon juice solutions have been shown to immobilize sperm in the laboratory,<!--
--><ref>{{cite paper |author=Roger Short, Scott G. McCoombe, Clare Maslin, Eman Naim and Suzanne Crowe |title=Lemon and Lime juice as potent natural microbicides |date=2002 |url=http://www.aids.net.au/aids-lemons.pdf |format=PDF |accessdate=2006-08-13 }}</ref> as has Krest Bitter Lemon drink.<!--
--><ref>{{cite journal |author=Nwoha P |title=The immobilization of all spermatozoa ''in vitro'' by bitter lemon drink and the effect of alkaline pH | journal = Contraception | volume = 46 | issue = 6 |pages=537–42 |year=1992 | pmid = 1493713 | doi = 10.1016/0010-7824(92)90118-D}}</ref> While the authors of the Krest Bitter Lemon study suggested its use as a postcoital douche, this is unlikely to be effective, as sperm begin leaving the ejaculate (out of the reach of any douche) within 1.5 minutes of deposition.<!--
--><ref>{{cite web |last=Ellington |first=Joanna |title=Sperm Leaking Out After Intercourse- Lessons in Sperm Transport Through the Cervix |work= Frequently Asked Questions with Dr. E |publisher=INGfertility Inc |date=2004 |url=http://www.ingfertility.com/FAQs.html#Sperm_Leaking_Out_After_Intercourse-_Lessons_in_Sperm_Transport_Through_the_Cervix_ |accessdate=2006-08-13 }}</ref> No published studies appear to have been done on the effectiveness of lemon juice preparations in preventing pregnancy, though they are advocated by some as '[[Natural birth control|natural]]' spermicides.<!--
--><ref>{{cite web |title=MoonDragon's Contraception Information: Spermicides |work=MoonDragon Birthing Services |date=1997? |url=http://www.moondragon.org/obgyn/contraception/spermicides.html |accessdate=2006-08-13 }}</ref>
Lactic acid preparations have also been shown to have some spermicidal effect, and commercial lactic acid-based spermicides are available.<!--
--><ref>{{cite web |title=Femprotect - Lactic Acid Contraceptive Gel |work=Woman's Natural Health Practice |url=http://www.naturalgynae.com/nav6_fact19.html |accessdate=2006-09-17 }}</ref><!--
--><ref>{{cite web |title=Contragel Green |work=Condomerie Webshop |url=http://condomerie.com/webshop/product_info.php?products_id=1392 |accessdate=2006-09-17 }}</ref> However, no published studies on the effectiveness of lactic acid in preventing pregnancy appear to have been done since 1936.<!--
--><ref>{{cite journal |author=Stone H |title=Contraceptive jellies: a clinical study | journal = J Contracept | volume = 1 | issue = 12 |pages=209–13 |year=1936 | pmid = 12259192}}</ref> Thomas Moench, a former assistant professor of medicine, has said that research into acids as spermicides has "pretty much been abandoned."<!--
--><ref>{{cite web |last=Venere |first=Emil |title=On Research: New Contraceptive Gel Prevents Pregnancy and STDs |work=The Gazette, The Newspaper of the Johns Hopkins University |date=September 1996 |url=http://www.jhu.edu/~gazette/julsep96/sep3096/sexgel.html |accessdate=2006-08-13 }}</ref>
Extratives of the [[neem]] plant such as [[neem oil]] have also been proposed as spermicides based on laboratory studies.<!--
--><ref>{{cite journal |author=Sharma S, SaiRam M, Ilavazhagan G, Devendra K, Shivaji S, Selvamurthy W |title=Mechanism of action of NIM-76: a novel vaginal contraceptive from neem oil | journal = Contraception | volume = 54 | issue = 6 |pages=373–8 |year=1996 | pmid = 8968666 | doi = 10.1016/S0010-7824(96)00204-1}}</ref> Animal studies of creams and pessaries derived from neem have shown they have contraceptive effects,<!--
--><ref>{{cite journal |author=Talwar G, Raghuvanshi P, Misra R, Mukherjee S, Shah S |title=Plant immunomodulators for termination of unwanted pregnancy and for contraception and reproductive health | journal = Immunol Cell Biol | volume = 75 | issue = 2 |pages=190–2 |year=1997 | pmid = 9107574 | doi = 10.1038/icb.1997.27}}</ref> however trials in humans to determine its effectiveness in preventing pregnancy have not yet been conducted.
==Use as microbicide==
To date, the only sexual lubricant shown thus far via animal testing as a [[microbicide]] effective against [[HIV]] and [[Herpes]] infection is [[Viva Gel]]. Because of its first in class potential, Viva Gel is slated for immediate further clinical trials with human subjects in Australia and the United States.<!--
--><ref>{{cite web |last=AAP Wire |title=Sex lubricant could stop HIV and herpes |work=Daily Telegraph c/o Australian News Network |date=July 24, 2007 |url=http://www.news.com.au/dailytelegraph/story/0,22049,22127964-5001028,00.html?from=public_rss ]|accessdate=2007-08-01 }}</ref>
Previously, it was believed that nonoxynol-9 reduced the risk of [[HIV]] infection, as it prevents transmission of the virus in the laboratory. However, many human studies have shown no protective effect. Because nonoxynol-9 creates abrasions in the vaginal and rectal walls, it may even make transmission of HIV and other [[Sexually transmitted disease|STD]]s more likely, especially if used frequently.<!--
--><ref>{{cite web |title=Nonoxynol-9 and the Risk of HIV Transmission |work=HIV/AIDS Epi Update |publisher=Health Canada, Centre for Infectious Disease Prevention and Control |date=April 2003 |url=http://www.phac-aspc.gc.ca/publicat/epiu-aepi/hiv-vih/nonoxynol_e.html |accessdate=2006-08-06 }}</ref>
While lemon juice has been proposed as a microbicide based on laboratory studies,<!--
--><ref>{{cite web |title=Lemons and AIDS |date=August 2004 |url=http://www.aids.net.au/lemons-intro.htm |accessdate=2006-08-13 }}</ref> human testing has shown that, at the concentrations needed to kill HIV, it causes the same abrasions as nonoxynol-9. Because these abrasions increase risk of pathogen transmission, lemon juice is not recommended as a microbicide.<!--
--><ref>{{cite paper |title=Why women should NOT use Lemon or Lime Juice as a microbicide |publisher=Global Campaign for Microbicides |date=June 2006 |url=http://www.global-campaign.org/clientfiles/New-Lemon-Lime_June24.pdf |format=PDF |accessdate=2006-08-13 }}</ref>
Neem extracts have also been researched as microbicides, as they have anti-microbial properties in the laboratory. In the Phase I clinical trial (to determine safety), almost half of the study participants reported negative side effects such as genital itching, burning, and pain. Because there were no serious adverse health effects, though, the researchers recommended continuing to a Phase II clinical trial (to determine efficacy).<!--
--><ref>{{cite journal |author=Joshi S, Katti U, Godbole S, Bharucha K, B K, Kulkarni S, Risbud A, Mehendale S |title=Phase I safety study of Praneem polyherbal vaginal tablet use among HIV-uninfected women in Pune, India | journal = Trans R Soc Trop Med Hyg | volume = 99 | issue = 10 |pages=769–74 |year=2005 | pmid = 16084547 | doi = 10.1016/j.trstmh.2005.01.007}}</ref> The Phase II trial has not yet been completed.
==Use with condoms==
Some condoms are lubricated at the manufacturer with a small amount of nonoxynyl-9. According to [[Consumer Reports]], spermicidally lubricated condoms have no additional benefit in preventing pregnancy, have a shorter shelf life, and may cause urinary-tract infections in women.<!--
--><ref>{{cite web |title=Condoms: Extra protection |work=ConsumerReports.org |date=February 2005 |url=http://www.consumerreports.org/cro/health-fitness/health-care/condoms-and-contraception-205/overview/index.htm |accessdate=2006-08-06 }}</ref> The [[World Health Organization]] says that spermicidally lubricated condoms should no longer be promoted. However, they recommend using a nonoxynol-9 lubricated condom over no condom at all.<!--
--><ref>{{cite web |title=Microbicides |work=World Health Organization |date=2006 |url=http://www.who.int/hiv/topics/microbicides/microbicides/en/ |accessdate=2006-08-06 }}</ref>
In contrast, application of separately packaged spermicide ''is'' believed to increase the contraceptive efficacy of condoms.<ref name="simultaneous" />
==Side effects==
Nonoxynol-9 has a number of possible side effects. These include irritation, itching, or burning of the sex organs (either partner), and in women, [[urinary tract infection]]s, [[Candidiasis|yeast infection]], and [[bacterial vaginosis]].<!--
--><ref>{{cite web |title=Drug Information: Nonoxynol-9 cream, film, foam, gel, jelly, suppository |work=Medical University of South Carolina |date=March 2006
|url=http://www.muschealth.com/cds/CPDrugInfo.details.aspx?cpnum=1477&language=english |accessdate=2006-08-06 }}</ref> These side effects are uncommon; one study found that only 3-5% of women who try spermicides discontinue use due to side effects.<!--
--><ref>{{cite journal |author=Xu J, Shi L, Zhou X, Xiao Z |title=Contraceptive efficacy of bioadhesive nonoxynol-9 Gel: comparison with nonoxynol-9 suppository | journal = Zhonghua Fu Chan Ke Za Zhi | volume = 38 | issue = 10 |pages=629–31 |year=2003 | pmid = 14728869}}</ref>
Concern has been raised over possible increased risk of birth defects in children conceived despite spermicide use, and also in children of women who, not yet aware of their condition, continued spermicide use during early pregnancy.<!--
--><ref>{{cite journal |author=|title=Study raises question of spermicide safety | journal = Contracept Technol Update | volume = 2 | issue = 5 |pages=57–61 |year=1981 | pmid = 12265917}}</ref> However, a review in 1990 of large studies on spermicides concluded "''there appears to be no increased risk of congenital anomalies, altered sex ratio, or early pregnancy loss among spermicide users.''"<!--
--><ref>{{cite journal |author=Huggins G, Cullins V |title=Fertility after contraception or abortion | journal = Fertil Steril | volume = 54 | issue = 4 |pages=559–73 |year=1990 | pmid = 2209874}}</ref>
==History==
The first written record of spermicide use is found in the [[Kahun Papyrus]],<!-- or Petri Papyrus? Sources for these (two?) documents seem to be pretty sketchy --> an Egyptian document dating to 1850 BC. It described a [[pessary]] of crocodile dung and fermented dough.<!--
--><ref name="evolution">{{cite journal |year=2000 | month = February |title=Evolution and Revolution: The Past, Present, and Future of Contraception | journal = Contraception Online (Baylor College of Medicine) | volume = 10 | issue = 6 | url=http://www.contraceptiononline.org/contrareport/article01.cfm?art=93}}</ref> It is believed that the low [[pH]] of the dung may have had a spermicidal effect.<!--
--><ref name="museum">{{cite web |last=Towie |first=Brian |title=4,000 years of contraception on display in Toronto museum |work=torontObserver |publisher=Centennial College journalism students |date=[[January 19]], [[2004]] |url=http://observer.thecentre.centennialcollege.ca/features/condom_museum011904.htm |accessdate= }}</ref>
Further formulations are found in the [[Ebers Papyrus]] from approximately 1500 BCE. It recommended mixing seed wool, acacia, dates and honey, and placing the mixture in the vagina. It probably had some effectiveness, in part as a physical barrier due to the thick, sticky consistency, and also because of the lactic acid (a known spermicide) formed from the acacia.<ref name="museum" />
Writings by [[Soranus (Greek physician)|Soranus]], a 2nd century Greek physician, contained formulations for a number of acidic concoctions claimed to be spermicidal. His instructions were to soak wool in one of the mixtures, then place near the cervix.<ref name="evolution" />
Laboratory testing of substances to see if they inhibited sperm motility began in the 1800s. Modern spermicides nonoxynol-9 and menfegol were developed from this line of research.<ref name="evolution" /> However, many other substances of dubious contraceptive value were also promoted. Especially after the illegallization of contraception in the U.S. by the 1873 [[Comstock laws|Comstock Act]], spermicides - the most popular of which was [[Lysol (cleaner)|Lysol]] - were marketed only as "feminine hygiene" products and were not held to any standard of effectiveness. Worse, many manufacturers recommended using the products as a [[douche]] ''after'' intercourse, too late to affect all the sperm. Medical estimates during the 1930s placed the pregnancy rate of women using many over-the-counter spermicides at seventy percent per year.<!--
--><ref>{{cite journal |last=Tone |first=Andrea |title=Contraceptive consumers: gender and the political economy of birth control in the 1930s | journal = Journal of Social History |date=Spring 1996 |url=http://findarticles.com/p/articles/mi_m2005/is_n3_v29/ai_18498205/pg_1 |accessdate=2006-10-21 }}</ref>
==See also==
*[[Personal lubricant]]
==Footnotes==
<div class="references-small">
<references />
</div>
{{Birth control methods}}
[[Category:Chemical contraception]]
[[Category:Personal lubricants]]
[[Category:Sexual health]]
[[de:Spermizid]]
[[es:Espermicida]]
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[[he:קוטל זרע]]
[[it:Spermicida]]
[[lt:Spermicidas]]
[[pl:Spermicydy]]
[[pt:Espermicida]]
[[ru:Спермицид]]
[[simple:Spermicide]]
[[fi:Spermisidi]]
[[uk:Сперміциди]]