Birth Control

Over-the-counter spermicide

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What is over-the-counter spermicide? Over-the-counter spermicide may be right for you if... How do you use over-the-counter spermicide? How much does over-the-counter spermicide cost? What are the side effects and benefits? Where can you get over-the-counter spermicide?

What is over-the-counter spermicide?

Over-the-counter spermicides are gels, creams, foams, films, and suppositories that contain a chemical called nonoxynol-9. Nonoxynol-9 works to prevent pregnancy in two ways. The first way is by making sperm less able to move. The second way nonoxynol-9 works is that when you insert it deep into the vagina, it blocks sperm from getting through your cervix into your uterus.

Over-the-counter spermicide isn’t the most effective birth control method, but it’s more effective when it’s used with another method, like condoms. Some condoms come coated in spermicide, or you can use a separate spermicide along with a condom. There are other methods, like the cervical cap and the diaphragm, that have to be used with spermicide to be effective.

Quick Facts

Pretty effective if you use it correctly. Can be put in up to an hour before sex and doesn't affect your hormones. Easy to find in lots of places.

Effectiveness

Over-the-counter spermicide on its own, without a barrier method like a diaphragm or condom, is pretty effective the way most people use it. Prescription-only spermicide (Phexxi) is more effective than over the counter. Using it with a barrier method increases pregnancy protection.

Perfect use: 84% effective

Typical use: 79% effective

What are perfect use and typical use?
Hormones

Spermicide is hormone-free.
Side effects

Irritation or urinary tract infections are possible.
Cost

Around $1 per dose.
STI protection

Over-the-counter spermicide doesn’t protect against STIs.
Ongoing effort

You have to apply a dose of spermicide before each time you have penis-in-vagina sex.

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Over-the-counter spermicide may be right for you if...

Effectiveness at preventing pregnancy is NOT your top priority.

If you plan to use spermicide by itself, without another method, keep in mind that it is not the most effective method of birth control out there.

Among those who use over-the-counter spermicide perfectly (following the directions exactly every time), it is 84% effective at preventing pregnancy. That means that out of every 100 people who use spermicide perfectly every time they have sex, on average, 16 of them will get pregnant within a year.

However, the effectiveness of over-the-counter spermicide with perfect use is based on the experiences of people involved in clinical trials who are using it perfectly for an entire year. Its effectiveness with typical use, which means how real people use it in real life, is going to be more relevant for most people. When over-the-counter spermicide is used without another method, in the way people typically use it, it is 79% effective at preventing pregnancy. That means 21 out of every 100 people using over-the-counter spermicide for a year will get pregnant.

You don’t mind using it with another method to make it as effective as possible.

Spermicide works best when paired with another barrier method, like the diaphragm, the cervical cap, or condoms.

You want birth control without hormones.

Over-the-counter spermicide doesn’t affect your hormones at all. It won’t change your period.

You’re willing to put in some effort before having sex, every single time.

In order for spermicide to work, you have to use it correctly, every time you have sex, no matter what.

You’re comfortable touching your body.

Over-the-counter spermicide comes in different forms. Depending on whether you use a gel, a cream, a foam, a film, or a suppository, over-the-counter spermicide may come with an applicator or it may not. If it comes with an applicator, inserting it is a lot like putting in a tampon or an over-the-counter yeast infection medication. If it doesn’t come with an applicator, you will need to insert it deep into your vagina with your fingers, which is similar to putting in a tampon without an applicator. If you’re fine with doing those things, you should be good to go.

You aren’t looking for STI protection, or you’re okay with combining over-the-counter spermicide with another method.

Over-the-counter spermicide doesn’t offer any STI protection. In fact, nonoxynol-9 can cause irritation, especially if you’re using it multiple times a day. This irritation affects the cells in your vagina and cervix that help to fight off infections, putting you at higher risk of getting a sexually transmitted infection (STI).

So if STI protection is something you’re looking for, you can use condoms or internal condoms along with spermicide. Dental dams and/or gloves also offer STI protection, depending on what kind of sex you’re having. You may also want to consider PrEP (pre-exposure prophylaxis), which is a daily pill or an injection you can get every two months to decrease your risk of getting HIV.

You want a method that won’t affect your future fertility.

The only birth control method that permanently affects your fertility is sterilization. Spermicide does not affect your ability to get pregnant after you stop using it. In fact, most types of over-the-counter spermicide are only effective at reducing your chance of pregnancy for an hour after you insert them. After that, your body returns to whatever level of fertility is normal for you.

You want birth control you can get without visiting a health care provider.

You don’t need to see a provider to get over-the-counter spermicide—you can get it at most drugstores and grocery stores, as well as online.

You don’t have these risk factors.

Spermicide isn’t recommended if:

You’re at risk of HIV transmission. Nonoxynol-9, the active ingredient in over-the-counter spermicide, causes changes in the sensitive skin of the vagina that can make you more susceptible to HIV. If your partner has HIV or hasn’t been tested recently, spermicides that contain nonoxynol-9 may not be the best choice for you.
Spermicide causes you irritation (or you’re prone to skin irritation in general). If you get irritated using spermicide, you’re probably allergic to it. Unfortunately, all spermicides and contraceptive gels sold over the counter in the United States contain the same active ingredient, nonoxynol-9. If you’re allergic to it, over-the-counter spermicide (and condoms with spermicidal lubricant) won’t work for you. In general, if you know you tend to get skin irritation often, spermicide may not be the best option for you. (However, Phexxi, a prescription-only spermicide, does not contain nonoxynol-9, so you may still be able to use Phexxi even if you’re allergic to over-the-counter spermicide.)
You’re planning on having sex with multiple partners over a short period of time. Spermicide can cause irritation, especially if you’re using it multiple times a day. This irritation affects the cells in your vagina and cervix that help to fight off infections, putting you at higher risk of getting a sexually transmitted infection (STI).

How do you use over-the-counter spermicide?

There are spermicide creams, gels, foams, suppositories, and films, and each type works a little differently. So be sure to read the instructions on the packaging (and, as always, check the expiration date). In general though, before sex, you insert the spermicide with your fingers or with an applicator if one is provided. It should be placed at or near your cervix to be most effective, which means that you need to insert it as far into your vagina as you can. How long you need to wait after inserting it before you have sex depends on the type of spermicide you’re using.

The foams, creams, and gels are effective immediately. Spermicidal films and suppositories have to dissolve before they start working, so you’ll need to wait 10 to 15 minutes (depending on the brand) after inserting them before you have sex. Most types of spermicide are also only effective for a single hour after you put them in—so you have to get the timing right.

Here are the steps for using spermicide by itself (without another form of birth control):

Wash your hands with soap and water (and make sure they are dry if you are inserting spermicidal film).
Insert the spermicide using your fingers or an applicator, if one comes with the spermicide.
Wait 10 to 15 minutes if you’re using a film or suppository—check the instructions that come with the spermicide to find out how long you need to wait.
Spermicide is effective for one hour or for one ejaculation, whichever comes first. That means you’ll need to insert more spermicide:

Before each time you have sex again after your partner has ejaculated, even if it’s within an hour of your last dose of spermicide. You need a new dose of spermicide before every ejaculation.
Every hour if you’re still having sex, and your partner is still going to ejaculate (meaning that your partner has not ejaculated yet but is going to). You need a new dose every hour because spermicide is only effective for an hour.

There are different steps to follow if you’re using spermicide with a diaphragm or a cervical cap.

How much does over-the-counter spermicide cost?

With or without insurance:

Over-the-counter spermicide is not covered by insurance. Luckily, it’s not too expensive. There are so many over-the-counter spermicidal products, and they all cost around $11 for ten doses.

What are the side effects and benefits?

There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what your friend experiences.

The Positive

There are lots of things about birth control that are good for your body as well as your sex life. Here are some of the benefits of over-the-counter spermicide:

Easy to use
Easy to get (no prescription needed!)
Doesn’t affect your hormones
Can be used while breastfeeding
Not too expensive

The Negative

It’s normal to worry about negative side effects, but for many people, they’re not a problem. Potential side effects include:

Irritation of your vagina and/or your partner’s penis
Increased risk of HIV and STI transmission due to vaginal irritation (especially if you use it more than once a day)
Irritation (and gross taste) in your mouth if you have oral sex after using spermicide for penis-in-vagina sex
Yeast infection, bacterial vaginosis, and urinary tract infections
Allergic reaction

In addition to possible side effects, there are some disadvantages to using over-the-counter spermicide:

Can leak out of your vagina and be messy
Have to remember to use it every time you have sex
May interrupt the moment to stop and insert spermicide and then wait 10 or 15 minutes before having sex

Where can you get over-the-counter spermicide?

You can get over-the-counter spermicide without a prescription at most drugstores, some supermarkets and convenience stores, and online.