Over-the-counter spermicide

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).