Contraception - pessaries, foam and cream

Reviewed by Dr David Delvin, sexual medicine expert



Among the less reliable contraceptive methods for women is the use of chemical-containing agents like pessaries, foams, jellies or creams, which can be inserted into the vagina . All of them are spermicidal - that is , they contain a chemical (nearly always one called nonoxinol-9) that kills sperm.

They can all be bought over the counter in chemists, but in the UK are very often issued on free prescription at Family Planning Clinics. General practitioners can also write prescriptions for them, but this is not common.

What you must be aware of

It is important to be aware that chemicals are not a lot of use on their own. Until quite recently, some brands of pessary and gel were promoted to the public as reliable contraceptives – but their makers' faith in them was not really justified.

So we strongly recommend that you only use chemicals as a way of increasing the efficiency of other methods of contraception.

Some products still come with literature indicating that they could be used on their own, but we suggest that you ignore that advice.

In fact all chemical contraceptives that are available in Britain should be used with barrier methods of contraception, such as condoms (male or female) and diaphragms. They must be inserted into the vagina shortly before sexual intercourse. They only work for 30 to 60 minutes. If you continue having sex after this time you must insert another 'dose' into the vagina.

Used on their own, chemicals will not protect you from sexually transmitted diseases, despite the fact that they have a slight anti-germ action.

What chemical contraceptive products are available

Until about the beginning of this century, there was a very wide range of chemical contraceptives available from chemists. However, as spermicidal methods have become less popular, the choice of brands has been sharply reduced.

Indeed, the number of products generally available for prescription in the UK has been reduced to just two. However, you would certainly be able to obtain other brands on the Continent, or by mail order from abroad, or via the internet.

The types of chemical contraception which remain generally available in Britain are:

Ortho-Creme – a white, slightly fragrant cream, which can be inserted into the vagina with a special applicator (and also spread on a cap or diaphragm).

Orthoforms – a small pessary (vaginal tablet).

How do I learn to use these products?

Instructions are provided with them. However, by far the best thing is to be taught how to use them by a specially-trained nurse or doctor.

In Britain, the majority of women who employ chemical contraceptives have been taught how to use them by the nurses or doctors at Family Planning Clinics.

In particular, the medical/nursing staff can demonstrate to you the technique of applying spermicides to a cap or diaphragm in such a way as to make it very difficult for sperms to 'get through' to the womb.

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