Choosing a Birth Control Method

(Published September 2011)

Description

The cervical cap is a small, bowl-shaped device that fits snugly over the cervix and has a strap for easy removal. The FemCap^® silicone cervical cap is the only cervical cap that is currently available in the United States. Like the diaphragm, the cervical cap is designed for use with spermicide. It works by creating both a physical and a spermicidal barrier at the opening of the cervix. The FemCap is available in three sizes (22, 26, and 30 mm as measured by the inner diameter of the rim).

Use

To use the cervical cap, a woman places spermicide inside the bowl and the groove around the outside of the device and inserts the device into the vagina. The cap is pressed up against the cervix to form a snug seal. There is no need to insert more spermicide with additional acts of intercourse.

After the last act of intercourse, the cap should be left in place for at least 6 hours. The cervical cap should not be worn for more than 48 hours. In addition, FemCap is not recommended for use during menstruation. Women should not rinse the vagina or douche while wearing the cervical cap and for at least 6 hours after the last act of intercourse.

The 22 mm cap is intended for women who have never been pregnant. The 26 mm is intended for women who have been pregnant—even if for a short duration (i.e., 2 weeks and did not have a vaginal delivery). The 30 mm is intended for women who had a vaginal delivery of a full-term baby. The FemCap requires a prescription from a clinician (for more information, visit www.femcap.com/clinician-information.html).

Effectiveness

This method is somewhat effective. The failure rate for the older version (Prentif™ Cavity-Rim Cervical Cap) is about 9 percent with perfect use and 20 percent with typical use among nulliparous women, and about 26 percent with perfect use and 40 percent with typical use among women who have had a vaginal delivery.58
Effectiveness data for the first generation FemCap showed a failure rate of 14 percent among nulliparous women and 29 percent among women who have had a vaginal delivery.88

Risks

Increased risk of bacterial vaginosis and vaginal candidiasis⁸⁹

Side Effects

None

Contraindications and Precautions

Medical Eligibility Criteria for the Cervical Cap
Category 4 (unacceptable health risk if the contraceptive method is used)	High risk for HIV infection
Category 3 (theoretical or proven risks usually outweigh the advantages of using the method)	HIV infection or AIDS History of toxic shock syndrome Antiretroviral therapy Allergy to latex Allergy to spermicides
Source: Reference 5

Advantages

Relatively discreet (can be inserted ahead of time)
Easily reversible
After up-front cost, relatively low ongoing cost for spermicide
After initial fitting and instruction, no need for repeated visits to health care provider other than for a new size

Disadvantages

Requires prescription
Required with every act of intercourse
May cause pain or discomfort with intercourse⁹⁰
Lower efficacy than other methods with typical use
Increased risk of certain vaginal infections
For some women, difficulty in learning insertion and removal techniques
No protection against STIs

Counseling Messages

Consistent and correct use is key to effectiveness with the cervical cap.
This method does not protect against STIs.

About Audrey Kelly, PharmD

Drug Integrity Associate Audrey Amos is a pharmacist with experience in health communication and has a passion for making health information accessible. She received her Doctor of Pharmacy degree from Butler University. As a Drug Integrity Associate, she audits drug content, addresses drug-related queries

Choosing a Birth Control Method – Cervical Cap