(Updated June 2014)
Description
The vaginal sponge is a small, circular, polyurethane sponge that contains 1 gram of nonoxynol-9 spermicide. The sponge has a dimple on one side that fits over the cervix and a loop on the opposite side for removal. The vaginal sponge can be purchased at a pharmacy.
Use
The sponge is intended for one-time use only. It is moistened with tap water before use, squeezed once to evenly distribute the 
spermicide, and inserted into the vagina with the dimpled side fit against the cervix. There is no need for repeated applications of spermicide with additional acts of intercourse.
The sponge remains effective for up to 24 hours after insertion, regardless of the number of times intercourse occurs during that time. After the last act of intercourse, it should be left in place for at least 6 hours but for no more than 24–30 hours (i.e., if the last act of intercourse occurs 24 hours after insertion, it should be left in place for another 6 hours and then removed), because the risk of toxic shock syndrome (TSS) increases after that time. Women should not rinse the vagina or douche while wearing the sponge and for at least 6 hours after the last act of intercourse. Some women have difficulty with proper placement and/or removal of the sponge.
Effectiveness
- This method is effective.
- The sponge is less effective in gravid women. In nulliparous women, the failure rate is 9 percent with perfect use and 12 percent with typical use.19
- In gravid women, the failure rate is 20 percent with perfect use and 24 percent with typical use.19
Risks
Increased risk of yeast infections and TSS if sponge is left in place for longer than 24–30 hours.
Side Effects
Some women experience vaginal dryness with sponge use.
Contraindications and Precautions
Allergy to spermicides
Advantages
- Relatively discreet (can be inserted ahead of time)
- Over-the-counter availability
- Easily reversible
Disadvantages
- Required with every act of intercourse
- Lower efficacy than some other methods with typical use
- Increased risk of yeast infection and TSS if sponge is left in too long
- No protection against STIs
Counseling Messages
- Because it is much less effective in gravid women, the vaginal sponge is a better contraceptive choice for women who have never been pregnant.
- The sponge should not be left in place for longer than the recommended time.
- There is an increased risk of TSS if the sponge is left in too long. (Providers should educate patients about the signs of TSS.)
- This method does not protect against STIs.