Cervical Cap

Description

Most commonly known by the brand name ‘FemCap’, the cervical cap is a device that is inserted into the vagina and placed over the cervix in order to block sperm from entering the vagina. Its shape is often likened to that of a thimble or a sailor's hat and is generally made of silicone, though latex and rubber versions are also available. A prescription is required and an initial fitting is, in almost all cases, a necessity. It is one of the least common methods of contraception.

The diaphragm and cervical cap were the most common marital contraceptives from the mid-19th century until the introduction of the pill. The cap was more popular in Europe and the diaphragm in much of the rest of the world. The American woman Margaret Sanger discovered its use in Germany and introduced the diaphragm into the States in the early 1920s. She spent much time in jail for contributing to licentious behavior! Most doctors would not prescribe or fit for single women. The Germans and French were a bit looser but even they restricted distribution to mostly married women. The importance of them was that these were the first modern contraceptives that gave the woman (rather than the man) primary control.

Effectiveness

The cervical cap's effectiveness depends on a few factors. Achieving a properly fitted cap, combined with a woman's motivation to anticipate or pre-plan sexual activity, will dictate how well it prevents pregnancy. That is because the cap is most effective when it is inserted prior to arousal. Using an oil based lubricant and vaginal creams or treatments for conditions such as yeast infections will also decrease efficacy.

In addition to having an irregularly shaped cervix, the cap's contraceptive effectiveness depends on a woman's obstetric history, namely whether or not she has given birth vaginally. Scar tissue can change the shape of the cervix and interferes with the cap forming a good seal around the cervix, thus ruling out many of the available sizes of caps to choose from.

If the cap has been perfectly fitted, and is inserted every time prior to sexual activity, the approximate failure rates have been reported as follows. For women who have not given birth, it ranges between nine to twenty percent. The failure rates are higher among women who have given birth, and are anywhere between twenty six to thirty two percent.

In order to improve its efficacy, this device is recommended to be used in conjunction with 2% Nonoxynol-9 spermicidal cream or jelly, a sperm killing agent, to reinforce the mechanical barrier. Thus, the cap works in two ways to prevent pregnancy: by blocking the opening to the uterus, while providing a holder for spermicide, to stop Sperm from potentially fertilizing an egg.

Usage

Similar in function to a barrier method like the diaphragm, the cap is inserted prior to sexual activity and can be left in place for up to forty eight hours. It must be kept in for at least six hours after having sex, though more spermicide should be added before re-engaging in more sexual activity. This can be done by placing a dab of spermicide onto the fingertip and inserting it deep into the vagina.

Directions

See Diaphragm for insertion instructions.

Cost

This will of course vary depending on your location and type of health coverage available – so enquire at your local Family Planning clinic or pharmacy. If health insurance covers birth control, the cervical cap is a device that will often be eligible as well. The kit usually includes some form of instructional media, such as a DVD. The FemCap specifically recommends replacing the cap every year - or sooner if cloudiness is observed in the material it is made of.

Advantages

Usage of the cervical cap is only as often as a woman has sex. It provides no disturbance to a woman's natural hormonal balance, which is extremely beneficial for those who experience negative side effects from hormone based contraceptives. Thus, it is also an effective option for women who have contraindications to IUDs.

The cap can be used while a woman is breastfeeding, and its pregnancy prevention measures are immediately reversible, a benefit for women who are considering conceiving children in the near-future. It is useful for women who are latex sensitive/allergic, or for those who do not want to rely on a male partner to use a condom. In order to improve sexual sensation for males, this device is a great option for monogamous couples who prefer not to use Condoms. The cap is discreet and provides women with contraceptive control.

Disadvantages

There are numbers of reasons why the cervical cap is not a preferred choice of birth control among many women. Insertion does take some getting used to, since it needs to be placed deep into the vagina to fit snuggly over the cervix. A backup contraceptive method is recommended to be used during the learning phase, which varies among users.

Incorrect sizing of the cervix can lead to dislodgement during sexual activity, as can very vigorous sex, some Sexual Positions, and certain penis shapes. Using the cap as a contraceptive measure requires a user who is highly motivated and capable of planning prior to sex (since the cap has to be inserted before arousal).

The cap cannot be used while a woman is menstruating, and can cause complications such as discharge and strong vaginal odor if it is left in for too long. Its use can irritate the cervix and the surrounding tissue, which may be attributable to the combined use with spermicide. Though rare, the material it is made of - especially latex - can contribute to an allergic reaction. Use of a cervical cap may cause abnormal results on a Pap test and it does not protect against STD's/STI's.

Final thoughts

Neither the diaphragm or cervical cap is very popular today, but some women still prefer them because they do not affect the body.