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What Is It?
Spermicides come in several different forms: cream, gel, foam, film, and suppositories. Most spermicides contain nonoxynol-9, a chemical that kills sperm. Spermicides can be used alone but are more effective when used with another method of birth control such as a condom or diaphragm.

How Does It Work?
Spermicides kill the sperm before they are able to swim into the uterus. To be effective, the spermicide must be placed deep in the vagina and make contact with the cervix. Creams, gels, and foams are squirted into the vagina using an applicator. Other types of spermicides include vaginal contraceptive film (VCF), a thin sheet placed in the back of vagina by hand, and vaginal suppositories.

Spermicides must be placed in the vagina before sexual intercourse. Some offer protection right away (like foams and gels), whereas suppositories and VCF must be placed in the vagina at least 15 minutes before sex so they have enough time to dissolve and spread. All forms of spermicides are effective when inserted less than 1 hour before having sex. If more than 1 hour goes by before having sex, or if you have sex again, another application of spermicide is needed. Spermicide should not be washed or douched away for at least 6 hours after having sex.

How Well Does It Work?
Over the course of 1 year, about 29 out of 100 typical couples who rely on spermicide alone to prevent pregnancy will have an accidental pregnancy. Of course, this is an average figure and the chance of getting pregnant depends on whether you use spermicides correctly and every time you have sex. Spermicides are most effective when used in combination with another form of birth control.

In general, how well each type of birth control method works depends on a lot of things. These include whether a person has any health conditions or is taking any medications that might interfere with its use. It also depends on whether the method chosen is convenient - and whether the person remembers to use it correctly all the time. Spermicides are not as effective on their own as other forms of birth control. However, they are convenient, inexpensive, and easy to use.

Protection Against STDs
Spermicides alone are not effective against sexually transmitted diseases (STDs). For those having sex, condoms must always be used with spermicide to protect against STDs.

Abstinence (not having sex) is the only method that always prevents pregnancy and sexually transmitted diseases.

Possible Side Effects
Spermicides may irritate the vagina and surrounding skin. Another possible side effect is recurrent urinary tract infections because the spermicide can disrupt the normal balance of bacteria in a girl's body.

Who Uses It?
People who can take responsibility for planning birth control in advance of having sex and couples using condoms or other barrier methods of contraception who want extra protection against pregnancy use spermicides.

How Do You Get It?
Spermicides are available without a prescription and are found in drugstores and some supermarkets. (In some stores, they will be in an aisle that's called "Family Planning.") They are often found near the condoms and feminine hygiene products. But be careful when choosing a spermicide - the packages may look like those of some feminine hygiene products, such as douches or washes, which don't provide any birth control protection at all.

How Much Does It Cost?
Depending on the type of spermicide you choose (film is more expensive than gel), spermicide costs only about $0.50 to $1.50 per use.

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