Spermicide is a hormone-free birth control option - here's how it works

• Spermicide is an over-the-counter, hormone-free birth control option that you use before sex.
• It comes in a number of forms, including gels, creams, foams, suppositories, and more.
• Spermicide is only about 72% to 82% effective, so you should use a second method like a condom with it.

When searching for the right birth control, it's important to know all your options and weigh your pros and cons.

Spermicide is a less popular (and less effective) form of birth control, but it is an over-the-counter contraception option that may work for you, especially under certain circumstances.

Here's what you need to know about spermicide, how effective it is, how to use it, and its risks.

What is spermicide?

Spermicide is an over-the-counter substance that you insert into your vagina to prevent pregnancy. It works in three ways, says Raegan McDonald-Mosley, MD, MPH, an OB-GYN and CEO of reproductive health non-profit Power to Decide:

1. Blocks the entrance to the cervix so a sperm can't get to an egg
2. Changing the cervical mucus to deter sperm from moving towards the uterus
3. Kills the sperm, in some cases

Forms of spermicide

According to Felice Gersh, MD, OB-GYN and founder/director of the Integrative Medical Group of Irvine, you can purchase spermicide in various forms including:

• Creams
• Gels
• Films
• Foams
• Suppositories

You may want to experiment with different brands and forms to determine which one works best for you, says McDonald-Mosley. It's all a matter of personal preference and what feels most comfortable.

Spermicide: Pros and cons

Perks to this form of birth control are that it's easy to find, it's hormone-free, and there's no prescription needed, McDonald-Mosley says.

However, spermicide is not as effective as other methods. With perfect use, spermicide is about 82% effective but with typical real-life use, spermicide used as a sole birth control method is 72% effective, says Gersh, MD.

This is much less effective than methods like the birth control pill, which is 93% effective, or the IUD, which is more than 99% effective.

Both Gersh and McDonald-Mosley agree that spermicide on its own is not reliable enough.

"If you're not looking to get pregnant anytime soon, it's important to double up with a condom or diaphragm, or switch to a method with maximum protection, like an IUD," says McDonald-Mosley.

Birth control methods that use spermicide

Diaphragms: A diaphragm is a small shallow silicone cup. Gersh says you apply spermicide around the rim of the cup and into the cup, covering its entire surface.

Then, you can insert the diaphragm into your vagina. This method is 88% effective with typical use.

The sponge: The birth control sponge is a small round sponge-like device that is infused with spermicide.

Although spermicide is in the sponge, you have to wet the sponge with clean water and squeeze it a bit so it gets foamy in order to activate the spermicide. Then, you can insert it into your vagina before sex.

This method is 86% effective for people who've never given birth, and 73% effective for those who have given birth.

How to use spermicide

McDonald-Mosley recommends the following steps to properly use spermicide:

1. Check the expiration date. Most spermicides can last up to about 2 years if stored correctly (at room temperature, away from heat direct light).
2. Check the instructions on the packaging because every type of spermicide is different and may have different instructions for use.
3. Most times, you simply just insert the spermicide with your fingers or an applicator, just like how you'd put in a tampon. "Getting into a relaxed and comfortable position - either laying down, squatting, or one foot on a chair - can help you insert the spermicide," says McDonald-Mosley.
4. With some spermicides, you need to wait ten minutes before having sex. Be sure to read the instructions thoroughly to see if and for how long you need to wait with your specific product.
5. Some spermicides only work for about an hour after you put them in your vagina, so, if you're going to have sex again later on, you need to use more spermicide.

Again, both McDonald-Mosley and Gersh advise against using spermicide as your only form of birth control, and encourage you to double up on protection. For example, consider having your partner use a condom.

Risks of spermicide

As with any form of birth control, there are risks to using spermicide. Gersh says some risks are:

• Burning on the genitals
• Itching on the genitals
• Allergic reaction on the genitals
• Skin irritation on the genitals
• Higher risk of unwanted pregnancy

Furthermore, McDonald-Mosley notes that spermicide will not protect you from STIs. Neither will a diaphragm or the sponge. For safer sex, use a condom along with your spermicide.

Additionally, while spermicide kills sperm it can also kill some of the "good" bacteria that keep your vagina clean and healthy, which increases the risk of a UTI. To reduce your risk, don't use spermicide more than once a week.

Insider's takeaway

If you're looking for a hormone-free, easily accessible form of birth control, spermicide is an option.

However, it is not the most effective type of birth control, and it's highly recommended that you use it alongside another type of birth control, like condoms, to further reduce your chances of an unwanted pregnancy.

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