CHEMICAL CONTRACEPTION

Chemical contraception

As discussed earlier Chemical contraceptives were used for thousands of years in form of fruit jellies, pastes and sponges soaked in quinine sulphate were used. In 1885 a suppository was made by an English pharmacist using cocoa butter and quinine sulphate. There after many products hit the market. In 1950 an effective   spermicide was developed called nonoxinol-9(N-9).This proved to be very effective and is still in use. Depending on what kind of preparation you are using they have to be inserted into the vagina10 minutes before or 30 minutes before.  The Pessaries (or suppositories) require more time to dissolve in the vagina. Do not use sponges if you are menstruating.

The chemical contraceptives do not last all night. If you have sex second time round, you will need to top up. These chemical contraceptives can cause irritation burning sensation and allergies for both partners. One woman once told me that she felt as if her vagina was on fire.  One serious problem with chemical contraceptives is that they can cause vaginal erosions and thus increase the risk of STI infections including HIV. Many peri menopausal women tend to use chemical contraceptives thinking that there fertility is low so it is ok to use just these. However this is not good as in menopausal years the vaginal skin is more delicate, it is more likely to be eroded. The risk of infections is higher, in these women so it is not uncommon for them to get infected. I have come across two such women in the past two years .Many woman use vaginal douches as contraceptives, but these have a high failure rate and a high risk of infection. I have come across women using coco cola douches this is like “closing the gate after the horses have bolted”.

The best chemical contraceptive available is Nonoxinol -9(N-9)

It is available as creams, jelly, foams, films and suppository. It is used to lubricate some condoms.  So far there is no published evidence that is helps to prevent pregnancy or infection. The failure rate of chemical contraceptive varies between 8% to 28%. It does not protect you from STI’s.

In the United Kingdom N-9 is sold as Gygel.  It is also available through the National Health Service. The best use of chemical contraceptive (N-9) is with barrier methods, e.g. with cervical caps, diaphragm and condoms. There is   ongoing research that looking at how we can combine contraception with microbicides. It seems that the researchers are close to this with their new diaphragm.  I will discuss this further when I talk about barrier methods.