Birth control sponge: The non-hormonal, OTC contraception you may not have heard of

Woman at pharmacy
You can get a birth control sponge at the store – no prescription needed. Longhua Liao/Getty Images
  • The birth control sponge is 86% effective if you have never given birth and 73% if you have.
  • It is filled with spermicide, which is a compound that kills or immobilizes sperm.
  • To use it, insert it into your vagina right before sex and leave it in for six hours after sex.
  • Visit Insider’s Health Reference library for more advice.

Birth control sponges have been around for centuries in one form or another. For example, the French in the 17th century soaked sponges in brandy to weaken sperm and prevent pregnancy.

Today, birth control sponges use something stronger than brandy: spermicide, a gel specifically designed to kill sperm. And for people who don’t have prescription birth control, the birth control sponge is a good option since it’s over-the-counter and you can find it in most drug stores or online.

But like every form of birth control, the contraceptive sponge has its downsides. For example, it’s one of the least effective forms of birth control out there.

Here’s what you should know about the birth control sponge, how to use it, and its benefits and risks.

What is the birth control sponge?

A birth control sponge is a small, round, spermicide-infused sponge-like device with a short strap. You’re meant to insert it deep into your vagina, up against the cervix, before sex.

The way it prevents pregnancy is twofold, says Sherry Ross, MD, OB-GYN and author of She-ology:

  • First, the sponge creates a barrier – physically blocking sperm from reaching your cervix.
  • Second, the active ingredient in the sponge’s spermicide (nonoxynol-9)kills or immobilizes sperm so it can’t reach an egg.

The birth control sponge is 86% effective for people who have never given birth, and 73% effective for people who have given birth. This is because after giving birth, the elastic vaginal tissue might stretch out a bit, making more room for the sponge to potentially get displaced, says Ross.

How to use a vaginal sponge

In order to prevent pregnancy, you must insert the sponge before sex starts.

Ross says you can insert it up to 24 hours before having sex, but she recommends that you put it in closer to the time you plan on having intercourse. You can even put it in right before sex.

To insert your sponge, Ross says you should follow these steps:

  1. Wash your hands.
  2. Wet the sponge with clean water and squeeze it a bit so it gets wet and foamy. (Getting the sponge wet is what activates the spermicide).
  3. With the strap side facing down, fold the cup in half like a taco.
  4. Get in a comfortable position to insert (like how you would insert a tampon).
  5. Insert the folded sponge into your vagina, sliding it as far back as it will go. The distance to the cervix is about 3 to 4 inches when not sexually aroused, Ross says. When you let go of it, the strap should be facing down, and the sponge will have unfolded.
  6. Run your finger around the perimeter of the sponge to ensure it’s properly in place and completely covering the cervix. You want to make sure you’re not able to feel your cervix, and you’re just feeling the sponge. If you can feel your cervix, you must reposition the sponge.

After sex, you have to leave the sponge in for at least six hours, so that the spermicide has time to work, and no longer than 30 hours, says Ross.

Once six or more hours have passed and it’s time to remove the sponge, follow these steps:

  1. Wash your hands
  2. Insert a finger into your vagina and hook your finger onto the strap or the edge of the sponge to pull it out.
  3. Throw the sponge in the trash.

Pros of the birth control sponge

  • It’s over-the-counter: Since the sponge is available OTC, you don’t need to see a doctor to get a prescription for one, which makes it more easily and immediately accessible.
  • It’s non-hormonal: The sponge does not contain any hormones, which makes it a good choice for people who choose to opt for non-hormonal birth control.
  • You can have sex multiple times with one: One sponge can provide protection for multiple acts of sex and ejaculation up to 24 hours after insertion – as long as you leave it in for six hours after the last round of intercourse.

Cons of the birth control sponge

  • It has a relatively high failure rate: The sponge has a 14% or 27% failure rate (depending on whether or not you have given birth before), making it one of the least effective types of birth control. For example, the pill has a 7% failure rate, and an IUD has less than a 1% failure rate.
  • It won’t protect you from STIs: While the sponge offers some protection from unwanted pregnancies, it does not protect you at all from STIs. If you want STI protection, you will need to use a condom along with the sponge.
  • It increases your risk of infections and irritation: The spermicide in the sponge can cause vaginal irritation or burning, as well as increase your risk of urinary tract infections (UTIs). It can also cause irritation to the penis or burning urination for your partner.
  • You have the risk of toxic shock syndrome (TSS): While TSS is primarily associated with tampon use, it can also be caused by using the birth control sponge, however, this is very rare.

Insider’s takeaway

If you’re seeking non-hormonal birth control, the sponge may be a decent option for you.

However, you have to consider the fact that it isn’t the most effective form of birth control, and it doesn’t provide STI protection.

For these reasons, Ross recommends using a condom along with the sponge for optimal protection.

What everyone should know about birth control, from the types to effectivenessA cervical cap is a non-hormonal birth control method that you only use during sex – here’s how it worksHow to decide which type of IUD is right for youA diaphragm is a reusable, non-hormonal birth control option – here’s how it works