Cervical Cap

A cervical cap is a small, reusable silicone or latex cup that fits snugly over the cervix to prevent pregnancy by blocking sperm from entering the uterus. When used with spermicide, this barrier method of contraception can be inserted several hours before sexual activity and must remain in place for at least 6 hours afterward.

What is a Cervical Cap?

A cervical cap is a small, reusable silicone cup that fits snugly over the cervix to prevent pregnancy. This barrier method of contraception creates a physical seal around the cervix, blocking sperm from entering the uterus and reaching an egg. Cervical caps are prescription-only devices that must be fitted by a healthcare provider to ensure proper size and effectiveness.

How Does a Cervical Cap Work?

The cervical cap works by creating a barrier between sperm and the cervix. When properly inserted, it forms a suction seal around the cervix, while spermicide applied inside the cap immobilizes or kills any sperm that manage to reach the edge of the cap. This dual-action approach - physical barrier plus spermicide - makes the cervical cap more effective than using either method alone.

Types of Cervical Caps

FemCap

FemCap is currently the only FDA-approved cervical cap available in the United States. It comes in three sizes and is made of soft, flexible silicone. The FemCap features a unique design with a brim that helps maintain its position and an outer groove that holds extra spermicide.

Lea's Shield

While no longer widely available, the Lea's Shield was another type of cervical cap that featured a one-size-fits-most design with a valve to allow cervical secretions to flow out while preventing sperm from entering. It had a slightly different shape than the FemCap but served the same purpose.

Effectiveness and Safety

Success Rates

The cervical cap is approximately 86% effective with typical use for women who have never given birth vaginally. However, this rate drops to about 71% for women who have previously given birth vaginally, as childbirth can affect the fit of the cap. Perfect use increases these rates significantly.

Potential Side Effects

Most users experience minimal side effects with cervical caps. Some people might notice a slight odor or vaginal discharge. There's a small risk of developing toxic shock syndrome, though this is rare. Some users report minor irritation or discomfort during intercourse.

Health Considerations

People with certain medical conditions should avoid using cervical caps, including those with a history of toxic shock syndrome, abnormal Pap smears, or cervical abnormalities. It's also not recommended during heavy menstrual flow or immediately after childbirth, miscarriage, or abortion.

Using a Cervical Cap

Insertion and Removal

The cervical cap must be inserted up to 6 hours before sexual activity. To insert, fill the cap one-third full with spermicide, squeeze the rim to create an oval shape, and guide it deep into the vagina with the dome pointing down. To remove, hook your finger under the removal strap and gently break the suction seal.

Duration of Use

A cervical cap can be left in place for up to 48 hours, though it's recommended to remove it within 24 hours to reduce the risk of toxic shock syndrome. You must leave it in place for at least 6 hours after the last act of intercourse.

Maintenance and Care

After each use, wash the cap thoroughly with mild soap and warm water, rinse well, and allow it to air dry completely. Store it in its case away from heat and direct sunlight. With proper care, a cervical cap can last about a year before needing replacement.

Benefits and Limitations

Advantages

Cervical caps are hormone-free, reusable, and can be inserted hours before sexual activity. They're discreet, can't be felt by either partner when properly placed, and don't interfere with sexual spontaneity once inserted. They also don't affect your natural menstrual cycle or fertility.

Disadvantages

The effectiveness rate is lower than many other contraceptive methods, especially for those who've given birth vaginally. Some users find insertion and removal challenging or messy. The requirement for spermicide can cause irritation in some people, and the cap must be properly fitted by a healthcare provider.

Getting a Cervical Cap

Medical Requirements

You'll need a prescription and professional fitting from a healthcare provider. During the fitting, they'll determine the correct size and teach you proper insertion and removal techniques. Regular check-ups are recommended to ensure proper fit, especially after pregnancy or significant weight changes.

Cost and Insurance Coverage

The initial cost of a cervical cap ranges from $60 to $75, plus the cost of the fitting appointment. Many insurance plans cover both the device and fitting under preventive care benefits. Spermicide, which must be used with the cap, adds ongoing costs of approximately $10-15 per tube.

Combining with Other Methods

Use with Spermicide

Spermicide is essential for cervical cap effectiveness and must be used every time. Apply fresh spermicide if you have sex multiple times or if the cap has been in place for several hours. Use only water-based spermicides specifically approved for use with cervical caps.

Backup Contraception

Consider using backup contraception, such as condoms, during your first few times using the cap until you're confident about proper insertion. Some people choose to combine the cervical cap with other methods like fertility awareness for added protection against pregnancy.

Examples

Sarah has been using a cervical cap for the past year because she wanted a hormone-free contraceptive option that she could insert before intimacy. She found that with proper fitting from her healthcare provider and regular practice, she can now insert it up to 6 hours before sex and remove it easily afterward.

A couple planning to start a family in the future chose a cervical cap because, unlike some other methods, it has no lasting effect on fertility. They appreciate that they can use it only when needed and that it doesn't interfere with their natural hormonal cycles. However, they always keep backup condoms available since they know the cervical cap has a higher failure rate than some other contraceptive methods.

FAQ

What is a cervical cap and how does it work?

A cervical cap is a small, silicone cup that fits snugly over the cervix to prevent pregnancy. It works by creating a physical barrier that stops sperm from reaching an egg. For best effectiveness, it should always be used with spermicide, which helps kill any sperm that might get around the edges of the cap.

How effective is a cervical cap at preventing pregnancy?

When used perfectly with spermicide, the cervical cap is about 86% effective for women who have never given birth and 71% effective for women who have given birth. With typical use (meaning not always used perfectly), these numbers drop to about 71% and 56% respectively. It's important to note that cervical caps don't protect against STIs.

How long can I leave a cervical cap in place?

You can leave a cervical cap in place for up to 48 hours at a time. However, during your period, you should not wear it for more than 24 hours at a stretch. After intercourse, you need to leave the cap in place for at least 6 hours, but not longer than 48 hours total. Remember to add more spermicide if you have sex again while the cap is in place.

What are the main advantages and disadvantages of using a cervical cap?

The main advantages include that it's hormone-free, reusable for up to a year with proper care, and can be inserted hours before sex. The disadvantages include lower effectiveness compared to other birth control methods, the need for a proper fitting by a healthcare provider, possible difficulty with insertion, and increased risk of urinary tract infections. Some people also find that it can be messy to use with spermicide.