Sponge birth control: what you should know

While its popularity may have dwindled in recent years, “the sponge” was the most popular form of over-the-counter birth control among women in the 1980s and early 1990s. At one point, an estimated 6.5 million women used it in the United States (George, 2007).

In the mid-1990s, its manufacturer temporarily removed it from the market, spawning an iconic episode of the sitcom Seinfeld. In the episode, Elaine has to ration her remaining birth control sponges and evaluate all her dates to determine their “sponge-worthiness” (George, 2007).

Later, the birth control sponge returned to pharmacy shelves. While not as widely used as it once was, it remains an option for preventing pregnancy. 

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Sponge birth control, also known as the contraceptive sponge, is a form of barrier birth control that first became available in the United States in 1983. 

The sponge is a small round piece of polyurethane foam coated in spermicide, a chemical that kills sperm. It also has a small strap on one side, used for removing the sponge after use.

It is inserted into the vaginal canal before sexual intercourse and remains there for at least six hours after intercourse. It is then removed and discarded.

The vaginal contraceptive sponge is a barrier method of birth control, meaning it prevents pregnancy by acting as a barrier that prevents sperm from coming in contact with an egg.

Other types of barrier contraception besides the sponge include:

• Male condoms

• Diaphragm

• Cervical cap

The contraceptive sponge, diaphragm, and cervical cap all function similarly. They hold a spermicidal contraceptive gel against the cervix. This gel, nonoxynol-9 in the case of the sponge, kills sperm before they can pass through the cervix to the uterus (Bartz, 2020).

Two clinical studies compared the effectiveness of the sponge, cervical cap, and diaphragm. The findings showed that the likelihood of failure in the first year with typical use is 17% for the sponge, 18% for the cervical cap, and 13–17% for the diaphragm (Trussel, 1993). 

With perfect use—that means using the method perfectly 100% of the time—the failure rate in the first year is 11–12% for the sponge, 10–13% for the cervical cap, and 4–8% for the diaphragm. Even with perfect use of the sponge, the likelihood of failure is much higher for women who have given birth in the past than for women who have not given birth (19–21% vs. 9–10%) (Trussel, 1993).

The contraceptive sponge is generally recognized as safe and used in the United States, Canada, and Europe for several decades.

In the mid-1990s, its manufacturer removed it from the market to avoid making changes to its manufacturing facilities mandated by the Food and Drug Administration (FDA) (George, 2007).

It's been back on the market for many years, and has never been removed from the market due to safety issues.

To correctly use sponge birth control (Today Sponge Vaginal Contraceptive Sponge, 2021):

1. Wash your hands.

2. Remove the sponge from its package.

3. Wet the sponge with clean water to activate the spermicide.

4. Squeeze the sponge several times until it becomes sudsy.

5. Fold the sponge upward so that it is long and narrow with the string loop on the bottom.

6. Insert the sponge into the vagina.

7. Using your fingers, push the sponge as far into the vagina as it will go until it rests against the cervix.

The birth control sponge may be left in for up to 30 hours. You can have multiple episodes of sexual intercourse during this time. The sponge must be left in place for six hours after your last episode to continue to prevent pregnancy. 

This means that you can safely have sex for up to 24 hours after putting in the sponge and still leave it in for the required six hours after sex.

To remove the sponge:

1. Wash your hands.

2. Using your fingers, reach up into your vagina to find the string loop.

3. Slowly and gently pull the sponge out using the loop, pushing down with the vaginal muscles.

4. Discard the sponge (do not flush it).

All forms of birth control have their pros and cons. Discuss any specific concerns with your healthcare provider, who can help you make the right choice for you.

One study noted some of the reported advantages and disadvantages of the birth control sponge (Smith, 1983).

Pros:

• Can be inserted up to 24 hours before sexual intercourse

• Can remain in for multiple episodes of intercourse

• Available over the counter without a prescription

Cons:

• Does not prevent sexually transmitted infections (STIs)

• Less effective than other methods at preventing pregnancy

• Some women report that they or their partner experienced discomfort

The main risk involved in using sponge birth control is that it may not prevent pregnancy, especially when not used as directed.

Other potential risks that have been reported include (U.S. National Library of Medicine, 2021):

• Vaginal irritation

• Allergic reaction to the sponge material or the spermicide

• Difficulty removing the sponge after use

• Rare risk of toxic shock syndrome

Toxic shock syndrome (TSS) is a rare, but very serious condition caused by the release of toxins produced by the bacteria Staphylococcus aureus or group A streptococcus. If these toxins build up in the body, they can potentially cause severe illness, organ failure, or death. It is most often associated with high absorbency tampon usage but can also occur in men and children from other sources of infection (Ross, 2020).

TSS is treatable but is best prevented by using good hygiene. Don’t keep a birth control sponge inserted longer than recommended (30 hours).

Sponge birth control is available over-the-counter. You don’t need a prescription from a healthcare provider to get it. It comes in one size only and does not need to be fitted by a healthcare provider. 

You can find it at most drugstores or in the pharmacy aisle at most major stores.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

April 07, 2021

Written by

Ellyn Vohnoutka, BSN, RN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.