The Today Sponge

The sponge is a reversible, over-the-counter barrier method of birth control. The Today Sponge is a round device that is 1.57 inches in diameter and about half of an inch thick. It is made of soft polyurethane foam, which feels like natural vaginal tissue, and is coated with sperm-killing nonoxynol-9 spermicide. It also has a cotton loop attached to the bottom for removal.

History

The Today Sponge was first introduced in 1983 and became the largest-selling over-the-counter female contraceptive in the U.S. It was the first product to combine a spermicide and a barrier contraceptive in one easy-to-use product for women.

The sponge was voluntarily taken off store shelves in 1995 by its previous manufacturer who chose to stop producing it rather than make FDA-mandated changes to the equipment at their manufacturing plant.

Allendale Pharmaceuticals bought the patents in 1998 to start producing the sponge again. After receiving FDA approval of their manufacturing plant, the Today Sponge was re-introduced in the U.S. in September 2005.

In 2007, Allendale Pharmaceuticals was acquired by Synova Healthcare, Inc. Synova wishes to educate all women about the benefits of the sponge as a safe and effective birth control option.

It is important to stress that the sponge was never taken off the market due to safety issues; the problem was with the equipment at the old manufacturing site.

How It Works

The Today Sponge prevents pregnancy for 24 hours by combining three separate modes of contraceptive action. Primarily, it works as a delivery system for spermicide. By continuously releasing spermicide throughout the vagina, it kills sperm on contact. It acts as a barrier method that blocks the entry of sperm into the cervix. The foam provides contraceptive protection by trapping and absorbing sperm.

The sponge is held in place by the vaginal muscles. Additionally, the indentation (dimple) helps position the Today Sponge properly and keeps it in place directly over the cervix.

The sponge is first moistened with water (which activates the spermicide) and then the woman places it into her vagina before sex. It can be inserted up to 24 hours before intercourse. The sponge must also be left in place for at least 6 hours after the last act of intercourse.

Advantages

The Today Sponge is sold over the counter and doesn't require a prescription.

• No special fitting is required
• It's disposable after each use
• Offers a reliable alternative to hormonal contraceptives, such as the pill
• Doesn't affect a woman's natural hormones
• Can be used by women who are breastfeeding
• Offers an immediate and continuous dose of spermicide for a 24-hour period
• It allows for as many acts of intercourse as desired within the 24-hour period of use without the need for additional spermicide
• Does not interfere with sexual spontaneity since it can be inserted 24 hours ahead of time and can be worn for up to 30 hours after insertion
• Fits comfortably over the cervix and usually cannot be felt by either partner
• Unlike some other birth control methods, the Today Sponge is used only when needed
• Its small size allows the sponge to be discreetly carried in a purse
• It is not messy and is easy to purchase and use

Disadvantages

Generally, most women have no side effects when using the sponge. However, possible drawbacks include:

• Some women complain that the sponge makes sex too dry; using a water-based lubricant can help reduce dryness
• Since the sponge cannot dissolve by itself, it must be removed
• The sponge may cause vaginal irritation
• May not be used by women (or their partners) who are allergic to sulfites or polyurethane
• It can’t be used within the first 6 weeks after giving birth
• It may be difficult for some women to insert or remove the sponge
• Pulling too hard or too quickly on the removal loop or grabbing for the sponge or pinching it may cause the sponge to break into pieces upon removal. The manufacturer suggests that “If you cannot remove any remaining pieces of the Today Sponge or if you are just concerned that there may still be pieces left, contact your physician."
• Using the spermicide nonoxynol-9 many times a day, by people at risk for HIV, may irritate tissue and increase the risk of HIV and other sexually transmitted diseases
• A woman who is having her period cannot use the sponge
• Women who use the sponge may be at a slightly increased risk of toxic shock syndrome; women who have a history of toxic shock syndrome should not use the sponge
• People who are sensitive to nonoxynol-9 may experience irritation which can include localized burning, itching, redness or rash; these symptoms will typically subside gradually within a few days to a week
• Some women may have a reaction to the Today Sponge that can trigger a white vaginal discharge which is often confused as a yeast infection. If this occurs, consult with your healthcare provider to evaluate the situation

Where to Buy and Costs

The sponge is available without a prescription and can be purchased in drugstores, some supermarkets, on the internet, and at family planning centers. It is easy to obtain and is available in only one size. Although prices vary, the typical cost of a package of three sponges is $12.00 to $18.00.

Who Can Use It?

Just about any woman who can use a tampon can also use the sponge. The Today Sponge may be an appealing birth control choice for women who:

• Prefer to use a non-hormonal contraceptive method
• Are on-the-go and want the convenience of contraception only when needed
• Are breastfeeding and desire a hormone-free option
• Prefer a non-systemic contraceptive (one that is not absorbed into the bloodstream)
• Are not good candidates for or who have experienced unwanted side effects from hormonal birth control
• Wish to avoid some of the side effects that may occur with taking hormonal methods
• Need a back-up method to the pill, the patch, or NuvaRing due to user error or if taking a medication that lowers the effectiveness of their hormonal method

Precautions

The sponge should not be used by women who currently have a reproductive tract infection, vaginal obstructions, or had a recent abortion, childbirth, or miscarriage. Women should not use the sponge if experiencing any kind of vaginal bleeding, including a period. Finally, if a woman is uncomfortable touching her genitals, this may not be the best birth control option.

Each sponge should be inserted one time. Never reinsert a used sponge. Once removed, it should be thrown away.

A woman can be in a bath, Jacuzzi, or pool while the sponge is inserted. It is not recommended that she have sex while in the water since the introduction of the higher quantity of water into the vagina could potentially dilute the spermicide in the sponge.

The sponge should not be used as a tampon.

Effectiveness

Estimated efficacy rates range between 68-91%

For those who have not given birth:

• Typical use: 88% effective
• Perfect use: 91% effective
• Of every 100 women who use the sponge for 1 year (and have never given birth), 12 will become pregnant with typical use and 9 will become pregnant with perfect use

For those who have given birth:

• Typical use: 76% effective
• Perfect use: 80% effective
• Of every 100 women who use the sponge for 1 year (and have previously given birth), 24 will become pregnant with typical use and 20 will become pregnant with perfect use

According to the manufacturer, with proper use, effectiveness is 89%-91% and for typical use, the efficacy rate is 84-87%. The manufacturer also suggests that effectiveness rates increase during the second year of use - perhaps because women have become more comfortable using this method.

To be most effective, the sponge should be inserted prior to having sex and before the penis comes into contact with, or enters, the vagina. It should stay in place for at least 6 hours after the last sexual act and removed within 30 hours of insertion. If the sponge falls out before 6 hours, a woman should wet and insert a new sponge.

A woman should read the insert inside the package for more detailed information.

STD Protection

The sponge offers no protection against sexually transmitted infections.