Cervical caps – all you need to know

Deciding which contraception option is best suited for you can be quite overwhelming and scary, especially if you have little experience with different types. That’s why, it is always important that you do your research and learn everything you can about different types, how they work, how effective they are, and their advantages and disadvantages. The truth is, every woman is different with a unique lifestyle and needs; therefore, what may work for someone else, may not necessarily be the best option for you. Understanding the different types of contraception options is really vital in the process of choosing the best one for you. That’s why, in this article, we will be discussing one of these contraception solutions – the cervical cap.

1. What are cervical caps?

Cervical caps are a form of barrier contraception: they are contraceptive device that gets inserted into the vagina and fits over the cervix, blocking the sperm from entering the uterus through the os; the cervical cap can be used as birth control method when used in combination with spermicide (gel that kills sperm). It is strongly recommended that you use cervical caps in combination with gel (spermicide gel) that will immobilize and kill sperm and therefore significantly contribute to the effectiveness of the cervical cap. Worldwide, you will be able to find several different types and brands of cervical caps: FemCap, Vimule, Dumas, Prentif, etc., but in the USA market, the only brand available and approved by FDA is FemCap. In the past, up till 2005, Prentif was also available in the USA, but not anymore.

2. Do you need a prescription to get them?

Yes, in order to get cervical caps you need to visit a health care provider who will screen you and determine if you can use a cavity cap; if you can use them, then they will further inform you which type and size is appropriate for you and give you a prescription which you will need if you are to buy cervical caps from pharmacy or online. Regardless of where you decide to buy your cervical cap from, online or in pharmacy, you will need to have a current prescription.

3. What are cervical caps made of and can everyone use them?

Cervical caps are made of deep, non-allergenic silicone rubber and are considered reusable. Interestingly enough, variations of them have been available on the market for over a century; that being said, not everyone should use them.

It is really important that you get examined by your health provider before deciding to use them; your health care provider will screen you and give you information on whether you should be using them or not. In some cases, if you have irregularly shaped cervixes or if you simply have scar tissue or any other issue that caused some changes to your cervix, the cervical caps won’t be a good solution for you as they may not fit your cervix and form a good seal. Additionally, in some cases, the available sizes may not be a correct fit for you, or you simply may be allergic to silicone or spermicide. (Read bellow more on who shouldn’t consider them in the ‘do/don’t use cervical caps if…’ section.) There are several issues like this that may be the reason why cervical caps may not be the recommended contraception for you, so it is really important that you consult your health provider before you try them. In general, typically, 80 to 85% of women are able to fit and use cervical caps.

4. Are there different sizes of cervical caps?

The reusable, dome-shaped cervical cap are comes in different sizes and your health provider will recommend which size you should use after they do a thorough exam. Depending on their design, the cervical cap can have low or high dome; low dome cervical cap has little air space between the dome and the cervix, and the high has plenty of air space above the cervix enclosed under the dome. In most cases, high dome is recommended more as the high dome cap has more room for storing secretions from the uterus, like menstruation or any flow resulting from orgasm.

5. How do you put them?

As to how you put them on, there are several steps on how you insert your cervical cap:

• Pee and empty your bladder before the process;
• Wash your hands thoroughly;
• Put spermicide in the dome of the cap and spread a thin layer on the rim of the cap and also add a smaller amount in the folded area between the rim and the dome;
• With one hand you need to separate your labia, and with the other one, you should squeeze the brim of the cervical cap and insert it into your vagina with dome side down.
• Then, you need to push the cap back towards the rectum and then up toward the cervix.
• Using your fingers, make sure that your cervix is completely covered;

Before sex, always check and make sure that the cervical cap is still in place; it should also stay there at least 6 hours after sex.

As for removing it, again, make sure you wash your hands before you start to avoid getting any bacteria in. Then, squat down, insert your fingers and grip the removal cap rotating it as you push the dome to release the suction. Then you should pull the cap out.

Always make sure you wash your cap with soap and water before and after using it and let it air-dry.

6. How do they differ from diaphragms?

Although they are quite similar and work on roughly the same concept – covering your cervix and using spermicide to kill sperm and prevent pregnancy, there is a difference between the cervical cap and diaphragms: cervical caps are a bit smaller, and they fit more tightly over the cervix; additionally, cervical caps have a dome-shape, while diaphragms are shaped like a dish. Moreover, the diaphragm needs to be inserted up to 2 hours before sexual intercourse, and if you are having sex more than once you need to add additional spermicidal gel into the vagina without moving the diaphragm and of course, that should be done before the intercourse, while the cervical cap can be inserted up to 42 hours before and you don’t need to apply additional spermicide if you have sex more than once. Both devices should be left in place at least 6 hours after sex; however, the cervical cap should not be inside your vagina for more than 48 hours while diaphragm not more than 24 hours.

7. How effective are the cervical caps?

Compared to diaphragm, cervical caps are considered less effective at preventing pregnancy. Cervical caps are only effective when used correctly every time before you have sex and you need to follow the directions strictly and use it every time you have sex if you want it to be effective.

Also, even if you are using it correctly, still the effectiveness of cervical caps is not 100%, and it can vary based on whether you have given birth or not; simply put, if you haven’t given birth, cervical cap will be 86% effective for you, but if you have given birth, that effectiveness goes for 15% down, as the cervical caps for women who had given birth shows 71% effectiveness. These percent refer to its effectiveness against pregnancy.

It is worth mentioning that cervical caps do not offer protection against any infections or STDs; using a cervical cap won’t protect you against any sexually transmitted diseases or infections such as herpes, HIV or AIDS. Although there are several different researches done around the world that are investigating how the diaphragm or cervical caps and different newer products made from silicone can help protect females from STI pathogens (including cervical dysplasia, tubal infertility, PID, gonorrhea,) the studies up till now haven’t really provided any strong proof or argument; in fact, these studies are rather observational and limited by their consideration of multiple barrier methods simultaneously and therefore still cannot be concluded as proof of the effectiveness of cervical caps and other similar devices against infections and STD. That’s why, it is important that you always use a condom while having sex, even in situations where you have a cervical cap or diaphragm.

8. Pros and cons of using cervical caps

There are a few advantages as well as disadvantages of using the cervical cap, such as:

Pros:

• Relatively effective contraception if used properly which doesn’t contain any hormones;
• Can be used by women who are breastfeeding;
• Can be inserted in advance without interrupting intimacy;
• Offers you control and privacy as you are inserting it before intercourse;
• If placed and used right, it will offer protection and not be felt by either partner during sex;

Cons:

• Not as effective as some other contraceptive solutions (effective rate of 71-85%); it is weaker than diaphragm;
• It requires a specific technique for inserting which may be challenging and difficult for some people;
• Doesn’t protect against infections, herpes, HIV/AIDs, and other infections;
• Must be used with spermicidal gel (or cream);
• Cannot be used during menstruation;
• Can’t be used by everyone, especially not by people who are allergic to silicone and/or spermicide;
• Needs to be inserted before intercourse, stay during it and at least 6 hours after;
• In some cases, it may increase the risk of toxic shock syndrome or urinary tract infections.
• Can slide or be pushed away or moved out of place during intercourse;
• You need to insert your fingers into the vagina to place it and check it regularly if it stays in place before sex;
• In some rare cases it may have some serious side effects such as redness and swelling, irritation, genital itching, burning during urination, blood when you remove it as well as pain while inside. In these cases, it should be removed instantly and you should contact your health provider.

9. Do/don’t use cervical caps if…

As we mentioned before, not everyone should be using cervical caps. Although they are considered pretty safe, still there are situations in which you can and should consider them, but also there are situations in which you shouldn’t use them, like:

Do use cervical caps if:

• They are recommended to you by your health provider and you know which model, type and size works for you;
• You are breastfeeding (after 6 weeks of delivery);
• You need contraception but can’t use hormones;
• You need a reusable, convenient solution that gives you control and doesn’t interrupt your sex;
• You want a prompt return to fertility;
• You do not need a partner’s cooperation for using it;
• In comparison to other contraception like hormonal they have fewer side effects;

Don’t use cervical caps if:

• They weren’t approved and recommended to you by a health provider;
• You are allergic to silicone or spermicide
• You are at high risk of or you have infections, HIV/ AIDs;
• You have a history of pelvic inflammatory disease, vaginal or cervical tissue tears, vaginal bleeding, vaginal, cervical or pelvic infection, cervical cancer, uterine tract infections, toxic shock syndrome, or any other similar infection/disease;
• You had a recent miscarriage, abortion, gave birth or had cervical surgery;
• You had previous bad experiences with vaginal barrier methods, or you have any vaginal/cervical abnormalities or issues which won’t allow a proper fit;
• You are at high risk of pregnancy, you have sex 3 or more times a week;