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The birth control sponge may sound like a nickname for a condom-clad Spongebob, but it’s a legit form of nonhormonal birth control.

Also known as a contraceptive sponge, the birth control sponge is a polyurethane disc soaked in spermicide that’s designed to be inserted deep into the vaginal canal ahead of P-in-V sex to prevent pregnancy.

The sponge was first introduced to shelves in 1983, and immediately became the most popular over-the-counter contraceptive on the market. Since then, its popularity has decreased significantly as more effective methods have been produced.

With the recent wave of social media gurus pushing nonhormonal birth control options, however, more and more people are asking healthcare professionals about the sponge.

Pros

  • Accessibility. You can buy a birth control sponge without a prescription at most drugstores.
  • Convenience. You can insert a birth control sponge up to a day before having P-in-V sex.
  • Flexibility. You can use a birth control sponge as needed, rather than daily or monthly.
  • Nonhormonal. Using a birth control sponge won’t affect your hormone levels.

Cons

  • The sponge is currently sold out in the United States.
  • Birth control sponges are less effective if you’ve delivered a baby vaginally.
  • They aren’t safe to use during menstruation.
  • Birth control sponges don’t protect against sexually transmitted infections (STIs) — only condoms can do that.
  • The sponge or spermicide may irritate your vagina, increasing your risk of STIs.
  • Insertion and removal require some finesse.

If you’ve never given birth vaginally, the sponge is about 91% effective. If you’ve previously given birth vaginally, the sponge is 76% effective.

Why the difference? Well, the sponge is a one-size-fits-all product — it is not sized to fit the particular dimensions of your cervix.

“Delivering vaginally changes the shape and size of the cervix and cervical opening, which means the same sponge that properly covered your cervix before birth probably won’t after birth,” explains Felice Gersh, MD, author of “PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones and Happiness.”

The birth control sponge may also be slightly less effective for people who recently had a later-term abortion, though there is no data on this.

The sponge works in three ways to keep sperm from fertilizing an egg.

First, “it acts as a physical barrier that physically prevents the sperm from reaching the cervix,” explains Gersh.

If sperm can’t enter the cervix, they can’t reach the uterus or the fallopian tubes, where fertilization occurs. The sponge can also trap and absorb sperm.

“The sponge continuously releases spermicide, which kills the sperm before they even approach the cervix,” adds Gersh.

No, the birth control sponge doesn’t prevent STI transmission.

Internal and external condoms are the only birth control method that reduces the risk of both unwanted pregnancy and STIs.

So, if you don’t know your partner’s STI status or they are STI-positive, pair your sponge with a condom.

The sponge is less effective for people who have previously given birth, experienced pregnancy loss, or had a later-term abortion.

So people who fall into any of the above categories probably want to opt for another, more effective, method.

Given that the sponge is pre-soaked with spermicide, you should avoid this product if you have had an allergic reaction to spermicide. You should also avoid the sponge if you have a polyurethane allergy.

Healthcare professionals also recommend that anyone with a history of toxic shock syndrome (TSS) — a bacterial infection most commonly caused by leaving a tampon in too long — avoid the product, too.

Finally, you need to manually insert the sponge. So, if you don’t like putting your fingers inside yourself or have previously had a bad experience with menstrual cups or menstrual discs, this probably isn’t the best option for you.

Unlike IUDs and implants, which are inserted by a clinician, you’re responsible for placing this pregnancy prevention device inside your body.

While there’s a bit of a learning curve, it isn’t difficult once you get the hang of it.

Here’s how:

  1. Wash your hands with soap and water.
  2. Wet the sponge with clean water like you’d run a sink sponge under water. The sponge should be wet all the way through, but not dripping.
  3. Squeeze the sponge to activate the spermicide. When you squeeze it, it should become sudsy.
  4. Fold the sponge up and away from the loop, so that it is long and narrow like a hotdog.
  5. From a standing, seated, or squatting position, slide the sponge as deeply into your vaginal canal as you can.
  6. Release the sponge. It will unfold and cover your cervix.
  7. Slide your finger around the sponge’s edge to ensure your cervix is covered.

“It may take some practice to figure out whether it’s easier for you to insert the sponge from a standing, squatting, or seated position,” says Gersh. “Everyone has a different preference.”

Immediately.

You can insert the birth control sponge immediately before you have sex, or up to 24 hours beforehand.

You must wait at least 6 hours after having sex to remove the sponge, and you shouldn’t keep the sponge in for more than 30 hours.

Potentially.

If you have a sensitivity or allergy to the polyurethane material of the disc or to the spermicide that the sponge is pre-treated with, you could experience vaginal burning.

“If the sponge or spermicide in the sponge irritates the vaginal tissues, your risk of contracting an STI from a person with an STI increases,” says Gersh. These micro tears function as an entryway for infectious pathogens, she explains.

If the sponge breaks when you’re trying to remove it and you can’t get all the pieces out, it’s important to seek medical attention. Leaving the pieces in your body may cause an infection.

The sponge is also associated with a slightly increased risk of TSS. If left untreated, TSS may cause your body to go into shock and result in organ damage.

You can reduce your risk of sponge-related TSS by:

  • carefully following the package instructions for insertion and removal
  • removing the sponge within 30 hours of insertion
  • using a different birth control method if you’re experiencing vaginal bleeding or menstruation

If you develop a fever, dizziness, or other flu-like symptoms, it could be a sign of TSS. Seek immediate medical attention.

“Using the sponge is going to require some math on your part,” says Dr. Sophia Yen, CEO, and co-founder of Pandia Health.

To prevent pregnancy, you must wait at least 6 hours since P-in-V sex before removing the sponge. But you must remove the sponge no later than 30 hours after initial insertion to prevent side effects or complications.

How is a birth control sponge removed?

  1. Wash your hands with soap and water.
  2. Insert your finger(s) into your vagina and feel around for a little loop.
  3. When you’ve hooked your fingers around the loop, gently pull straight until the entire sponge is out.
  4. Throw the sponge away. Don’t flush your sponge down the toilet, and don’t attempt to reuse it.

If you struggle to pull it out the first go-round, try to remain calm.

When you’re ready to try again, put your foot on the ledge of a toilet or tub. Reach your finger(s) in, then bear down and exhale (as if you were trying to poop). Bearing down helps the muscles inside the vaginal canal contract, pushing the device further out.

To be very clear: Birth control sponges can only be used once. Once a sponge has been removed, it can’t be used again.

But you can immediately pop a new sponge in after removing an old sponge.

The birth control sponge is a nonprescription birth control method, which means you can purchase it on your own.

If you want a new birth control sponge, simply purchase one. Or, buy them in bulk.

What are the side effects of the birth control sponge?

Side effects are uncommon. The most common side effect is irritation from the sponge itself or the spermicide it comes soaked with.

Irritation can cause burning, itching, and general discomfort. It also makes you more susceptible to STIs.

TSS is also a risk in very rare cases.

How many times can you use a birth control sponge?

From when the sponge is in until you take it out, you can have as much sex as you want.

But these devices can only be used once — as in, one period of up to 30 hours — before getting tossed out.

Is the birth control sponge hard to insert?

This answer will vary user-to-user. But if you’ve ever used a menstrual disc or cup and had no problem with insertion, this shouldn’t be an issue either.

Is the birth control sponge uncomfortable?

It shouldn’t be! The person wearing it usually can’t feel it if it’s inserted correctly.

For a penetrating partner, it typically doesn’t feel any different than the rest of the vaginal canal.

Where do you get the birth control sponge?

The only birth control sponge currently being manufactured is Today Sponge.

At one point, it was available at drugstores, pharmacies, and online sites like Amazon.

Unfortunately, at the time of publication, the Today Sponge is out of stock everywhere, with no stated date of when the product will be back in stock.

“We continue to be out-of-stock and out of production. We are unable to advise when or if this situation will change,” the website reads.

Selecting a method of birth control that’s right for you often comes down to finding the right balance between your personal preferences and what’s appropriate for your body based on your medical history.

Use this guide to jump-start your selection process. But talk with a clinician about your options to ensure you’re opting for the one that makes the most sense for you and your partner(s).


Gabrielle Kassel is a New York-based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.