Spermicides

Effectiveness: 71 to 82 percent. (15-29 pregnancies per 100 women each year; when used alone, spermicide is not very effective, but it increases the effectiveness of other barrier methods of contraception).

What is it? Spermicides are chemicals, primarily Nonoxynol-9, that kill sperm. They come in the form of foam, gel, cream, suppository or vaginal contraceptive film.

How does it work? The spermicide chemicals (usually Nonoxynol-9) are inserted deep in the vagina before sex. They block the cervix and stop the sperm from moving, which prevents fertilization of an egg. Follow the product instructions. In general terms, you insert the foam, gel, cream, suppository or vaginal contraceptive film into your vagina, over the cervix. Insert 10 minutes to one hour before intercourse (follow package instructions) and repeat each time you have intercourse. Do not douche for at least 6 to 8 hours after intercourse. Spermicides are more effective when used with a condom, diaphragm or cervical cap.

STD protection: No; you will still need to use condoms if you are concerned about STDs.

Benefits: Spermicides are readily available, relatively inexpensive and can easily be carried with you. They do not affect your natural hormones and can be used when breastfeeding. They can be very effective when used with a condom, diaphragm or cervical cap. Lubrication may increase pleasure.

Disadvantages: Spermicides can be messy, though the vaginal contraceptive film is more discreet. Applying spermicide may interrupt sex play, and you'll need to add more if an hour passes before you have sex. Allergic reactions or irritation are possible. Spermicides taste bad but may be washed off with a damp cloth before oral sex. Some research indicates that frequent use of spermicide may increase the risk of HIV infection by irritating the vagina. Serious complications are rare, but always talk with your health care provider about risks and benefits.

Availability: Readily available at drugstores.

Cost: Varies depending on product. Applicator kit of foam costs about $8 and contains 20 to 40 applications.*

Notes: If one brand causes irritation, consider trying another product. Avoid running out by keeping an extra container on hand.

* The Affordable Care Act requires insurance companies to cover with no co-pay any FDA-approved contraceptive method prescribed by your doctor, including barrier methods, hormonal methods, implanted methods, emergency contraception, female sterilization and patient education and counseling. These estimated costs apply to women who do not have insurance coverage or who work for a "religious employer," who may be exempt from providing contraceptive coverage. For details about what your insurance covers, contact your benefits coordinator or health insurance provider.