II. Preparations: Models available
- FemCap
- Only available Cervical Cap in U.S,
- Prentif Cavity Rim Cap (Lambert in U.K)
- No longer available in U.S.
- Vimule and many other models available in Europe
III. Efficacy
- Overall failure rate 17.4% (range 7-18% in studies)
- Method failure: 6.3%
- User failure: 11.1%
- Multiparous users have higher failure rate (26%)
- Contraceptive Diaphragm has similar failure rate
IV. Mechanism
- Thimble shaped device fits snugly over Cervix
- Develops slight suction to prevent cap dislodging
- Prevents sperm entry into upper genital tract
-
Spermicide provides extra protection
- Spermicide not required (contrast with diaphragm)
V. Dose: Sizing
- Sizes available (80% of women can be fitted)
- Small: 22 mm internal diameter
- Medium: 25 mm internal diameter (most common)
- Large: 28 mm internal diameter
- Extra-large: 31 mm (rarely needed)
- Fitting pearls
- Cervix Requirements
- Timing of Fitting (very similar to Diaphragm)
- Fit during mid-cycle (Contrast for diaphragm)
- Postpartum: >6 weeks
- Post-Miscarriage or abortion: >2 weeks
- Refit needed after completing Lactation
- Refit needed after 10 pounds weight gain or loss
- Preparation for fitting
- Confirm no pelvic infection
- Empty bowel and Bladder prior to fitting
- Check fitting for:
- Adequate Cervical Coverage
- Proper seal
- Suction rim should be visible after removing
- Positional stability
- Sterilize Cervical Caps between patients
VI. Contraindications
- Toxic Shock Syndrome History
- Vaginal Spermicide allergy
- Latex Rubber allergy
- Anatomical variation of Cervix preventing good fit
- Anteverted Cervix
- Severe cervical Laceration or vaginal septum
- Cervical or uterine malignancy
- Unresolved abnormal Pap Smear or recent cervical biopsy
- Acute Pelvic Inflammatory Disease
- Cervicitis or vaginal infection
VII. Technique
- Can leave in 48 hours (Contrast with 24h for diaphragm)
- Can place 40 hours before intercourse
- Leave in place at least 6-8 hours after intercourse
- Place small amount of Vaginal Spermicide in top of cap
- Place in vagina and apply over Cervix
- Do not use during Menses or to catch Menses
VIII. Adverse Effects
- Increased risk of Urinary Tract Infection
- Allergic Reaction to Vaginal Spermicide
- Vaginal odor if cap left in place too long
- Discoloration and odor if cap is not properly cleaned
- No reported cases of Toxic Shock with Cervical Cap