II. Indications

  1. Use with contraceptive barrier methods
    1. Cervical Cap
    2. Contraceptive Diaphragm

III. Preparations

  1. Nonoxynol-9 (Gynol II)
    1. Shortens Condom shelf life and is more costly
    2. Highest concentration (150 mg) is most efficacious
      1. Failure rate is still 14% at 150 mg
      2. Overall failure rate for all concentrations: 22%
      3. Raymond (2004) Obstet Gynecol 103:430-9 [PubMed]
    3. Do not use for STD protection
      1. Does not increase Condom efficacy
      2. Does not protect against Gonorrhea and Chlamydia
        1. Roddy (2002) JAMA 287:1117-22 [PubMed]
      3. Increases risk of Gonorrhea
        1. Richardson (2001) Sex Transm Dis 28:394-400 [PubMed]
      4. Increases HIV risk (disrupts vaginal epithelium)
    4. References
      1. Apgar (2003) AAFP Board Review, Seattle
  2. Octoxynol-9
  3. Benzalkonium
  4. Phexxi
    1. Contains Lactic Acid, citric acid and Potassium bitartrate
    2. Marketed as a "vaginal contraceptive gel" but it is simply a Spermicide
    3. No more effective than other barrier methods (14% will become pregnant in 7 months)
    4. Very expensive ($270 per 12 applicators)
    5. One applicator intravaginally up to 1 hour before intercourse and must be reapplied for each episode
    6. Does not protect against STDs (use Condoms)
    7. (2020) presc lett 27(9): 52
  5. Homemade Spermicide (anecdotal with unproven efficacy)
    1. Aloe Vera Gel: 1 Tablespoon
    2. Lemon juice: 3 drops
    3. Keep refrigerated for no longer than 72 hours
    4. Reference
      1. Summerhayes (1999) CMEA Women's Health, San Diego
      2. Oyelola (1987) Contraception 36(4):435-40 [PubMed]

IV. Mechanism

  1. Spermicide attacks sperm acrosomal membranes
  2. Breakdown of membranes immobilizes sperm
  3. Spermicide delivered in base to adhere to Cervix

V. Efficacy

  1. Overall Failure rate: 21% (3-31%)

VI. Technique

  1. Allow time for activation and well timed for sex
  2. Reapply Spermicide for repeat intercourse
  3. No douching for 6 hours post intercourse

VII. Disadvantages

  1. Sex may need to be interrupted to apply
  2. Messy or difficult to apply
  3. Unpleasant smell or taste

VIII. Adverse Effects

  1. Allergy to Spermicide in 2-4% of men and women

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Related Studies

Ontology: Spermatocidal Agents (C0037862)

Definition (NCI) A chemical product that is deleterious to sperms and can be in the form of either a jelly, foam, or cream.
Definition (MSH) Chemical substances that are destructive to spermatozoa used as topically administered vaginal contraceptives.
Definition (CSP) agent destructive to spermatozoa.
Concepts Pharmacologic Substance (T121)
MSH D013089
SnomedCT 425484006, 169528000, 108901002
English Agents, Spermatocidal, Agents, Spermatocidal Contraceptive, Agents, Spermicidal, Agents, Spermicidal Contraceptive, Contraceptive Agents, Spermatocidal, Contraceptive Agents, Spermicidal, Spermatocidal Contraceptive Agents, Spermicidal Agents, Spermicidal Contraceptive Agents, Drugs, Spermatocidal, Spermatocidal Drugs, Spermatocides, Spermicide, Spermicide (substance), spermaticide, Spermatocidal Agents, spermicides, spermicides (medication), spermicidal contraceptives, spermicide, spermicidal agents, Spermicidal contraceptive, Spermicidal contraceptives, Spermicides, Spermicides (product), Spermicides (substance)
French Contraceptifs spermicides, Agents spermicides, Spermicides
Swedish Spermiedödande medel
Czech spermicidy
Spanish espermicida (sustancia), espermicida, Espermicidas, Espermaticidas, Agentes Espermicidas, Agentes Espermatocidas, Espermatocidas, espermicidas (producto), espermicidas (sustancia), espermicidas
Finnish Spermisidit
Japanese 殺精子剤, 殺精子物質, 殺精子薬, 殺精薬
Italian Spermatocidi, Contraccettivi spermicidi, Spermicidi
Polish Czynniki plemnikobójcze
Portuguese Espermicidas, Espermaticidas, Agentes Espermicidas
Norwegian Sæddrepende midler
German Spermatozide, Spermizide Mittel

Ontology: Nonoxynol (C0068943)

Definition (MSH) Nonionic surfactant mixtures varying in the number of repeating ethoxy (oxy-1,2-ethanediyl) groups. They are used as detergents, emulsifiers, wetting agents, defoaming agents, etc. Nonoxynol-9, the compound with 9 repeating ethoxy groups, is a spermatocide, formulated primarily as a component of vaginal foams and creams.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D017137
SnomedCT 326454008, 397179004
English Nonoxinols, Nonoxynols, Nonoxinol, Nonoxynol, Nonylphenoxypolyethoxyethanol, Nonylphenoxypolyethoxyethanols, Poly(oxy-1,2-ethanediyl), alpha-(4-nonylphenyl)-omega-hydroxy-, Nonoxynol [Chemical/Ingredient], nonoxynol, nonoxinol, Nonoxinol (product), Nonoxynol (substance), Nonoxinol (substance), NONOXYNOL
Swedish Nonoxynol
Czech nonoxynol
Finnish Nonoksinoli
French Nonoxinol, Nonoxynol, Nonylphénoxy polyéthoxyéthanol, Nonoxynols
German Nonoxinol, Nonoxynol, Nonylphenoxypolyethoxyethanole
Polish Nonoksynol, Nonylofenoksypolietoksyetanole
Japanese ノニルフェノキシポリエトキシエタノール, ノノキシノール9, ポリオキシエチレンノニルフェニルエーテル, Cフィルム, マイルーラ, ノノキシノール
Norwegian Nonoxynol
Spanish nonoxinol (producto), nonoxinol (sustancia), nonoxinol, Nonilfenoxipolietoxietanoles, Nonoxinol
Italian Nonossinolo
Portuguese Nonilfenoxipolietoxietanóis, Nonoxinol