Cervical Cap

What is a Cervical Cap?

A cervical cap, also known as a FemCap or cervical cover, is a small silicone cup that is inserted into the vagina in order to prevent pregnancy. Suction allows the cap to be seated over the cervix, blocking sperm from entering the uterus and preventing fertilization. In order to be used as effectively as possible, the cervical cap should be used in conjunction with a spermicidal cream or jelly.

Effectiveness

When deciding which birth control method is best, the user’s primary concern is often efficacy. Like any other type of contraception, a cervical cap is most effective when used correctly and consistently. The perfect use rate for preventing pregnancy using a cervical cap is 96%. When properly fitted, cervical caps have typical use rates of 84-91% for women who have never given birth and 68-74% effective for women who have previously given birth.

The cervical cap needs to seal the cervix as tightly as possible to prevent sperm from fertilizing an egg. Women who have given birth naturally may have stretched cervixes because theirs dilated so the baby could pass through the vaginal canal. The cervix may also have been cut or torn during birth, leaving behind scar tissue that can misshape the cervix. Even postpartum after the cervix shrinks back from its dilated state, it may be slightly misshapen and seldom returns to its unpregnant size.  The varieties of shapes and sizes that the cervix may take can make attaining a strong seal more challenging. As a result, the cervical cap is most effective for women who have not previously given birth.

How To Use the Cervical Cap

The effectiveness of the cervical cap depends on how well it fits. There are many sizes and shapes of cervical caps to fit differently sized and shaped of a cervixes. An initial fitting is conducted in a medical clinic, where a medical practitioner will demonstrate the proper insertion, removal, and usage techniques. Caps are not recommended for use during menstrual periods. It is important to practice properly inserting and removing your cervical cap before engaging in sexual activity with a partner.

 

 

Insertion

  • Wash hands thoroughly with soap and water.
  • Prepare the cervical cap by filling it about one-third full with spermicide, while spreading a thin layer around the brim. Be careful not to spread too much around the edge, as this could cause the cap to slip off the cervix during sexual intercourse.

  • Put about one-half of a teaspoon of spermicidal jelly between the crease of the dome and the brim.
  • Find a comfortable position to insert the cap. You can stand with one foot on a chair, lie down, sit on the edge of a chair with knees parted, or squat.
  • Using one hand, put your index and middle fingers into the vaginal canal to locate the cervix.
  • Now that you know where to place the cap, separate the labia with one hand and squeeze the outer edge of the cap with the other hand. With the cervical cap’s dome facing down, push it far into the vagina with the long brim side entering first.

 

  • Use a finger to position the cap over the cervix.
  • Make sure that the cervix is completely covered by running a finger around the cap’s edge. Test the seal of the cap by gently tugging on it; there should be some suction and resistance.

Removal

After each time you engage  in intercourse, confirm that the cervical cap is still covering the cervix. If one wishes to have sex again the cap can be left in place, and more spermicidal jelly can be inserted into the vagina. A cervical cap must be left in place for 8 hours after intercourse and may stay in place up to a total of 48 hours in anticipation of further sexual activity. In order to remove the cervical cap, follow the steps below.

  • Wash hands thoroughly with soap and water.
  • While squatting down, grip the removal strap, and use a finger to break the suction at the rim of the cap.
  • Use the removal strap to pull the cervical cap out of the vagina.

Caring for Your Cervical Cap

A well-maintained cervical cap can last up to two years if properly cared for. Cleaning a cervical cap is simple.

  • After the cap has been removed, wash it with a small amount of mild soap and warm water.
  • Allow the cap to air dry.
  • If odors persist after use, soak the cap in a solution of lemon juice and water. Air-dry the cap after soaking. Repeat the process as necessary until any lingering smell is gone.
  • Do not use any powders to clean the cap as this can cause infections.

Be sure to check the cap regularly to make sure it stays effective and in good working condition. You can hold the cap up to light or fill it with water to look for tears or small punctures.  A cervical cap may still be used if it becomes discolored over long-term use, but if any holes or weak spots form talk to your physician about obtaining a replacement.

 

To prevent wear, do not use oil-based lubricants or douche while the cervical cap is in place. Oil-based lubricants can weaken or damage the silicone material, and douching weakens the spermicidal jelly. Please note that a cervical cap should only be used by you and you alone. Do not share the cap with friends.

 

Refitting

Giving birth or having an abortion will often affect the cervical cap’s ability to create a seal around the cervix. After an abortion or a birth it is recommended that a medical provider check to that the cap is still fitting properly.

 

Where Do I Get a Cervical Cap? How Much Does it Cost?

In order to obtain a cervical cap, visit your preferred health care provider, clinic, or Planned Parenthood health center. During your appointment, a health care professional will examine you and consider your health background to determine whether a cervical cap is an appropriate method of contraception. Your health care provider will assist you in locating the correct size cap, give you information for its proper use, and demonstrate the proper insertion and removal techniques. If you have been approved for a cervical cap in the United States, a physician will give you a prescription for the FemCap.

The FemCap is available in three sizes:

  • Small, for women who have never been pregnant
  • Medium, for women who have previously had an abortion or cesarean delivery
  • Large, for women who have given birth vaginally

With a prescription, a cervical cap can be purchased at a clinic or local drug store.

The typical cost of a preliminary examination ranges from $50 to $200. The cervical cap itself costs an average of $60 to $75, while spermicidal jelly or cream costs $8 to $17 per kit. If the cost of a cervical cap is an issue for you, some health care providers may be able to adjust the price according to your income.  Statewide health care programs or Medicaid may provide financial assistance when purchasing this form of contraception.

Advantages of Cervical Cap Use

Use of a cervical cap is a safe, simple, and convenient way to prevent pregnancy. Many women use the cap because:

  • It is small, comfortable, and easy to carry around in a small bag or pocket
  • It is immediately effective upon insertion and can be removed at any time
  • It usually cannot be felt by a partner
  • It has no effect on the natural hormones a woman produces
  • The cap can be inserted many hours ahead of time, so as not to interrupt sexual activity
  • It can be used during breastfeeding
  • It does not affect future fertility
  • It may help you get to know your body better
  • It helps protect against pelvic inflammatory disease (PID) and cervical cancer

Disadvantages of Cervical Cap Use

Considering all of the benefits and risks when choosing a type of contraception is an important aspect of the decision making process. The possible disadvantages of the cervical cap include that it *

  • cannot be used during menstruation
  • may be difficult to insert for certain women
  • may be dislodged in certain sexual positions or under heavy thrusting
  • must be in place every time a woman wishes to engage in vaginal intercourse
  • may need to be replaced with a larger diameter cap after an abortion or pregnancy
  • does not protect against sexually transmitted infections
  • requires a prescription from a heath care provider

Health and Side Effects

Most women who use the cervical cap have no problems, but some may experience some side effects.

  • On occasion, women may experience an allergic reaction or vaginal irritation to the type rubber/silicone of the cervical cap.
  • Spermicidal jelly may also cause an allergic reaction or irritation. Most spermicides contain nonoxynol-9, which has its own set of risks. If it is used many times per day, or by those at risk for HIV, it may irritate vaginal tissue and increase the risk of  contracting HIV and other sexually transmitted infections.  If you begin to experience irritation from spermicidal jelly that contains nonoxynol-9, try a spermicide that does not include this chemical.

 

Although serious side effects when using a cervical cap are exceedingly rare, check with a health care professional if you experience the following:

  • Feel a burning sensation while urinating
  • Are uncomfortable while the cap is in place
  • Have irregular bleeding or spotting
  • Feel irritation or itching in the genital region
  • Have redness or swelling of the vulva or vagina
  • Have unusual discharge from the vagina

Though most of these symptoms are easily treated, they may be a sign of infection or other contagion. Cervical caps are not recommended for women who have Toxic Shock Syndrome, a bacterial infection that causes fever, shock, and impaired organ function. Always speak to a physician if complications begin to arise.

 

References

"Birth-Control-Comparison.info from Cedar River Clinics." BirthControlComparisoninfo from Cedar River Clinics. N.p., n.d. Web. 24 Apr. 2014.

"Cervical Cap (FemCap)." Cervical Cap. N.p., n.d. Web. 24 Apr. 2014.

"Toxic Shock Syndrome." Definition. N.p., n.d. Web. 24 Apr. 2014.

 

Last Updated 24 April 2014.

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