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Sponge versus diaphragm for contraception: a Cochrane review
M A Kuyoh1, C Toroitich-Ruto, D A Grimes
1Family Health International, P.O. Box 13950, Research Triangle Park, NC 27709, USA.
Contraception
|January 11, 2003
Summary
The vaginal contraceptive sponge is less effective and has higher discontinuation rates than the diaphragm. More research is needed on spermicides for preventing STIs or causing adverse effects.
Area of Science:
- Reproductive Health
- Contraception
- Clinical Trials
Background:
- The contraceptive vaginal sponge offers convenience over the diaphragm, usable for multiple acts without reapplication of spermicide or a prescription.
- It was developed as a user-friendly alternative to the traditional contraceptive diaphragm.
Purpose of the Study:
- To systematically review randomized controlled trials comparing the contraceptive sponge and diaphragm with spermicide.
- To evaluate and compare the efficacy and continuation rates of these two contraceptive devices.
Main Methods:
- Systematic review of randomized controlled trials.
- Inclusion of trials comparing vaginal contraceptive sponge directly against diaphragm with spermicide.
- Analysis of pregnancy prevention and discontinuation rates.
Main Results:
- The vaginal contraceptive sponge was statistically significantly less effective in preventing overall pregnancy compared to the diaphragm.
- 12-month cumulative pregnancy rates were higher for the sponge (17.4-24.5 per 100 women) versus the diaphragm (10.9-12.8 per 100 women).
- Discontinuation rates at 12 months were higher for the sponge (OR 1.3; 95% CI 1.1-1.6), with more allergic-type reactions reported.
Conclusions:
- The diaphragm demonstrates superior efficacy in preventing pregnancy compared to the contraceptive sponge.
- Higher discontinuation rates and increased allergic reactions are associated with the contraceptive sponge.
- Further randomized controlled trials are necessary to clarify the role of spermicides in STI prevention and adverse effects.