%0 Journal Article
%T Vaginal contraceptives merge old forms, new data.
%J Contracept Technol Update
%V 4
%N 7
%D Jul 1983
%M 12339358
暂无%X At the recent conference of the American College of Obstetricians and Gynecologists (ACOG), health care professionals concluded that, while there has been much speculative information in the past few years about the risks involved with vaginal contraceptives, women often prefer them over oral contraceptives (OCs) or an IUD.  Dr. Gerald S. Bernstein, noted at the cervical cap symposium, sponsored by the Atlanta Feminist Women's Health Center, that the following are the most common vaginal contraceptive methods:  solid barriers (cervical caps and diaphragms); vehicle barriers (contraceptive foams, creams, suppositories); or spermicides.  Bernstein cited as major advantages of the methods their local action, their lack of systemic effects, and the few contraindications they may cause.  The disadvantages included a requirement for user motivation, the association of some methods with coitus, inconvenience, messiness, and the necessity of manipulation.  He also emphasized that the methods are less effective than the OCs or IUD in preventing pregnancy.  Major safety issues or risks concerning vaginal and barrier methods are the toxicity of spermicides, effects of using spermicides after the user is pregnant, and trauma caused by some solid barriers.  Whether or not spermicides used after a pregnancy occurs can cause congenital anomalies is still an unanswered question.  It was Bernstein who discovered that the Vimule cervical cap could cause vaginal lesions of the portio vaginalis cervicis, ranging from erythematous impressions to abrasions and lacerations.  He emphasized that trauma by a mechanical contraceptive device is probably not restricted to the Vimule cap.  At this time Bernstein is completing a study to determine how long women should leave their cervical caps in place.  Commenting that the cap is not yet approved for producation in the US, Dr. Daniel Mishell said at the ACOG conference that the vaginal contraceptive sponge is an attractive new means of vaginal contraception.  The sponge, approved by the US Food and Drug Administration for 24 hour use, contains spermicide and is expected to have an efficacy rate similar to the diaphragm--in the 85% range.  A new clinical study of women using the diaphragm with 2% nonoxynol-9 gel shows a failure rate much lower than average for other vaginal contraceptives.  Dr. Bohdan Malyk reported that the combined method used in the 12-month independent study show a failure rate of 2.4%.