Cervical caps

Various physical barrier devices are available for contraceptive use by men and women. Modem barrier methods such as diaphragms, condoms, and cervical caps were made possible by the discovery of the vulcanisation of mbber. 

The cervical cap birth control device has been available in Europe for many years and in the U.S. since late 1988. It is a small, mbber, dome-shaped device that fits snugly over the cervix. The cervical cap has some advantages over the diaphragm, but has not Hved up to widespread expectations that it would become an overwhelmingly popular method of contraception (100). 

The uptake of TRA into cervical tissue was determined by measuring tissue radioactivity following insertion of the collagen sponge cervical cap containing tritium-labeled TRA. The TRA concentrations peaked at 4 hr and then diminished rapidly by 24 hr. Since measurements of blood samples revealed that no systemic absorption had occurred, high local concentrations over an extended period of time may be possible without systemic side effects. 

Clinical trials (60,61) have shown that TRA can be safely delivered topically using the cervical cap and collagen device. In these studies the TPA was applied as a cream to the sponge, which was then inserted into the vaginal vault. A new device was used daily for up to 4 days. Systemic effects were minimal, and local toxicity was dose-related and acceptable. 

The cervical cap, smaller and less messy than the diaphragm, fits over the cervix like a thimble. Caps can be inserted 6 hours prior to intercourse, and women should not wear the cap for longer than 48 hours to reduce the risk of toxic shock syndrome. 

Cervical cap (FemCap, Leah s Shield) Allergy to spermicide History of TSS Abnormal gynecologic anatomy Abnormal Papanicolaou smear Low cost Latex-free Some protection against STDs FemCap reusable for up to 2 years High user failure rate Decreased efficacy with parity Cannot be used during menses 9 ]6b... 

Condom, diaphragm, or cervical cap with contraceptive or antimicrobial agent (including virucidal) agent. 

Conjugated estrogens vaginal cream exposure has been reported to weaken latex condoms. Consider its potential to weaken and contribute to the failure of condoms, diaphragms, or cervical caps made of latex or rubber. 

There are numerous choices of contraception for women, and the efficacy and costs of each must be balanced when giving advice, both to the individual and to the community at large. Hormonal contraception is still the most effective method of fertility control, and in this section only hormonal contraception will be considered. However the relative merits of other methods such as intrauterine contraceptive devices (lUCDs), condoms, and vaginal or cervical caps should be kept in mind as alternatives. Condoms in particular have important advantages in limiting spread of sexually transmitted disease. 

Antibiotic peptides and peroxides or peroxidases can also be introduced to enhance the vaginal defense mechanisms. FemCap (manufacturers of the cervical cap) are currently developing a gel that contains N-9 and hydrogen peroxide. The peroxide component minimizes the adhesion of microbicides to the vaginal wall, and kills a number of pathogens and enhances the effects of N-9 [117]. 

Cervical cap Allergy to rubber or Low cost High user failure rate 6 18... 

The effectiveness of barrier methods and spermicides depends almost exclusively on a couple s motivation to use them consistently and correctly. These methods include the diaphragm, cervical cap. 

The Prentif cervical cap is a soft, deep, rubber cup with a firm round rim that is smaller than a diaphragm and fits over the cervix like a thimble. Spermicide is used to fill the cap one-third full prior to insertion and is held in place against the cervix until the cap is removed. The cap remains effective for more than one episode (up to 48 hours) of intercourse without adding more spermicide thus it is less messy to use than a diaphragm. However, because of the limited number of sizes, it may not be possible to fit some women with this device. It is recommended that women not wear the cap for longer than 48 hours to reduce the risk of toxic shock syndrome. A recent review by the Cochrane Library found that the Prentif cap was as effective as... 

Gallo ME, Grimes DA, Schulz KE. Cervical cap versus diaphragm for contraception. Cochrane Review 2003 3. 

Cervical cap—A thimble-shaped latex rubber device which is held on the cervix by suction, thus acting as a barrier to reduce the risk of pregnancy. 

The physical barriers include diaphragms and cervical caps made of rubber that fit in the vagina over the cervix. They are mechanical barriers to block the passage of sperm and are often used with spermicidal agents, such as nonoxynol (a surfactant 16.10). 

Contraception and Sterilization. Some applications of reproductive science are intended to prevent, not facilitate, impregnation. Most of the available contraceptive methods are designed for use by the female partner alone, although a few are meant for shared use or use by the male partner alone. Barrier methods, such as the sponge, the diaphragm, the male and female condoms, and the cervical cap, prevent sperm from reaching the egg inside the Fallopian tube. Hormonal methods, such as the pill, the... 

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