Alice,

I have recently become aware of the vaginal contraceptive film (VCF) and am wondering about its effectiveness. We are currently using condoms, but my husband is not thrilled with them. Is the VCF as effective as the condom to use by itself?

Dear Reader,

There are numerous contraceptive methods out there, so props for investigating your options! Vaginal contraceptive film (VCF) is a soluble film — a super thin, wafer-like substance filled with spermicide (chemicals that kill sperm), usually nonoxynol-9 — that's inserted into the vagina before sex, which then "melts," delivering spermicide into the vagina. Nonoxynol-9 works by separating the head from the midpiece of the sperm, which makes it impossible for it to swim up the cervix and join with an egg. Available over-the-counter at most drug stores, nonoxynol-9 spermicide is also available in jelly, cream, foam, suppository, tablet forms, and is coated on some lubed condoms; however, these condoms have been found to offer no more protection against pregnancy than those without spermicidal lube.

VCF, when used alone, is 72 percent effective against pregnancy with typical use, which is significantly less effective than a condom. Condoms, when used consistently and correctly, offer a 98 percent protection rate and an 85 percent protection rate with typical use. VCF seems to be most effective when used as a backup with another form of birth control. As far as sexually transmitted infections (STIs) are concerned, as a barrier method, condoms also protect against STIs. VCF does not protect against them. In fact, spermicide may increase the risk of infection by damaging the tissues in the vagina and causing open wounds in the vaginal walls, allowing for STI transmission.

If you opt to use VCF, it might be helpful to be aware of some usage tips to help reach its maximum contraceptive effectiveness:

  • Using dry, clean fingers, insert one VCF sheet into your vagina, making sure it's placed on or near your cervix, at the deepest point of the vaginal canal.
  • Wait 10 to 30 minutes after insertion to allow the VCF to dissolve in the vagina before having sex.
  • Use a new VCF for each sex session as a single application is good for up to only one hour after initial insertion.
  • After sex, it isn't necessary to clean out the vagina, as the film will naturally dissolve on its own after about six hours.

If you decide to try VCF, there are a few signs to keep an eye out for that could warrant a call to a medical provider, as spermicide is known to cause irritation at times. Changes in smell or color of vaginal discharge, a rash in or around the vagina, the frequent need to urinate, unexplained fever or pain, or pain during sex are all symptoms to indicate if a user is having a reaction.

Finding a form of birth control that you're comfortable with may take some trial and error. To learn more about your options, check out the Contraception category in the Go Ask Alice! Sexual and Reproductive Health archives. Trying various kinds of condoms (e.g., non-latex, lambskin, lubricated, ribbed, etc.) may yield a certain favorite. Other options include both non-hormonal (e.g., such as the contraceptive sponge, a diaphragm, or a copper intrauterine device, among others) and hormonal (e.g., the pill, hormonal intrauterine devices, the contraceptive injection, the ring, the patch) choices. After some discussion, and possibly sampling your options, you might then have the information to help figure out which method may best meet your own needs and the needs of your partner.

Alice!

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