Cervical Cap – A Birth Control Method

When it comes to birth control, many couples largely opt for condoms and contraceptive pills. While condoms suffer from a slightly higher rate of failure, contraceptive pills being hormones themselves, interfere with the hormonal balance of the woman’s body. Other natural hormone-free options like implants and intrauterine devices (IUD) come as long-time fixtures inside the woman’s uterus, which can make it difficult to remove when necessary. A very safe and natural alternative to these methods is the cervical cap. The cervical cap is growing in its popularity as a contraceptive owing to its innumerable benefits over other conventional birth control methods.

What Is a Cervical Cap?

A cervical cap is a small cup-shaped reusable and temporary contraceptive device, used by women to prevent unplanned pregnancies. Contrary to the intrauterine barriers like IUD, the cervical cap can be inserted and removed as and when required, by the woman at any place and time. The cervical cap, made of medical-grade silicone, is shaped like a small hat. It has a small dome-shaped structure encapsulated inside a loop. Before sexual intercourse, the woman can insert it into her vagina, in such a way that the dome covers the cervix. This effectively blocks the path for the sperm to enter the uterus. The loop-shaped structure has a broader side and a narrow side to it. It gets rolled while inserting into the vagina and then uncurls back when it reached the cervix.

The cervical cap is always used along with a spermicide. A spermicide is a substance that has chemicals that can kill sperms. Before inserting the cervical cap, a prescribed amount of spermicide is applied on to the deep groove on the underside of the cap and inserted. This gives double-layered protection against the incoming sperms, by creating both a physical and chemical barrier.

Is It Safe to Use a Cervical Cap?

Cervical caps are safe for the body as they are latex-free and hormone-free. The silicone material used in manufacturing the cervical cap is of medical-grade, making it a hostile surface for the growth of any micro-organism. However, it can be unsafe for women with a history of toxic shock syndrome or with any cut or injury in the vagina or cervical area. The spermicide, used along with the cervical cap, is mostly safe for women except for a few of them who have allergic reactions to it.

Effectiveness of Cervical Cap

The cervical cap has a reported effectiveness of 82-91% in preventing pregnancies. The cap is more effective in women who have not had any vaginal delivery before compared to those who have had a natural delivery. Although contraceptive pills have a slightly higher success rate than the cap, this method of birth control is preferred by many as it is natural and has very fewer side effects.

How to Make Your Cap More Effective for You

The use of a cervical cap is usually recommended along with a spermicide. The spermicide effectively deactivates and kills the incoming sperm. When used alone, the cervical cap only provides a physical barrier, but when used along with a spermicide the chances of pregnancy are reduced further, thereby increasing the efficacy of this method of contraception. Along with the cap, other methods like condom can be used to increase the success rate.

Benefits of Using Cervical Cap

There are many benefits of using a cervical cap over other methods of contraception.

• Caps are hormone-free and its use does not affect the hormonal balance of the body.
• It does not interfere with the sexual pleasure for either of the partners, as it is mostly undetectable while in use.
• It does not require any medical intervention or guidance for regular use.
• As the cervical cap is made of medical-grade silicone material, it does not carry the risk of developing any toxic shock and can safely be worn for up to twelve hours.
• When used with a spermicide, it gives protection against some sexually transmitted diseases also.
• It does not have any recurrent maintenance cost.
• It can be used for multiple intercourses without the hassle of removing and inserting it every time.
• It does not impede the intercourse, as it can be worn much ahead of time.
• As it is very small in size, it can be easily carried to any place.
• It can be safely used by women who are breastfeeding their babies.

How to Use it

The cervical cap is relatively simple to use. It can be a little difficult for the first time, but with use, most of the women don’t even realize its presence inside their vagina. Here is a stepwise guide to using the cap.

Pre-preparation:

Before inserting the cap into the body, you must take a couple of precautions. Wash and clean your hands and the cervical cap before use. If you are using it for the first time, try inserting and removing it before the actual intercourse, to get an idea of using it. Once you are confident about inserting and removing it, try keeping it for at least six hours in the cervix to check for any discomfort or irritation. Ideally, most women do not feel its presence after a couple of uses. Once you are confident about using it go ahead and use it for contraception. During the first time of intercourse with the cervical cap, keep other birth control aids handy to use if you face any issue with the cap.

Inserting:

During every use of the cervical cap, wash it thoroughly with sterile water and clean it. After sanitizing it, check for any leaks or damages in the cap. After ensuring its intactness, apply a ¼ teaspoon of spermicide in the cup-shaped structure of the cap. Apply some more of the spermicide in between the dome and the brim on the other side. Now it is ready for being inserted into the vagina. Typically, the cap has to be inserted at least fifteen minutes before the intercourse. Inserting the cap requires some practice and during the first few attempts, you can take the help of your doctor. To insert the cap, open your legs wide and sit in half squatting position. With clean hands, squeeze the two side of the rim to make them meet each other. When it is rolled into a cylinder-shaped structure, insert it up into the vagina, all the way up to the mouth of the cervix. When you reach the cervix, release the hand for the cap to unfurl and seal the cervical opening. You can also insert the cap while lying down with a raised knee or while keeping one leg on a chair. You can check the various tutorial videos available on the techniques of inserting the cap, for a better idea.

After inserting check if the cap has covered the cervix properly by inserting a finger into the vagina. You can remove and reinsert it if you feel that the cap has not positioned itself properly.

Removal:

After intercourse, you have to leave the cap inside for a minimum of six hours. You can also check immediately after intercourse if the cap has dislodged from its place. In the case of the cap shifting its place inside the cervix during or after sex, immediately take birth control pills to avoid any unintended pregnancy.

For removing the cap, squat your legs as you did for inserting and remove the cap by pulling the removal strap. Always use clean fingers to remove the cap and gently give the dome a push to overcome the suction pressure, before removing. After removal, clean the cap with soap and water and dry it thoroughly before storing it is a cool, dry and sterile place. Check for any holes or leaks in the cap before putting it aside.

Where to Get It

The cervical caps are usually available in drug stores and in select health care centres. In the United States, it can be purchased from a drug store only with a valid prescription from a medical practitioner. It can also be purchased online from the manufacturer’s website or from other online shopping sites. It is typically available in three different sizes to fit women with different vaginal canal diameters. An assessment of the vaginal canal measurement can be done by certified medical practitioners. Choosing the correct size critically affects the efficacy of the cervical cap. The Femcap is available in diaphragm sizes of 22mm, 26 mm and 30 mm. The 22 mm cap is designed for smaller women or those who have never been pregnant or have not had a vaginal delivery before. The 26 mm cap is suitable for pregnant women or women who have been pregnant for a short time without having a vaginal delivery and the 30 mm cap is suitable for women who have had a vaginal delivery before. Women can choose the cap depending on their size and purchase it from any one of the above-mentioned sources.

How Much Does the Cap Cost?

Cervical caps are one of the most cost-effective contraceptive options in the market. The reusability makes the cap a very economical option. The cervical cap manufactured and marketed as Femcap in the United States and some other countries come at a price point of approximately Rupees 17,000 in India. As a one-time investment, this product comes with very low maintenance cost and reusability.

Disadvantages 

There are a couple of disadvantages associated with the use of the cervical cap. They are,

• There are some chances of the cervical cap slipping out during the process of intercourse. This can be very inconvenient and unsafe.
• It cannot be used during the time of the menstrual cycle.
• It requires the use of spermicide, to which causes allergic reaction or irritation in some women.
• Some women find it slightly uncomfortable and distracting.
• There are chances of wrongly inserting it inside the vaginal cavity, thereby giving way for some misfit.
• Some women find it uncomfortable to insert and remove as it involves the use of the finger in the vagina.
• The rate of successfully avoiding unintended pregnancy is still not very high compared to other birth control measures. The success rate is especially low in women who have already had a vaginal delivery.

Difference Between Cervical Cap and Diaphragm

The mechanism of action for a diaphragm and a cervical cap is more or less similar, but they fundamentally differ from each other in certain aspects. Although both of them act by forming a barrier on the cervix, the design in which the cap and diaphragm are constructed is slightly different. The diaphragm is designed in the shape of a dish, while the cervical cap looks like a sailor’s hat. The metal ring of the cup-shaped structure of the diaphragm exerts a slight pressure on the walls of the vagina, which is absent in the case of the cervical cap. For easy removal, the cap has a removal strap, whereas the diaphragm lacks such a provision.

Diaphragms come in nearly ten different sizes and the guidance of a medical practitioner is necessary to identify the correct size. The size of the cervical cap can be easily decided based on whether the woman has had a pregnancy and/or a vaginal delivery. The success rate with the diaphragm is slightly higher than the cervical cap.

Risks of Using Cervical Cap

There are a few risks associated with the use of a cervical cap, which couple should be aware of before using it.

• It does not offer protection against many of the sexually transmitted diseases. If one of the partners is affected with STD, then use of cervical cap does not offer any protection from its transmission.
• Use of spermicide may cause irritation and allergic reaction in some women. It may even increase the risk of catching a sexually transmitted disease, as it alters the balance of microorganisms in the vagina.
• There are chances of the cervical cap getting dislodged during intercourse, exposing the couple to the risk of unintended pregnancy.
• Leaving the cervical cap for more than 24 hours inside the vagina exposes the woman to the risk of toxin shock.

Who Should Avoid Using the Cervical Cap

Cervical caps might not be the best choice for contraception for women with certain conditions. Here are some of them.

• Women with urinary tract or vaginal infection should avoid using the cervical cap, as it increases the risks associated with the infection.
• Menstruating women should not use the cervical cap.
• Women with weak muscles in the vagina must avoid the use of the cervical cap.
• Women with cuts or injuries in the vaginal or cervical area, should not opt for the cervical cap.
• As the cervical cap is made of silicone material, women who have had a history of toxic shock syndrome should avoid the usage of the cap.
• Women who are not comfortable in inserting their finger through the vagina can avoid the cap.
• Women who have had any surgery in any of the reproductive organs.
• Women who have been diagnosed with a malignancy in the reproductive organs.
• Women who have had an abortion or missed pregnancy six weeks before the intercourse.

FAQs

1. When to buy a new cap?

Cervical caps are reusable birth control aids. You can use it multiple times while it is inserted into the cervix or it can be cleaned and reused. It can be replaced after using it for a year or two, based on the frequency of usage. To check the intactness of the cap, closely examine it for any damage or cuts. You can check for any leakages by pouring water into it. You can also take it to your doctor, after a year to get it certified for use. Apart from wear and tear, the fit and size of the cap also have to be reassessed once a year to ensure that there is no room for any leakage. This also can be done with the help of a certified medical practitioner.

2. How soon after childbirth can I start using cervical barrier?

Cervical caps are not ideally recommended for use by new mothers. The cervical cap can be used only eight to ten weeks after the delivery.

3. Is it safe to use cervical barrier while breastfeeding?

Cervical caps do not contain any hormones in them. Therefore, it does not interfere with the balance of hormones in the body. As it only creates a physical barrier, it is completely safe to breastfeed your baby while using a cervical cap. The spermicide used along with the cervical cap also does affect the breastfeeding.

4. Is it safe to use the cap on my periods?

No. Caps are not recommended for use during the menstrual cycle. The cap that seals the mouth of the cervix, acts as a barrier to the flow of blood. This can cause unwanted effects on the body. In fact, the use of a cervical cap during any vaginal blood discharge is not advisable.

5. Does the cap prevent the transmission of STDs?

The use of the cervical cap is not recommended if either of the partners is affected by the sexually transmitted disease. It does not offer any protection against the transmission of the microorganisms causing the STD. In such cases, use of a condom can offer better protection than the cervical cap. Also, the spermicide used along with the cap increases the chances of infection and may aggravate it further.

6. What to do if the cap gets dislodged during sex?

There are chances for the cervical cap to get dislodged during sex and expose the couple to the risk of an unexpected pregnancy. If the cap dislodges after ejaculation, then you must resort to taking the emergency birth control pills called the ECPs. These pills ensure that the fertilization is prevented in the uterus. You can also consult your doctor if you are doubtful about the effectiveness of the pills.

Among the safe and effective contraceptives available in the market, the cervical cap is undoubtedly one of the best tools for birth control. More and more women are exploring the option of using the cervical cap, besides the conventional condoms and contraceptive pills, because the caps are harmless and do not affect the hormonal balance of the body.