Contraceptive Sponge is Back on the Market But Contains Nonoxynol-9

Richard J. Fehring
Reprint from Current Medical Research
Vol 15, No 1-2, Winter/Spring 2004
Washington, DC
Reproduced with Permission

According to an article in The Alan Guttmacher Institute's journal, Perspectives on Sexual and Reproductive Health, the Today contraceptive sponge is back on the market.1 The Today sponge is a polyurethane type intravaginal device that is placed over the cervix. The sponge contains and releases the spermicide Nonoxynol-9. The Today sponge was taken off the market in 1995 because the manufacturer failed to meet Food and Drug Administration (FDA) standards. Another manufacturer has bought the copyrights for the Today sponge and is currently shipping the device to Canadian markets. The new manufacturer does not yet have FDA approval but the device is available on the Internet.

Of interest is a recent study showing that multiple use of Nonoxynol-9 could cause toxic effects and actually enhance the HIV-1 infection rate. Belgium researchers tested the effectiveness of a vaginal gel spermicide with Nonoxynol-9 to prevent sexually transmitted diseases among 892 female "sex workers" in four countries (Benin, Cote d'Ivoire, South Africa, and Thailand).2 The researchers randomized the workers into a Nonoxynol-9 group (N = 449) and a placebo gel group (N = 443). The primary outcome was the rate of HIV-1 infection. They also followed the rates of gonorrhea and chlamydia infections between the two groups. Among the workers who used the gel at least an average of 3.5 times a day there was almost twice the rate of HIV-1 infections among the Nonoxynol-9 gel users than the placebo group. When the rate of use dropped to less than 3.5 times a day there was no difference between the two groups in HIV infections. The researchers also found no differences in the rate of gonorrhea and chlamydia infections. The researchers concluded that the nonoxynol-9 gel could cause toxic effects that enhance HIV-1 infections and that the drug should no longer be considered a potential protection from HIV infection.


If Nonoxynol-9 can cause toxic effects on the cervix and vagina I would think twice about using the Today sponge as a contraceptive method. The FDA should take into account these findings before approving the Today Sponge for use in the US.


1 Hollander, D. The sponge bounces back. Perspectives on Sexual and Reproductive Health. 2003;March / April. [Back]

2 Van Darnme, L., Ramjee, G., & Alary, M, et al. Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomized controlled trial. Lancet. 2002;360:962-3. [Back]