How the Sponge Works
The sponge is first moistened with water and then inserted into the vagina before intercourse. It covers the cervix and blocks sperm from entering the uterus. It also continuously releases a spermicide that immobilizes sperm, preventing it from joining an egg.

How Well the Sponge Works
Sixteen out of 100 women who have never given birth and use the sponge will become pregnant during the first year of typical use. Nine will become pregnant with perfect use. Of 100 women who have given birth and use the sponge, 32 will become pregnant during the first year of typical use. Twenty will become pregnant with perfect use.

The sponge cannot reduce the risk of sexually transmitted infections.
Latex and female condoms can.

Using the spermicide nonoxynol-9 many times a day, by people at risk for HIV or for anal sex, may irritate tissue and increase the risk of HIV and other sexually transmitted infections.

Advantages of the Sponge
No prescription or fitting is needed to use the sponge. Once learned, the insertion of the sponge is easy, and it

• can be used during breast-feeding
• can easily be carried in pocket or purse
• does not have an effect on a woman's natural hormones
• does not interrupt sex play — can be inserted hours ahead of time and can be worn for up to 30 hours after insertion. During that time, intercourse may be repeated without additional preparation during the first 24 hours.
• generally cannot be felt by either partner

Special Advantages for Teens — Many teen women have vaginal intercourse only now and then.  Many of them prefer to use over-the-counter methods on those occasions.  That way they avoid the possible, ongoing side effects of prescription methods.

How the Sponge is Used
Detailed instructions for correct use are included in the packaging. Be sure to read and understand them before you use the sponge.

Before inserting the sponge, wet it with at least two tablespoons of clean water. Gently squeeze the sponge. The spermicide will become active when the sponge is thoroughly wet. Fold the sides of the sponge upward and away from the loop on the bottom to make it look long and narrow. Then slide the sponge as far back into your vagina as your fingers will reach.

The sponge will unfold and cover the cervix when you let go of it. To make sure the cervix is covered, slide your finger around the edge of the sponge and check its position. You also should be able to feel the nylon loop on the bottom of the sponge.

The sponge can be inserted up to 24 hours before intercourse. It must be left in place for at least six hours after the last act of intercourse. It should not be worn for more than 30 hours in a row.

To remove the sponge, put a finger inside your vagina and through the loop. Pull the sponge out slowly and gently. Use a sponge only once. Always discard a used sponge in a waste container. Do not flush it down the toilet.

Who Can Use the Sponge
The sponge can be used by most women. Some conditions may rule out use:

• allergy to polyurethane, spermicide, or sulfa drugs
• current menstruation
• current reproductive tract infection
• difficulty with insertion
• discomfort with touching one's genitals
• history of toxic shock syndrome
• recent abortion, childbirth, or miscarriage
• vaginal obstructions

Women should not use the sponge during any kind of vaginal bleeding, including menstruation.

Possible Disadvantages of the Sponge
Most women have no side effects. But sometimes

• It may be difficult for some women to insert or remove the sponge. If the sponge cannot be removed, or if it breaks into pieces and you cannot remove all of them, see your clinician immediately to have it removed.
• Some women may notice vaginal irritation while using the sponge.
• Some women complain that the sponge is messy because it requires too much liquid. Others have complained the sponge makes sex too dry. Using a water-based lubricant may help dryness.

Sponge users may be at slightly increased risk of toxic shock syndrome, which is also associated with the prolonged use of highly absorbent tampons. To minimize such risk

• Do not leave the sponge in place longer than 30 hours.
• Do not use the sponge after childbirth, miscarriage, or abortion, until your clinician approves.
• Never use the sponge during any vaginal bleeding.

How to Get the Sponge and What it Costs
The sponge is available at family planning centers, drugnstores, online, and in some supermarkets.

Nationwide, a package of three sponges costs $7.50-$9.  Costs vary from community to community, based on regional and local expenses.