Cervical cap

form of barrier contraception

The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the os.

The cervical cap is an ancient method of contraception revitalized during the 1970s by feminist health care practitioners. It acts as a contraceptive both mechanically and chemically. ~ Deborah Boehm

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The cervical cap, used even in antiquity, has been modified and improved so that it now promises to be an effective, safe, and convenient method of fertility control. Gynecologist U. Freese and dentist R. Goepp, working at The University of Chicago, have combined the techniques of their 2 disciplines to provide this improved form of the cervical cap. Using dental techniques, a method has been established for fitting the cervical cap exactly to the individual cervix. ~ C Arthur
 
[U]se of the cap should probably not be encouraged as a primary means of contraception, but should be reserved for those women with multiple contraceptive problems or for highly motivated women who seek out this means, understand its limitations, and can accept the relative uncertainty of its effectiveness. ~ Joann M. Johnson
  • The cervical cap, used even in antiquity, has been modified and improved so that it now promises to be an effective, safe, and convenient method of fertility control. Gynecologist U. Freese and dentist R. Goepp, working at The University of Chicago, have combined the techniques of their 2 disciplines to provide this improved form of the cervical cap. Using dental techniques, a method has been established for fitting the cervical cap exactly to the individual cervix. Such a method allows for longterm use of the device without appreciable dislodgment and odor. The method is comfortable and permits sexual spontaneity. No chemical spermicides are necessary. A 1-way valve in the cap allows the menstrual flow to be released each month without removal of the device. Minimal time and cost are required for the initial fitting. Most women will be able to remove and replace their own caps.
  • The cervical cap is an ancient method of contraception revitalized during the 1970s by feminist health care practitioners. It acts as a contraceptive both mechanically and chemically. This study looks at the effectiveness and satisfaction of the cervical cap in 76 women fitted over a 1-year period. The cap is 80.4% effective according to the Pearl Index and 89% of the women are satisfied with using the cap. There is a 51 % continuation rate over a 1-year period. The cervical cap appears to have a satisfactory rate of contraception when compared with other barrier methods and women are adept at its use. A significant finding is that most pregnancies occur in the first three months of cap use. A much higher effectiveness is seen subsequently.
  • The cervical cap is a small barrier device which can be filled with spermicidal agent and placed over the cervix. Protocol at the authors’ practice recommends that women fill the caps two-thirds full with a contraceptive agent containing 5% nonoxynol-9 spermicide. The cap can be left in place for a maximum of seven consecutive days without further attention provided the cap retains its spermicide. The cap should be removed when menstruation begins.
    Currently, there are no contraceptive caps manufactured in the United States. However, there are several types of cervical caps available from Europe. (The caps discussed below are available from Lamberts (Dalston) Ltd., Queens-bridge Road, London, England: approximate price, $11.00.)
  • Matching a cap to a woman depends on multiple factors related to the angle, shape, and size of her cervix. Careful attention to the anatomy of the cervix is essential when fitting a woman for a cap. An assessment of the angle at which the cervix enters the vagina is crucial. If the cap’s rim can be touched by the penis during intercourse, then the potential for cap displacement is greatly increased. The length of the cervix must also be assessed. If the cervix is exceptionally long or short, it may be impossible to create a suction between the cervix and the cap’s interior.
  • A follow-up study on 130 women fitted with a cervical cap over a 12-month period drew a response rate of 43% (56 respondents). The group was young, well educated, and highly motivated. The failure rate was 16.9 per 100 women years (Pearl method), with inconsistent use and dislodgement being of major importance. The continuation rate was 75% (minimum 3 months of use), and 84% expressed satisfaction with the method. No significant side effects or risks to health were encountered. The conclusion is that there is a significant demand for alternative contraceptive methods among a select group of women. However, in the present state of knowledge, use of the cap should probably not be encouraged as a primary means of contraception, but should be reserved for those women with multiple contraceptive problems or for highly motivated women who seek out this means, understand its limitations, and can accept the relative uncertainty of its effectiveness.
  • By 1941, most doctors recommended the diaphragm as the most effective method of contraception (Tone, 2001). But with the invention of the pill and the increased popularity of the IUD, the diaphragm and cervical cap fell out of favor during the 1960s. Diaphragms continued to be available but U.S. companies stopped producing cervical caps. When the early high-estrogen birth control pills and certain IUDs were found to cause medical problems, American women increasingly returned to using simple barrier methods that didn’t affect their hormones or menstrual cycles (Bullough & Bullough, 1990). Diaphragms became quite popular again, but the cervical cap had disappeared from the American scene (Chalker, 1987). The Food and Drug Administration approved the Prentif Cavity-Rim Cervical Cap for use in this country in May 23, 1988 ⎯nearly 60 years after it was introduced in the United Kingdom. Strenuous efforts by clinicians affiliated with feminist health centers had brought the cap back to America (Bullough & Bullough, 1990). But by 2002, the Prentif cervical cap was displaced in the marketplace by FemCap® (Cates & Stewart, 2004). Today, fewer than 0.01 percent of U.S women rely on diaphragms and caps for contraception (CDC, 2010).

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