What is the cervical cap?
The cervical cap - or cervical cup - is a relatively effective mechanical contraceptive ("barrier") instrument to prevent unwanted pregnancies.
The contraceptive efficacy of the cervical cap is rather poor; therefore, to reduce the risk of failure of the contraceptive method, it is recommended to use the cervical cap in association with chemical contraceptives (spermicides), capable of killing sperm or blocking motility before they enter the uterus.
The cervical cap can be applied directly by the woman inside the vagina (in close contact with the cervix) or inserted by a gynecologist.
Note: the cervical cap is NOT synonymous with contraceptive diaphragm.
The cervical cap differs from the diaphragm by two features:
- Small size
- Ability to adhere closely to the tench muzzle, through a "suction" mechanism
Cervical cap and spermicides
As mentioned, the cervical cap is not considered a highly reliable mechanical contraceptive method (unlike, instead, the condom or female condom). In fact, during sexual intercourse, spermatozoa can pass the narrow gap between the cervical cap and the cervix, thus fertilizing the egg. To cope with this problem - therefore to increase the contraceptive efficacy of the cervical cap - it is strongly recommended to use it exclusively in association with spermicidal creams, capable of killing or damaging any spermatozoa that have "escaped" the mechanical contraceptive.
To allow the spermicide to act, the cervical cap should be removed no earlier than 6-8 hours after sexual intercourse.
Types of cervical cap
Before using the cervical cap as a first choice contraceptive method, the woman must undergo a gynecological examination.
The most common variants of cervical cap - composed of latex (eg Prentif) or silicone (eg FemCap) - are washable; therefore, they can be reused several times for a period varying from 2 to 5 years.
The Oves cervical hood is disposable instead, ie it must be removed after intercourse.
An alternative to the classic cervical cap, known as Lea's shield, requires no dimensional adjustment as it adheres perfectly to the tench muzzle through a particular "suction" mechanism. Even the shield of Lea, composed of silicone, is washable; therefore, it can be reused several times over the next 6 months.
Curiosity
Some types of cervical cap are applied by the gynecologist in close contact with the cervix immediately after the menstrual flow, and left there until the next menstruation.
Indications and contraindications
INDICATIONS
Ideally, all women can use the cervical cap as a first choice contraceptive method. However, in reality, the cervical contraceptive cup is more suitable for nulliparates and for women who have not yet given birth vaginally.
To understand...
Vaginal delivery involves major changes in the cervix and vaginal canal, especially in terms of shape and size. For this reason, the use of the cervical cap is not recommended for women who have given birth naturally.
CONTRAINDICATIONS
By not offering any coverage from sexually transmitted diseases, the cervical cap is contraindicated for occasional intercourse and with multiple partners.
Furthermore, to prevent an unwanted pregnancy, the woman should use a contraceptive method different from the cervical cap in the following circumstances:
- Latex or silicone allergy
- Full ovulatory phase (the woman is highly fertile, therefore the chances of pregnancy increase)
- Vaginal malformations or cervical abnormalities (of the uterine cervix)
- Cervicitis, pelvic inflammatory disease, metritis and endometritis
- Past history of toxic shock syndrome
- Predisposition to vaginal or urinary tract infections
- Recent abortion
- Recent surgery on the cervix
- Vaginal birth
Contraceptive efficacy
The cervical cap is not a highly reliable contraceptive method, since the estimates show an average failure rate ranging from 2 to 20%. Precisely, it is estimated that this contraceptive method fails in 9% of nulliparous women and in 26% of women who gave birth vaginally.
How to apply
After having undergone a gynecological examination, the woman can start using the cervical cap as a first choice contraceptive instrument, possibly always associating her with spermicides.
The woman must be carefully instructed by the doctor on the correct insertion of the device, especially during the first applications.
Before inserting the cervical cap, it is strongly recommended to wash your hands thoroughly. Next, fill the dome with spermicidal cream.
The classic models of cervical cap can be inserted into the vagina immediately before the sexual act, or in the previous 24 hours. However, it is recommended to insert the barrier contraceptive before sexual excitement: by doing so, the correct positioning of the cap is facilitated.
Application procedure
- Wash your hands
- Fill the cervical cap with spermicide (about ½ teaspoon). Apply the spermicide also on the edge of the cap
- Find a comfortable and relaxed position to insert the cervical cap (eg squatting or sitting on the toilet)
- With one hand, open the vaginal lips
- With the other hand, grasp the cervical cap (with the cup facing upwards). Press the edge of the cap between thumb and forefinger
- Slide the cervical cap along the vaginal canal, making sure that it fits perfectly around the cervix
- Always check the correct placement of the cap before sexual intercourse (simply insert a finger into the vagina and press upwards on the dome to make sure that the cervix is covered)
- To remove the cervical cap, squat down, push with the pelvic muscles (as if to defecate) and, using your fingers, rotate and extract the dome. If the device is equipped with a special tongue (located at its lower end), the ejection of the cap is facilitated by pulling it outwards with your fingers.
To eventually give spermicide a chance to act, it is necessary to wait 6-8 hours before removing the cervical cap.
