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Use of the Today contraceptive sponge in the United States.

Use of the TODAY contraceptive sponge in the U.S. has been monitored in three ways since it became an OTC product in June, 1983: The Phase III clinical trials in the U.S. were extended for a second year (Life Table method efficacy rate for a second year of use = 96.6%; N = 103). The manufacturer has solicited comments and complaints from family planning professionals and from women who purchased sponges over-the-counter. One complaint has been received for every 33,000 sponges distributed, primarily related to removal difficulty, infection and allergy to spermicide. By December of 1984, there were an estimated 1.25 million sponge users in the U.S. Voluntary, spontaneous reporting to regulatory or health agencies has tracked case reports of toxic shock syndrome (TSS) in sponge users. To date 13 cases have been reported with over 25 million sponges sold. The risk of TSS in sponge users is thus very small and may not represent an increased risk over baseline.

Actuarial Analysis↗

The female condom. A pilot study of the acceptability of a new female barrier method.

The best available prevention against sexually transmitted diseases is limited to a consistent and correct use of a condom by the male. A new barrier method has been developed for the female. As it can be inserted into the vagina before sexual intercourse starts, and as it covers the entrance of the vagina, the opening of the urethra and the root of the penis, it is presumed to give a high degree of protection against sexually transmitted diseases and unwanted pregnancy. The preliminary results concerning acceptability are promising, and further investigations concerning acceptability and efficacy are in progress or completed in several countries. The method should be regarded as one aspect in the pattern of protection, particularly suitable for females with sexual risk behavior.

Adult↗

Effectiveness of the diaphragm, used continuously, without spermicide.

The experience of 670 diaphragm users from three Brazilian clinics was retrospectively reviewed. Most of the subjects (441) followed the traditional method (TM) of using the diaphragm, only at the time of sexual intercourse and with spermicide. One third (215) used the diaphragm continuously (CU), without spermicide, removing it only at the time of their daily shower to wash it, with immediate re-insertion. The total pregnancy rate was 7.0 per 100 women-years for the whole group. Patient and total failure rate were significantly lower in the CU (0.6 and 2.8), in comparison with the TM sub-group (6.5 and 9.8). The discontinuation rate for urinary infection or other medical reasons was not greater in the CU group. Logistic regression analysis, including age, parity, number of abortions and of living children, years of schooling, whether living with a partner, presence of mild cystocele or retroverted uterus, and form of use of diaphragm (TM or CU), showed that only the TM of diaphragm use was positively associated to patients' and total failure rate.

Adult↗