What is the cervical
cap, the Fem Cap and Lea's Sheild?
The cervical
cap is a rigid, thimble-shaped cup made of latex rubber that fits
over the cervix and is held in place by suction. The cervical cap is slowly being phased out and replaced with the Fem Cap. The Fem Cap is
a silicone cup shaped like a sailor's hat that fits securely in
the vagina to cover the cervix. Lea's Shield is also a silicone
cup with an air valve that fits snugly over the cervix and has a
loop to help remove it. As with a diaphragm, it is necessary to
use a small amount of spermicidal cream or gel with each method.
How do they work?
Each method
acts as a physical and a chemical barrier, similar to the diaphragm,
to prevent sperm from entering the uterus and fertilizing an egg.
They must be used with spermicidal cream or jelly which helps inactivate
sperm.
How effective are
they in preventing pregnancy and STIs?
For cervical
caps, the typical pregnancy rate (which includes imperfect insertion
and inconsistent use) for users who have never given birth is 16%
per year; the perfect use rate is 9% per year. Pregnancy rates for
women who have given birth are 32% for typical use and 26% perfect
use. The difference in rates is because the cervix is bigger after
childbirth and the cap may not fit as well.
For Fem
Caps, the pregnancy rate for perfect use is not available, but for
typical use the rate is 14%.
For Lea's
Shields, the pregnancy rate for perfect use is not available, but
for typical use the rate is 15%.
It is
important to consider that none of these methods offer any protection
against sexually transmitted infections (STIs).
How do I use them?
Insert
the cervical cap no more than 24 hours before sexual intercourse.
Before use, hold the cap up to the light and look closely for tears.
Fill the cap 1/3 full of spermicide cream or jelly. Insert it into
the vagina so that it covers the cervix. Do not remove the cap for
at least 6 to 8 hours after intercourse. The cap can be worn for
up to 48 hours. During this time, you can have sex again, but you
must insert more spermicide into your vagina and make sure the cap
is still in place.
Insert
the Fem Cap no more than 24 hours before sexual intercourse. Before
use, hold it up to the light and look closely for holes or weak
spots. Put 1/4 teaspoon of spermicide cream or jelly in the dome
of the Fem Cap, spread a thin layer on the brim, and put 1/2 teaspoon
in the folded area between the brim and the dome. Insert the Fem
Cap in the vagina with the long brim entering first and the dome-side
down. Push towards the rectum and then up and onto the cervix. Do
not remove the Fem Cap for at least 8 hours after intercourse. It
can be worn for up to 48 hours. During this time, you can have sex
again, just make sure the Fem Cap is still in place and and you
can insert more spermicide into your vagina if you like. To remove,
grip the removal strap and rotate Fem Cap. Push on the dome with
your finger to break the suction. Hook your finger under the removal
strap and pull it out.
Insert
Lea's Shield no more than 24 hours before sexual intercourse. Before
use, hold it up to the light and look closely for holes or weak
spots. Coat the inside of the bowl around the hole, the front of
the rim, and the outer part of the valve with spermicide. Pinch
the rim of the shield and slide the shield into the vagina with
the valve facing down and the thickest end inserted first. Push
the shield up as far in the vagina as is possible and comfortable.
Make sure the look is not sticking out of the vagina. Insert the
Fem Cap in the vagina with the long brim entering first and the
dome-side down. Push towards the rectum and then up and onto the
cervix. Do not remove the shield for at least 8 hours after intercourse.
It can be worn for up to 48 hours. During this time, you can have
sex again, just make sure the shield is still in place and and you
can insert more spermicide into your vagina if you like. To remove,
grasp the loop with your finger and rotate the shield slightly to
break the suction. Or grasp the rim of the shield with your thumb
and pointer finger. Pull the shield down and out of your vagina.
Care
for caps and shields:
After using, clean the cervical cap, Fem Cap or shield with mild
soap and let them air dry after each use. Store it in a dry place,
away from heat and light. You will need to replace the cervical
cap yearly or sooner if you notice any tears or holes. You will
need to replace the Fem Cap after 2 years and the shield after 6
months.
What
are some advantages?
They
are non-hormonal barrier methods.
These
methods can be used during breastfeeding.
They
are effective immediately and can be reversed immediately.
They
may help make sex more spontaneous because they can be left in
for up to 2 days.
They
are inexpensive and reusable.
Using
these methods increases familiarity with one's vagina and cervix.
What are some disadvantages?
They
cannot be used during menstruation.
Some
women may have difficulty inserting them correctly.
Occasionally,
they may come off during intercourse or a bowel movement.
Availability
of these methods require a prescription from your medical provider.
The
cervical cap can cause cervical changes, such as cervicitis.
The
cervical cap should not be used by women who have a history of
pelvic inflammatory disease or abnormal pap smears.
Women
may experience more frequent bladder infections using the shield.
Some
women or their partners may feel discomfort or pain when using
the Fem Cap or the shield.
What are the possible
side effects?
Toxic
Shock Syndrome (TSS) is a very rare but serious disorder. Patients
should be aware of danger signs. Risk of TSS may be decreased
by avoiding use of these methods cap during menstruation.
Possible
allergic reaction to the spermicide or to the rubber may occur.
Some
medical providers fear that the continued contact of the cervix
with the rubber and spermicide might cause the cervix to erode
or to become irritated. Women with cervical erosion, laceration
or an abnormal pap smear should not use these methods until the
conditions are resolved.
Another
concern arises because cervical secretions build up in the cap
or shield instead of bathing the vaginal wall. Some medical providers
feel that free flow of cervical secretions is important in preventing
infections.
A
repeat pap test is recommended 3 months after you start using
the cap. If the pap smear is abnormal, cap use is discontinued.
If pap smear is normal, an annual pap test is recommended.
Where
can I get a cervical cap, Fem Cap or Lea's Shield?
Because
women have different-sized cervices, thecervical cap and the Fem
Cap need to be fitted individually to each woman by a medical provider.
The fit should be checked during a pelvic exam each year and/or
after every pregnancy. The cervical cap comes in 4 sizes and the
Fem Cap comes in 3 sizes, while the shield only comes in 1 size.
These sizes may not fit all women. If you are interested in being
fitted for a cervical cap or Fem Cap, a medical provider at Health
Services can discuss this with you and give you a referral.
Links you can use
If you
want to learn more about cervical caps and shields, you can visit:
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
