Cervical Cap (FemCap)

Effectiveness: 80 to 90 percent for women who have not given birth; 60 to 74 percent for women who have given birth (14 pregnancies per 100 women each year who have never been pregnant or given birth vaginally; 29 pregnancies per 100 women each year who have given birth vaginally, and it's more effective when used with spermicidal cream or gel).

What is it? It's a cervical silicone cup (or cap) that you insert into your vagina over your cervix. It is more effective when you spread spermicide in the dome of the cup and around the brim. FemCap is the only brand available in the United States. It lasts up to 2 years.

How does it work? Used with spermicide, the cervical cap creates a physical and chemical barrier. The combination of the cap and spermicide physically blocks and kills sperm, preventing fertilization. You put a small amount of spermicide into the cup and around the edge and insert it over the cervix. It can be inserted up to 6 hours before sex and should be left in place at least 6 hours after sex. Do not leave the cap in place more than 48 hours. It can be used for multiple acts on intercourse, but check to make sure it's still in place and add spermicide before each act of intercourse.

STD protection: No; you will still need to use condoms if you are concerned about STDs.

Benefits: Readily available, easy to use and easy to carry. It does not affect your natural hormones and can be used during breastfeeding. Because it can be inserted up to 6 hours before sex, it doesn't need to interrupt foreplay. It is effective immediately and should stay in place for 6 hours after you have sex. It generally can’t be felt by your or your partner.

Disadvantages: May irritate your vagina, often due to allergies to spermicide. Some research indicates that frequent use of spermicide may increase the risk of HIV infection by irritating the vagina. It can be dislodged due to penis size, vigorous thrusting or some sexual positions. The cap should not be used if you are bleeding vaginally, including during your period, because it may increase your risk of toxic shock syndrome. Certain other conditions may make the cervical cap an inappropriate choice, such as physical problems with your vagina or uterus (see Notes below). Serious complications are rare, but always talk with your health care provider about risks and benefits.

Availability: Requires a visit to your health care provider to fit you for a cervical cap; it comes in small (if you’ve never given birth), medium (if you’ve had an abortion or cesarean delivery) and large (if you’ve given birth vaginally). Cervical caps are available by prescription at drugstores and clinics.

Cost: $60 to $75; lasts up to 2 years.* Spermicide costs vary, starting at about $8 per kit.*

Notes: It is not recommended if you have had toxic shock syndrome or are allergic to silicone or spermicide. It may not be recommended if you are not comfortable touching your vagina; have certain problems with your vagina or uterus; have cuts or cracks in your vaginal or cervical tissue; have a reproductive tract infection; recently gave birth or had an abortion; recently had surgery on your cervix; or have cancer of the uterus, vagina or vulva. The cap is more effective if you are taught how to use it and have help from a health care provider in practicing how to put it over your cervix. It’s important to clean and store your cap properly after use and check it regularly for signs of wear.

* The Affordable Care Act requires insurance companies to cover with no co-pay any FDA-approved contraceptive method prescribed by your doctor, including barrier methods, hormonal methods, implanted methods, emergency contraception, female sterilization and patient education and counseling. These estimated costs apply to women who do not have insurance coverage or who work for a "religious employer," who may be exempt from providing contraceptive coverage. For details about what your insurance covers, contact your benefits coordinator or health insurance provider.