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NONOXYNOL-9 is a type of contraceptive (birth control) that is inserted into the vagina. The creams, foams, or gels may also be applied to the outside of condoms before sexual intercourse begins. Nonoxynol-9 works by damaging and killing sperm in the vagina before they reach the uterus and fallopian tubes where fertilization usually takes place. Nonoxynol-9 used alone is less effective in preventing pregnancy than birth control pills, the IUD, or nonoxynol-9 used with another form of birth control like a condom, cervical cap, or diaphragm. Nonoxynol-9 does not provide protection from the HIV virus or other sexually transmitted disease (STD, like gonorrhea or chlamydia).
They need to know if you have any of these conditions:
allergies, irritations, or infections of the sex organs
any medical problems that may worsen if you become pregnant
history of toxic-shock syndrome
HIV infection or AIDS
recent childbirth or abortion
sexually transmitted disease, like herpes, gonorrhea, or chlamydia
an unusual or allergic reaction to nonoxynol-9 or other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
It is very important that nonoxynol-9 containing products be used properly. The written instructions on how to use the product may be different for each product. Make sure you carefully read and follow the instructions that come with each product.
If you are using nonoxynol-9 containing products with latex cervical caps, condoms, or diaphragms, make sure the product is labeled as safe for use with latex products. If not, this may cause the cervical cap, condom, or diaphragm to weaken and leak or even break during intercourse. If leakage or breakage occurs during intercourse, additional spermicide may be inserted into the vagina. Other products that can weaken latex include hand, face, or body cream; petroleum jelly; cooking oils or shortenings; and baby oil. These are oil-based products and should not be used as lubricants. Instead, use a water-based product safe for use with cervical caps, condoms, or diaphragms.
For patients using nonoxynol-9 vaginal cream alone:
Insert one (1) applicatorful of the cream into the vagina just before each time you have sexual intercourse.
For patients using nonoxynol-9 vaginal film alone:
Insert one (1) film into the vagina 5 to 15 minutes (but not longer than one and one-half hours) before each time you have sexual intercourse.
For patients using nonoxynol-9 vaginal foam alone:
Insert one (1) applicatorful of the foam into the vagina just before but not longer than one hour before each time you have sexual intercourse.
For patients using nonoxynol-9 vaginal gel or jelly alone:
Insert one (1) applicatorful of the gel or jelly into the vagina just before each time you have sexual intercourse. The contraceptive effect will last for one hour.
For patients using nonoxynol-9 vaginal suppositories alone:
Insert one (1) suppository into the vagina 10 to 15 minutes (depending on the product) before but not longer than one hour before each time you have sexual intercourse.
For patients using nonoxynol-9 containing vaginal cream, foam, gel, or jelly with a cervical cap:
NOTE: To be most effective at preventing pregnancy, always use a spermicide with a cervical cap.
Inspect the cervical cap for holes, tears or cracks. If there are holes or defects, the cervical cap will not work effectively and must be replaced.
Before putting the cervical cap over the cervix (opening to the uterus), fill the cup of the cervical cap one-third full with a nonoxynol-9 containing cream, foam, gel, or jelly. Follow the manufacturer's directions on how long before sexual intercourse you may apply the spermicide. Do not put any spermicide around the rim of the cervical cap; this may interfere with the attachment of the cervical cap to the cervix.
To insert the cervical cap, squeeze the rim between your thumb and forefinger so that it is narrow enough to fit into the vagina. While in a comfortable position, push the cervical cap as deeply into the vagina as it will go. Release the rim and press it into place around the cervix with your finger. The rim should be round again and be directly on the cervix. The cap is held onto the cervix by suction.
Put more spermicide into the vagina each time you repeat sexual intercourse. You should also check to make sure the cervical cap is in place before and after each time you have intercourse. You may wear the cervical cap for up to 48 hours (2 days), however, do not remove the cap if it has been less than 8 hours since the last time you had sexual intercourse. For the cervical cap to be most effective at preventing pregnancy, it must remain in place for at least 8 hours after sexual intercourse.
To remove the cervical cap, use 1 or 2 fingers to push the rim away from the cervix. This will break the suction seal with the cervix. Then gently pull the cervical cap out of the vagina.
For patients using nonoxynol-9 containing cream, foam, gel, or jelly with condoms:
Spermicides do not have to be used with condoms, however, the spermicide may provide a back-up if the condom breaks or leaks.
Spread some spermicide on the outside of the condom, after it is unrolled over the penis. A female partner should also use a spermicide inside the vagina. Each time you repeat intercourse, a new condom must be used; condoms should never be reused. Spermicide should also be applied to the outside of the new condom. A female partner must also put more spermicide in the vagina for each time she has intercourse.
For patients using nonoxynol-9 containing cream, foam, gel, or jelly with a diaphragm:
NOTE: To be most effective at preventing pregnancy, always use a spermicide with a diaphragm.
Inspect the diaphragm for holes, tears or cracks by holding it up to a light. If there are holes or defects, the diaphragm will not work effectively and must be replaced.
Before putting the diaphragm over the cervix (opening to the uterus), fill the cup of the diaphragm with a nonoxynol-9 containing cream, foam, gel, or jelly. Follow the manufacturer's directions on how much spermicide to use and how long before sexual intercourse you may apply the spermicide. Also, spread some spermicide around the rim of the diaphragm that will be touching the cervix. You may also spread some spermicide on the outside of the cup of the diaphragm.
To insert the diaphragm, squeeze the rim between your thumb and forefinger so that it is narrow enough to fit into the vagina. While in a comfortable position, push the diaphragm as deeply into the vagina as it will go. Release the rim. The rim should be round again and be directly on the cervix. A special applicator may be available to make it easier to insert the diaphragm.
Put more spermicide into the vagina each time you repeat sexual intercourse. Do not remove the diaphragm if it has been less than 6 or 8 hours (depending on the spermicide product used) since the last time you had sexual intercourse. For the diaphragm to be most effective at preventing pregnancy, it must remain in place for at least 6 or 8 hours (depending on the spermicide product used) after sexual intercourse. Be careful not to move the diaphragm out of place while you are applying more spermicide.
Do not wear the diaphragm for more than 24 hours, since doing so increases the risk of getting toxic-shock syndrome or a urinary tract (bladder) infection.
To remove the diaphragm, hook 1 finger over the rim nearest the front. Pull the diaphragm downward and out of the vagina.
For patients using nonoxynol-9 vaginal suppositories with a diaphragm:
After the diaphragm with spermicide has been placed into the vagina, insert one (1) suppository into the vagina 10 to 15 minutes (depending on the product) but not longer than one hour before sexual intercourse. Also, insert another suppository before each time you have sexual intercourse or if six hours have passed since you have inserted the diaphragm.
Use nonoxynol-9 containing products before each time you have sexual intercourse. If you miss a dose, you may become pregnant.
Other vaginal products may affect the action of nonoxynol-9. Do not use any other vaginal products (including douches or non-prescription treatments for vaginal yeast infections) without consulting your health care professional. Check with your health care professional before stopping or starting any of your medicines.
You or your partner may notice burning, stinging, warmth, itching, or other irritation of the skin, sex organs, anus, or rectum. If so, try using a weaker strength product or one with a different ingredient. If any of the side effects continue after you have changed products, you may have an allergy to these products or an infection. Contact your physician as soon as possible.
This spermicide does not protect against transmission of human immunodeficiency virus (HIV) infection or other sexually-transmitted diseases (STD). Talk to your health care professional about effective ways of reducing your chances of getting an STD or passing an STD to your partner(s).
Serious side effects of nonoxynol-9 are rare and may include the following:
If you are female and use the cervical cap or a diaphragm:
sunburn-like rash that is followed by peeling of the skin
unusual redness of the inside of the nose, mouth, throat, vagina, or insides of the eyelids
Call your physician immediately if any of the above occur.
Other side effects with nonoxynol-9 include:
For females and males:
irritation, itching, or burning of the sex organs that does not go away within a short period of time
For females only:
These side effects may be signs of urinary tract infection or vaginal allergy or infection. Contact your physician as soon as possible.
cloudy or bloody urine
increased frequency of urination
pain in the bladder or lower abdomen
pain on urination
thick, white, or curd-like vaginal discharge
Cervical cap or diaphragm:
vaginal irritation, redness, rash, dryness
whitish vaginal discharge
Keep out of the reach of children.
Store away from heat and direct light. Do not store in damp places such as the bathroom or near the kitchen sink. Do not refrigerate. Discard any unused product after the expiration date.
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