What is a contraceptive or cervical cap: types, prices and features of use. What is a vaginal cap

None of the currently offered contraceptive methods is completely convenient or acceptable for all women. There is a compelling need for a wide range of contraceptive choices, especially for barrier methods used and controlled by the woman. The barrier method is the only one that protects against sexually transmitted diseases (STDs). The availability of female barrier methods available today is extremely limited; They have been used for more than a century without noticeable changes. The female cap is a method of barrier contraception, which is a serious weapon in the fight against STDs.

The main goal in developing the Women's Cap was to create a safe, effective and, most importantly, affordable female controllable contraceptive barrier product. In addition, it was necessary to minimize the risk of transmitting STDs.

Materials used to make a women's cap

When creating a female cap, the anatomy and physiology of the cervix and vagina were taken into account: the results served as the basis for choosing a comfortable material and shape that is adapted to the physiological changes of the cervix and vagina. For example, the size, shape, and angle of the cervix in relation to the vagina varies from woman to woman. The length and elasticity of the vagina are also not the same among different women; even within one woman they are different and depend on the number of pregnancies and births.

When creating a new contraceptive and instructions for its use, changes that occur during sexual arousal were taken into account. During sexual activity, the vagina lengthens by approximately 3-5 cm, the cervix moves upward to the same height; During orgasm, the upper part of the vagina expands, although the lower part contracts along with the contraction of all the muscles of the pelvic floor.

Changes that occur during the menstrual cycle mainly affect the cervix. After menstruation, the cervix is ​​low in the vagina and has a firm consistency. In response to rising estrogen levels, the cervix rises relative to its previous level and becomes softer. After ovulation, the cervix returns to its original position and becomes firm again.

The described changes were taken into account when creating the women's cap (shapes, sizes, instructions for use).

Silicone rubber was chosen as the most convenient material for the production of the new product. It is a soft material which, however, cannot be damaged by nails. This is not an allergenic material; it has excellent stretchability - it can be compressed or twisted many times, but easily returns back to its original shape. It does not absorb odors and is easy to clean. This material can be sterilized in a variety of ways, including autoclaving. Neither contact with oily liquids or secretions, nor exposure to extreme temperatures causes any deterioration in the quality of the material. Silicone rubber is an excellent safe material used in many medical products. The female cap, to confirm the safety of its use, has been the subject of a large number of preclinical and toxicological tests.

Women's cap design

The female cap is adapted to the anatomy of the cervix and the physiological changes of the vagina. The cup of the cap covers the cervix completely. The edge is made so that it is tightly fixed to the walls of the vagina, covering the vaginal vault. The edge designed in this way is able to withstand the physiological contractions of the vagina inwards. The back pressure that occurs due to physiological contractions of the vaginal wall causes the edge of the cap to take the desired shape and adhere to the vaginal walls. In accordance with the anatomy of the vagina, the edge was designed so that the back of it is longer than the front. The protruding edge, located opposite the vaginal opening, acts like a funnel, directing ejaculatory fluid into the groove between the cup and the edge. This groove functions as a reservoir for bactericidal spermicides and as a trap for sperm and STD pathogens.

This innovative form of the female cap provided a barrier function for sperm and STD pathogens, creating an insurmountable obstacle for them, but without closing the vagina; The cap does not put undue pressure on the cervix, vagina or urethra. This is also possible because this product has soft and smooth edges.

To facilitate removal of the cap and to protect the vagina and cervix from damage by nails during this process, a special ribbon was added to the cup of the cap.

Selecting the size of a women's cap

The size of the cervix varies among different women. Even for the same woman, these sizes vary significantly in different phases of the menstrual cycle, sexual arousal and, most importantly, depend on the state of pregnancy and the number of births. The listed factors also cause large changes in the tone and elasticity of the vagina. Because of this, it is impossible to have one size of women's cap that would be acceptable for all women.

In this regard, three sizes of women's caps were created. Using only three sizes simplifies the instructions and installation process. It also eliminates the complexity and need to make special measurements during use without compromising safety, effectiveness or acceptability.

Cervical size and diameter and vaginal tone are not significantly associated with a woman's height or weight. The main factors determining size, diameter, elasticity and vaginal tone are a history of pregnancy and childbirth. The correct size of the female cap can be determined from the obstetric history without any additional measurements.

The smaller size of the women's cap (22 mm) is intended for women who have never been pregnant. The medium size (26 mm) is intended for women who were pregnant but did not have a natural birth, that is, they had an abortion or gave birth by caesarean section. A larger female cap size (30 mm) may be recommended for women who have had at least one spontaneous birth.

Ease of use of the female cap

The female cap, like other methods of contraception, is not completely convenient for all women. For example, a female cap is not convenient for teenagers who do not plan sexual intercourse in advance.

The female cap is most suitable for educated women who are highly motivated or have contraindications to the use of hormonal methods or intrauterine contraception. This method is also most suitable for women who want to control their own fertility and protect themselves from STDs, regardless of their partner's desire to use a condom.

Instructions for using the women's cap

Women's knowledge of the instructions for proper use of the female cap is essential for effective and consistent use. It is absolutely necessary for women to know their anatomy, the consistency of the cervix, how far from the vaginal opening it is located, how inclined it is in relation to the vagina. A woman should also know the difference in the position of the cervix with a full and empty bladder, in a standing, lying or squatting position. She should also understand the sensations of the vagina and the process of lifting the cervix upward during intercourse.

The clinician (nurse, midwife, or doctor) should determine the appropriate size of female cap for the woman based on her obstetric history. The clinician can provide instructions and a video for self-study. A woman should be encouraged to examine the female cap, watch the video and study the instructions until she is confident in fully understanding the proper use of the female cap. Then the woman should try to introduce and remove this remedy on her own. Proper use of a lady's cap is a learned skill that only develops with practice. In other words, a woman must participate in her own educational process.

Finally, the clinician should check that the female cap is positioned correctly on the cervix, repeat the most important instructions, answer any questions the woman may have, and encourage the woman to consistently use the female cap.

Increasing the efficiency of using a female cap

Despite our best efforts, barrier products that are safe 100% of the time are only effective if they are used correctly and consistently. To improve the effectiveness of the use of the female cap, each clinician and each user should adhere to the following points.

1. Responsibility for the correct selection of women most suitable for using this method lies with the clinician. When obtaining informed consent to use this method, the woman's age, education, level of motivation and standard of living must be taken into account.

2. The clinician should provide all educational means available to encourage the woman's active participation to ensure that the user of the female cap will develop the habit of consistent use of this method.

3. Each woman should be provided with two women's caps: one for home and one for storage in her purse, thereby ensuring the ability to use it anywhere and at any time.

4. The female cap should be inserted before any sexual activity to ensure proper installation and avoid spontaneous loss.

Determining the duration of sexual intercourse is difficult, but contraception, however, must be planned, i.e. the user should not find himself in a situation where he is unprepared to use this method. A female cap can be placed anywhere from a few minutes to a few hours before sexual intercourse, but not after sexual intercourse has begun.

Women should also use a calendar to track the date of insertion and removal of the cap, as well as the date of their last menstrual period.

Results of comparative tests of the female cap and diaphragm

There have been numerous multicenter randomized clinical trials of the female cap in the United States comparing it with the vaginal diaphragm (Table 1).

Comparative characteristics of the female cap and the vaginal diaphragm.

Table 1

Women's cap	Diaphragm
Design Anatomical shape, the cup covers the cervix. The edge is adapted to fit tightly to the vaginal vault and cover the vaginal vault. The edge is convex outward, thereby creating conditions for its tight adhesion and compliance with the vaginal wall. Does not cause noticeable pressure on the vagina, cervix and urethra. There is a unique groove directed towards the vaginal opening. This groove is designed to place spermicides and collect sperm and germs as they enter the vagina. The protruding edge acts like a funnel, directing the ejaculate into the groove between the dome and the edge. A special removal strip is placed across the cup to avoid injury to the vagina by fingernails when removing the cap.	Design Cup shape with a metal spring on the edge. The metal edge puts pressure on the vaginal walls and urethra. The spermicides in the dome of the cup “look” towards the cervix, and there is a high probability that the spermicides will leak out of the vagina. When the diaphragm is removed, injury to the vaginal wall or puncture of the material (rubber) of the diaphragm may occur.
Material Non-allergic, high quality silicone rubber. Made from simple material, withstands heat and cold equally, and can be autoclaved. Durable, cannot be damaged by nails, withstands extreme temperatures, as well as oils. Easy to clean using any method. Does not absorb or emit odors.	Material Latex rubber and stainless steel spring located on the edge of the diaphragm. Natural latex rubber may cause allergic reactions. Can be easily damaged by nails, quickly destroyed when treated with oils, under the influence of heat and light. Needs special care and may have problems with unpleasant odors.
Size selection No special measurements required. The size can be determined by obstetric history: non-pregnant women - the smallest size; women who had an abortion or cesarean section - average size; those who gave birth - large size.	Size selection It is necessary to take measurements, which take a lot of the doctor's time, to select one of nine or ten sizes. The size needs to be adjusted if a woman has gained or lost more than 4 kg in weight.
Educational materials Each package of women's cap is supplied with a color brochure or video.	Educational materials A video exists, but is rarely included with the aperture.
Risk of infectious complications Low risk of urinary tract infection, no increase in morbidity.	Risk of infectious complications High risk of developing urinary tract infections, increased incidence.
The protective effect is valid for 48 hours.	Duration of use Recommended use for 24 hours only.

Women's cap safety

None of those examined had any significant side effects. This was confirmed by clinical observations and colposcopic examination. During clinical trials, it was found that the risk of developing a urinary tract infection is lower than in women using a vaginal diaphragm.

The effectiveness of the female cap

The female cap was found to be 86.5% effective in typical use. It has also been calculated that the method's effectiveness can increase to 98% if a woman uses it correctly, that is, every time she has sexual intercourse, adds spermicide every time she has additional sex, and uses emergency contraception as a backup method.

The female cap is a highly acceptable method for the woman and her partners. In clinical trials, the majority of women who had experience using a diaphragm preferred the female cap.

Advantages of the female cap as a barrier method of contraception

Currently, the barrier method of contraception is the only one that can protect against the spread of STDs. Although female barrier methods are safe and effective, they are rarely used due to a lack of choice. The vaginal diaphragm is the most common barrier method of contraception for women, out of a very small number of barrier methods. Table 1 shows the difference between a female cap and a vaginal diaphragm.

The female cap was designed with a special groove opposite the vaginal opening; and was designed specifically to accommodate any bactericidal spermicides. Currently, a number of vaginal bactericidal spermicides for topical use have passed all stages of clinical trials. It is expected that the use of the female cap in conjunction with chemicals will be very effective in preventing STDs.

Conclusion

The female contraceptive cap is a method of birth control that is safe, effective, highly acceptable and controllable by the woman. This method may also protect against STDs, especially if used in conjunction with chemical barrier agents.

"Female contraceptive cap, instructions for use" - section

One of them is based on creating a mechanical obstacle to the penetration of sperm into the uterus.

For this purpose, men's and female condoms, vaginal diaphragm, cervical or contraceptive cap. What it is? Let's look at the last contraceptive in more detail.

The principle of action of the contraceptive

The dome to some extent protects against sexually transmitted infections, but much worse than a condom. Therefore, it can only be used with a regular, trusted sexual partner. The need to introduce a contraceptive before sexual intercourse implies regular sexual activity, in which a woman can plan the time of insertion.

Advantages and disadvantages of a cervical cap

The need to visit a gynecologist, the complexity of administration (especially at the beginning of use), not the highest effectiveness - all these factors have led to the fact that in Russia the prevalence of this drugs as a method of contraception quite low.

Another disadvantage is the low availability of the method - the device is difficult to find on sale, it is mainly delivered to order. The estimated price of a cervical (uterine or contraceptive) cap is 1,500 rubles and more. To this amount should be added the price of spermicides, without which the effectiveness of the method is sharply reduced. The dome will have to be replaced as it wears out, but at least once every 12 months.

Some caution is required during sexual intercourse so as not to dislodge the contraceptive from the cervix. Some women note the appearance of an unpleasant odor while wearing the dome, which goes away within a day after its removal. Due to direct contact with the cervix, the method is not suitable for women who have erosion or other diseases in this area.

The undoubted advantages of the method include:

• no effect on the woman’s body;
• does not change sensations during sexual intercourse;
• can be used while feeding the baby;
• the contraceptive effect lasts up to 48 hours;
• Easy to use once you get used to it.

Possible complications

An incorrectly selected dome size can lead to injury to the vagina and cervix, its compression, and bleeding. Whenever pain during intercourse or wearing a contraceptive, you should immediately remove it and consult a gynecologist.

Poor care and long wearing of the dome create conditions for the proliferation of pathogenic microflora, which leads to an infectious complication - colpitis (inflammation of the vagina). It manifests itself as foul-smelling white-yellow discharge from the vagina, itching and burning in the perineum.

With prolonged use of the method, there is a risk of developing infectious-toxic shock. This is a serious condition that can be fatal. This happens extremely rarely if you follow the rules for using the canopy, remove it on time and wash it thoroughly.

The cervical cap is not very common, but in certain cases it is the only possible method of contraception that is worth remembering.

Cervical caps, as an effective means of contraception, were created at the same time as diaphragms. These designs have the shape of a cup or a wide thimble. At first, caps were made of copper or silver, later - from aluminum, rubber, plastic, dense rubber, and currently - from soft rubber. Should I use a cap and how should I do it?

What types of cervical caps are there?

There are:

• Kafka cap made of aluminum, rubber, dense rubber, sizes 28, 25, 31 mm (according to the internal diameter of the cap in millimeters); placed on the cervix three days after the end of menstruation and removed three days before the next menstruation; recommended for patients with a long, cylindrical cervix;
• Prentif's cap is made of very soft rubber, has a recess along the inner surface of the rim; placed on the cervix for 36 or 48 hours; sizes - 25, 22, 31, 28 millimeters; recommended for women with a cylindrical cervix;
• Tsumasa cap - made of thick soft rubber, shallow, the cap fits tightly to the vaginal vault, reminiscent of a diaphragm; sizes from 50 to 75 millimeters; recommended in case of deformation or scarring of the cervix; put on the patient for 36 or 48 hours.

How to select cervical caps

The Tsumasa cap is selected, as is the diaphragm. If the Prentiff and Kafka caps are fitted correctly, the inner rim can fit snugly against the cervix. In this case, the dome-shaped part of the cap does not touch the area of ​​the outer pharynx.

How to insert the cap

Fill the dome of the cap one third with spermicide. While lying on your back or squatting, feel the cervix. With your left hand, spread your labia. Fold the cap between the thumb and forefinger of your right hand, insert it into the vagina, push it along the back wall to the cervix and press the rim of the cap to the pericervical area. If positioned correctly, the cap can create negative pressure over the cervix. After the cap is inserted, check its position - the cervix should be completely covered. Insert the cap directly or half an hour before sexual intercourse (in order to create negative pressure) and leave it in the vagina for six or eight hours (up to a maximum of two days, with the exception of the Kafka cap).

How to remove the cap

Feel the rim of the cap on the cervix, press it with your finger, try to break the tightness of the contact of the cap with the cervix. Lift it, pick it up with your finger, and remove it from the vagina.

After each use, wash the cap with soap, wipe it, and soak it in a solution of bleach (one part lime to three parts water). This is necessary to prevent sexually transmitted diseases.

What is a cervical cap, what are the pros and cons of using it, and who is suitable for it, read the website.

If the man's sperm reaches one of the woman's eggs, pregnancy occurs. You can calculate the “dangerous” days when pregnancy is most likely. Contraception aims to prevent this process by stopping a woman's body from producing eggs or keeping eggs away from sperm. One of the barrier methods is the cervical (contraceptive) cap.

The contraceptive cap is a round dome made of thin, soft silicone. Traditionally it has been made from latex, but increasingly the material is soft silicone. It is inserted into the vagina before sexual intercourse and covers the cervix so sperm cannot enter the uterus. The cap, like the cap, is intended for use in combination with a spermicide.

After sexual intercourse, the cap must remain inside for at least another 6 hours, after which it is removed and washed. This product is available in different sizes, so you need to select a product with a specialist.

Contraceptive cap: briefly about the main thing

• When used correctly with spermicide, the cap can provide up to 92-96% effectiveness in protecting against unwanted pregnancy.
• The product does not pose any serious health risks
• You need to remember about contraception immediately before sex
• The cap can be inserted several hours before sex
• It may take you some time to learn how to use it
• Some women develop cystitis while using the cap. The doctor will help solve the problem by choosing a smaller size product.
• If you lose or gain more than 3 kg, or have had a childbirth, abortion, miscarriage - you may need a new cap
• Using condoms in combination with a diaphragm will help protect against STIs.

How does a cervical cap work?

The cap, like the diaphragm, is a barrier method of contraception. It is placed inside the vagina and prevents sperm from entering the uterus. The caps are thin, soft domes made of silicone that come in a variety of shapes and sizes.

To provide effective protection against pregnancy, the cap must be combined with a spermicide, a chemical that destroys sperm.

You should use the cap only if you plan to have sexual intercourse, and also leave it inside for at least 6 hours after it. It is also not recommended to leave the cap inside longer.

The optimal type and size of the cap for a woman is selected by a doctor. Before this, a woman must undergo a gynecological examination to determine the structural features of the genital organs. The specialist will teach you how to use the product, as well as spermicide, which must be used each time the cap is inserted.

The cap provides only partial protection against STIs. If you are at risk of infection - if you have more than one partner - you may need additional or a different form of contraception.

How to use a contraceptive cap

All caps come with instructions, the principle of which is quite similar:

• With clean hands, fill the cap 1⁄3 full with spermicide, but do not apply the gel to the outside of the cap as this will prevent it from seating properly. The silicone cap has a recess between the dome and the rim - a small amount of spermicide should also be placed there.
• The cap must be pressed between the thumb and index finger with the dome down and inserted into the vagina.
• Having felt the cervix, you need to press the rim of the cap against it. It should fit snugly.
• Depending on the type of cap, you may need additional spermicidal gel after insertion.
• The cap should be inserted in the most comfortable position (lying, squatting and standing).
• The cap can be inserted three hours before PA, but after this time it will need to be removed and spermicide added.

Your doctor may provide you with a temporary cap, which will allow you to adjust to its use, but will not protect you from pregnancy. Once doctors are sure that the size and shape is right for you and you can insert the product correctly, you will be offered a contraceptive cap.

Removing the contraceptive is also quite simple, and the procedure should also be performed with clean hands in any comfortable position. You need to pick it up by the rim and carefully remove it. Remember that after PA, any type of cap must be left inside for at least 6 hours.
It is not recommended to leave the cap inside for more than 48 hours (including the mandatory 6 hours). The latex product should not remain inside for more than 30 hours.

Cervical cap - how to care for it?

After each use, the cap should be washed with warm water and unperfumed soap. Then rinse thoroughly and dry. When you purchase a cap, you will be given a small container to store it in. It will need to be stored in a cool, dry place.

• Do not boil the cap
• Do not use disinfectant, oil-based products or talc to maintain cleanliness as these may damage the product.
• Over time, the cap may lose color, but this does not make it any less effective.

Always check the condition of the cap before use.

The cap can be used for a year, but if you have had weight fluctuations, childbirth, miscarriage or abortion, you will need a new product that fits properly.

How do I know if a birth control cap is right for me?

For most women, using a cap is perfectly acceptable, but there are still some limitations. The cap should not be used by those who:

• anomalies in the anatomical structure of the genital organs that do not allow the cap to be inserted;
• weak vaginal muscles, possibly due to childbirth, unable to hold the diaphragm
• allergic reactions to the material from which the cap is made (latex) or to spermicide
• toxic shock syndrome, which occurred previously
• recurring urinary tract infections (infection of the urinary system, urethra, bladder, or kidneys)
• vaginal candidiasis
• pain in the perineum when touched
• high risk of STIs, with multiple partners

Research shows that spermicides that contain the chemical nonoxynol-9 do not protect against STIs and may even increase the risk of getting an infection.

When might a cervical cap become ineffective?

• it is damaged - for example, it is torn or cracked
• wrong size
• used without spermicide
• you do not use additional spermicide with reusable PA
• remove the cap too early (less than six hours after the last PA)
• Using oil-based products such as baby lotion, bath oils, moisturizer, or vaginal products (such as pessaries) with a latex product can damage the latex

If any of the above applies to your situation and you have had unprotected PSA, you may need to use emergency contraception.

You can use the cap after delivery, but you will need a different size. It is recommended to wait at least six weeks after giving birth before using the cap. You can use the cap after a miscarriage or abortion, but you may also need a different size.

Benefits of a cervical cap

• You only need to use the cap when you plan to have sex.
• You can insert it at any convenient time before sexual intercourse
• There are no associated health risks or side effects.

Disadvantages of the cervical cap

• Not as effective as other types of contraception.
• Provides only partial protection against STIs.
• It will take time to learn how to use it
• Insertion may interrupt sex
• Cystitis (inflammation of the bladder) may be a problem for some women who use the cap.
• Latex and spermicides can be irritating to some women and their sexual partners.

Are there any dangers of using a cervical cap?

There are no health risks associated with the use of a contraceptive/cervical cap.