To insert spermicide by hand, wash and dry your hands and place the suppository, film or tablet on your fingers. Slide your fingers along the back wall of your vagina as far as you can so that the spermicide covers or rests on or near your cervix. If you're using spermicide with a diaphragm or cervical cap, follow the instructions that come with the device.
If you have sex more than once, apply fresh spermicide before each sexual encounter. Similar to spermicide, you apply the vaginal pH regulator gel Phexxi directly to your vagina. The combination of lactic acid, citric acid and potassium bitartrate in the gel immobilizes sperm so that they can't fertilize an egg.
You need to apply the gel within an hour before having sex and reapply the gel each time you have sex. Talk with your health care provider if you develop persistent vaginal irritation or recurring urinary tract infections after using spermicide or a vaginal pH regulator gel.
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Overview Spermicide gel Open pop-up dialog box Close. Spermicide gel Spermicide is a contraceptive substance that immobilizes or kills sperm before they enter the uterus. Request an Appointment at Mayo Clinic. Spermicide film Open pop-up dialog box Close. Spermicide film Spermicide comes in many forms. Spermicide foam Open pop-up dialog box Close.
The ORs for exposure to any of these products were not statistically significant 0. In this population-based, case-control study, we identified several important risk factors for UTI caused by S saprophyticus , the second most common bacterial pathogen causing UTI in young women.
In agreement with several prior investigations, 6 , 8 , 9 , 27 we found that younger age and sexual activity were strongly associated with the risk of UTI caused by this organism. We also found that the risk for a UTI was more than 3-fold higher among women who reported a prior UTI caused by any organism compared with women with no history of UTI.
Although our study design did not permit us to determine whether the preceding UTI was caused by S saprophyticus , this finding is consistent with that of Rupp and associates, 7 who found that women who had vaginal colonization with S saprophyticus reported having a UTI within the past year nearly 3 times more often than those who were not colonized.
Similarly, Latham and colleagues 6 reported that 6 of 72 patients with UTIs caused by S saprophyticus had recurrences with the same organism.
The similarity of risk factors for UTI caused by S saprophyticus and E coli suggests that these infections occur by the same route. Thus, although S saprophyticus is not ordinarily a constituent of the fecal flora, colonization probably begins in the rectum and extends to the vaginal introitus and periurethral area before reaching the bladder.
As is the case for E coli infection, 24 we observed that condom use was also a risk factor for UTI caused by S saprophyticus. Coupled with the findings that this infection was also more common in individuals with multiple sexual partners and more frequent intercourse, this raises the possibility of sexual transmission. This organism has been suggested as a cause of urethritis in men. Use of uncoated condoms did not appear to increase the risk of infection. After adjustment for other risk factors frequency of sexual activity, number of sexual partners, history of UTI, or use of other contraceptive methods the odds of UTI among women exposed to condoms coated with nonoxynol 9 were more than 3 times higher than for sexually active women who did not use coated condoms.
The association between risk of UTI and exposure to coated condoms was consistent in every analysis performed. We also observed a strong dose-response relationship between the frequency of using spermicide-coated condoms and the risk of UTI. We hypothesize that, as in the case of gram-negative bacteria, vaginal spermicides damage the normal vaginal flora in a manner that promotes colonization with S saprophyticus , possibly by enhancing mucosal adherence.
Like E coli , S saprophyticus possesses several adhesins that hemagglutinate sheep red blood cells and mediate attachment to uroepithelium. Surprisingly, unlike most other investigators, we did not find a seasonal variation in the incidence of these infections. Whether this represents a unique feature of the population we studied or changing epidemiologic patterns of this infection is uncertain.
We took several precautions to minimize biases that can affect case-control studies. To avoid the biases introduced by using control patients drawn from individuals visiting a clinic or hospital, we randomly selected control patients from the entire GHC enrollment base in the 4 counties studied. Exclusion criteria applied identically to the case and control groups. To minimize recall bias and misclassification of exposure, we interviewed case patients as soon as possible following diagnosis of their UTI.
Patients were told only that the investigators were interested in the epidemiologic characteristics of UTI. In gathering information about spermicide use, we asked questions about use of products both "coated with nonoxynol 9" and those "coated with spermicides" and obtained nearly identical results with both wordings.
In addition, to help patients identify types and brands of condoms, the interviewers used a notebook with photographs of the packaging and a description of almost every condom marketed in the United States.
Interview data were gathered using a computerized system that provided instantaneous checks for consistency between items and out-of-range responses. Reliability among our interviewers was very high. Furthermore, we attempted to keep our interviewers uninformed about a patient's case or control status until exposure data had been collected.
Although we made every effort to eliminate bias, there were limitations to this study. First, a considerable number of women declined to participate or could not be contacted, suggesting the possibility of response bias. However, many of these women may have been deemed ineligible if their medical records had been reviewed and they had been interviewed, but the possibility remains that participants may have differed from nonparticipants in terms of the exposures of interest.
Second, we had no comprehensive source of external data with which to validate patients' reported exposures. Random misclassification of exposure that may have resulted would have tended to reduce the size of any effect observed. Furthermore, examining just the group about which we were most certain yielded a nearly identical point estimate. Finally, the women we studied had health insurance and were mainly white, possibly limiting generalizability to other groups of women.
This population, however, is more inclusive than that seen in student health centers and emergency departments where women with UTIs are most often studied. Despite these potential limitations, our results suggest a strong association between exposure to spermicide-coated condoms and UTI caused by S saprophyticus.
This association is supported by the consistency of these findings with earlier studies regarding spermicide exposure and UTI and by the strong dose-response relationship. Women who use coated condoms and experience recurrent UTIs, particularly those caused by S saprophyticus , may be advised to consider other methods of contraception and protection from sexually transmitted diseases.
In the future other topically applied, nonsurfactant agents that protect against sexually transmitted pathogens but are not associated with UTI risk may become available. Reprints: Stephan D. Our website uses cookies to enhance your experience.
By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Table 1. View Large Download. Reasons for Exclusion of Case and Control Patients.
Although rare, hospitalization may be needed in some cases. Many factors can increase your risk of getting a UTI, including some types of birth control, such as diaphragms, cervical caps, spermicides, and spermicide condoms.
UTI prevention involves things like changing your bathroom habits, drinking lots of fluid, urinating before and after sex, and more. There are also…. Does drinking cranberry juice actually help treat UTIs or reduce your risk of getting one? This article separates the myths from the science. Anthropophobia is a fear of people. Typically, a fear of people is associated with…. Health Conditions Discover Plan Connect. Medically reviewed by Carolyn Kay, M. Which types of birth control may increase your risk of a UTI?
This association is supported by the consistency of these findings with earlier studies regarding spermicide exposure and urinary tract infection. Women who use coated condoms and have recurrent urinary tract infections, particularly infections caused by S. Already a member or subscriber? Log in. Interested in AAFP membership?
Learn more. Fihn SD, et al. Use of spermicide-coated condoms and other risk factors for urinary tract infection caused by Staphylococcus saprophyticus. Arch Intern Med. February 9, ;—7. This content is owned by the AAFP.
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