Cervical cap: mode of action, price, without a prescription?

Easy to use And reusable several times during two years, the cervical cap is a very thin dome made of latex or silicone, which is placed in the vagina before sexual intercourse. As it follows the shape of the cervix, it is able to block the passage of sperm. But to protect yourself effectively, the cape must always be associated with a contraceptive gel (spermicide)a substance that inactivates or destroys sperm.

What is the definition of a cervical cap?

The Cape cervical is a contraceptive in the form ofa very fine little dome latex or silicone. She places herself deep in the vagina to block the passage of sperm during intercourse. Note that the cape does not protect against sexually transmitted diseases such as HIV. The cervical cap resembles the diaphragm but has some differences (especially in shape or effectiveness in women who have already had children). The cervical cap is smaller than the diaphragm and can be left in place longer (72 hours after intercourse versus 24 hours), reports a study available in the Cochrane Library review.

Do you need a prescription to have a cervical cap?

The cape requires a medical prescription, according to article L. 2311-4 of the Public health code. Before opting for this contraception, it is therefore necessary to consult a general practitioner, a gynecologist or a midwife. The cervical cap can only be purchased in pharmacy (often on order) or in a Family Planning or Education Center (CPEF).

What is the mode of action of the cervical cap?

The cape acts as a mechanical barrier to sperm (and therefore to spermatozoa). It should be applied just before intercourse and up to two hours before. To be effective, the cape must be coated with a spermicidal gel. Of course, the cervical cap should be used when each sexual intercourse. Before use, you must determine the size of the cervical cap that is best suited to your anatomy. For this, it is advisable to consult a gynecologist, a general practitioner or a midwife. It is this healthcare professional who will decide if this contraception is suitable for you and will determine the size and shape of the contraceptive according to the size of your cervix. Also, it is important to reassess the size of your diaphragm or cervical cap after weight loss or gain, pregnancy, and miscarriage. If some contraceptives have a standard size, supposed to be suitable for all women, it is better to choose a really suitable model (a larger size for women who have already had several children by natural means, or a smaller one for nulliparous women for example. ..). There are three sizes: 22 millimeters, 26 or 30. The doctor will also be there to bring you explanations and advice on its installation, its removal, its advantages or disadvantages, as well as its handling. Finally, he will be able to tell you when to replace the cape; usually after 2 years.

The cervical cap is placed just before intercourse (no more than two hours before the report). You should have clean handsgold of its manipulation. Before first use, wash it with mild soap and clean water.

► Pour approx. 4 ml (one teaspoon) of spermicidal gel on the membrane and spread some on the edges and on the dome.

► In a comfortable position (squatting, lying down, standing with one leg at an angle…), insert the cap into your vagina. With your free hand, spread the lips of your vagina, then introduce it along the back wall of the vagina, like a tampon.

► Check if the cervix seems covered by the membrane and make sure that the cap does not move. Normally, the cap is supposed to adhere to the wall of the cervix and cover it like a hat. If it seems to move, it is badly positioned. Likewise, if it is slipping during intercourse, is that it is either incorrectly installed, or that its size is not suitable.

When should the cervical cap be removed after intercourse?

The cape must be left for 8 hours after sex. It can be withdrawn at the latest up to 72 hours after the report. A removal notch (or a handle depending on the model) makes it easier to remove the contraception by simply pulling on it in order to detach it from the walls and extract it from the vagina. After removal, wash it with soap and water and let it air dry (away from direct sunlight as heat may damage it). Before each use, always check the condition of your cape (if there are any holes or cracks in it, for example).

How effective is a cervical cap?

The cervical cap is effective at 74% in women who have not had children and 68% among women who have already had children. Indeed, for women who have had children (and therefore with a slightly more open cervix), the cervical cap loses its effectiveness since it covers the cervix less well. (the rates for France come from the COCON study (Moreau 2007, Moreau 2009) and are reported by the High Authority of Health). If they are well cleaned between each report, these contraceptives are reusable sometimes up to 2 years. It is also your gynecologist or your doctor who will tell you when it will be necessary to change it.

To whom is the cape contraindicated?

The cape is not recommended for women:

• for which pregnancy would pose a serious risk such as heart disease. The effectiveness of the cape is not optimal enough. These women must seek the advice of their gynecologist in order to define together an appropriate contraception.
• suffering from recurrent urinary tract infections or having a genital prolapse (descending of organs).
• in the first 6 weeks after delivery
• women who have already had several children because the changes in the uterus associated with pregnancy can reduce its effectiveness.
• to women bothered by vaginal manipulations. Indeed, the installation, the removal or the various checks require putting your fingers in your vagina and touching your genitals. This is why these contraceptive methods may not be very recommended for young girls who are just starting their sexual life because their installation can be delicate and impose a good knowledge of their body.

How much does a cervical cap cost? What reimbursement?

The cervical cap is sold at the price of 60 euros and is not reimbursed. Note that the spermicidal gels that accompany the cape are sold in pharmacies (without a prescription) between 7 and 19 euros and are not reimbursed. In France, the mainly marketed brand of cervical cap is Gyneas Femcap©.