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Cervical Cap

A cervical cap is a reusable method of contraception. It is made of silicone or rubber (with or without latex) and looks like a deep cup.



This article is part of our Contraception Series!

 

What we're covering


 

Note: the information below was sourced from references (1-5), unless stated otherwise.


What is it?

A cervical cap is a reusable method of contraception. It is made of silicone or rubber (with or without latex) and looks like a deep cup. The device is inserted into the vagina and placed over the cervix. It is often used in combination with a spermicide. Read more about why this is and how they work here. There are also caps on the market that don’t require spermicide. Your cap should be replaced every year or so. Check this with your healthcare provider.



Because the cap has to fit well to be effective, they’re only available on prescription in most areas. Your doctor will measure the space inside your vagina using model caps. This requires a pelvic exam, in which the doctor looks and feels around the vagina and cervix using their fingers and a speculum. This can be uncomfortable, both physically and mentally. Let your doctor know if you’re nervous for the examination and procedure or if you’re uncomfortable at any time. If you lose or gain weight (about 3 kilograms [7 pounds] or more), or go through pregnancy (even if you have a miscarriage or abortion), you should get your cap refitted.


In some regions, you can get a cap in store or online. These typically come in sizes based on whether you’ve given birth or not.


Inserting a cervical cap has a bit of a learning curve. If you find it too difficult, you might be more inclined to skip it when you’re having sex. If that’s the case for you, a different method may be more suitable to keep your risk of pregnancy low. You could opt for a male or female condom or a hormonal method instead.


How does it work?

Just like other barrier contraception methods, the cervical cap works by using a physical barrier to prevent sperm cells from entering the uterus (womb) via the cervix and vagina. As mentioned above, some caps are used in combination with a spermicide. A spermicide is a gel or cream that kills sperm cells or prevents them from moving around. It can also be used as a contraception method on its own, but it’s not very effective that way (read more about spermicides here). You can insert the cap up to six hours before you expect to have sex. If you insert it more than two hours before you have sex, and you’re using a variety that requires spermicide, add some spermicide high up in the vagina (as if you’re inserting a tampon) right before you have sex. Before you start using this method, you should carefully check the instructions provided to you by your doctor or on the packaging.

How do I use a cervical cap?

You should leave your cap in place for at least eight hours after the last time you had sex. This is the time needed for sperm cells to die in the acidic environment of the vagina. If you want to continue having sex or have sex again before the eight hours have passed, put more spermicide in the vagina (if using a cap that requires spermicide), but don’t take out the cap. Start counting the required eight hours from then on again.


How effective is it?

The effectiveness of a cervical cap varies widely between users. This depends mainly on whether you’ve given birth or not. A cervical cap is somewhere between 70% and 85% effective, meaning out of 100 people* using the cap, around 15 to 30 people will get pregnant within a year. Discuss with your doctor whether a cervical cap would be effective enough for you.


What are possible side-effects?

If your cap contains latex and you or your sex partners have a latex allergy, you could develop an allergic reaction. If you or people you have sex with have a latex allergy, choose a cap made out of silicone or latex-free rubber. Moreover, a cervical cap can irritate the cervix or vagina, especially when combined with spermicides. Lastly, if the cap is left in place for too long, there is a very small chance of toxic shock syndrome. Don’t leave your cervical cap inside for more than 24 hours to minimize that risk.

When can't I use it?

Some people can’t use a cap because they have a prolapse that’s too severe. If you have a prolapse, or a different issue with your pelvic floor, ask your doctor if a cap would be suitable for you. The cap also can’t be used in combination with an oil-based lubrication (lube), because this damages the device’s material. Choose a water-based lubrication instead. The cap shouldn’t be used if you have cervical cancer or if you have a high risk to catch HIV (or have an HIV infection). In case you or your sex partners have a latex allergy, don’t choose a cap containing latex.


Does it work immediately?

Usually, yes. When you’ve inserted the cap with spermicide, you’re good to go. However, some spermicides take longer to work (read the box carefully to make sure), and you should insert more spermicide in the vagina if you inserted the cap more than two hours before starting sex and if you have sex multiple times.

What happens to my fertility if I stop using it?

Since nothing in your body changes when you use this method, nothing’s different when you stop using this method. You have a higher risk of pregnancy if you’re having unprotected sex compared to when you’re using contraception.


Does it protect against sexually transmitted diseases (STDs)?

No. While the cap may protect against some STDs, it doesn’t do so reliably. It doesn’t protect at all against some other STDs, including HIV. Therefore, if there is a risk you or your partner has an STD, use a condom instead.



*People, here, means anyone who is able to become pregnant, including girls, women, and non-binary people and transgender men who still have their uterus, vagina, and ovaries.



Are you curious about other methods to protect yourself from an unwanted pregnancy? Read about other birth control options here!



This article is pending medical review.

Contributors

Written by Juliëtte Gossens

Reviewed by Sophie Oppelt and Selina Voßen

Edited by Juliëtte Gossens

 

References


  1. McFarlane I (ed.). Seeing the unseen: The case for action in the neglected crisis of unintended pregnancy. United Nations Population Fund. 2022. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/EN_SWP22%20report_0.pdf

  2. Hacker NF, Gambone JC, Hobel CJ (eds.). Hacker & Moore’s Essentials of Obstetrics & Gynecology. 6th ed. Philadelphia: Elsevier; 2016.

  3. Hoffman BL, Schorge JO, Halvorson LM, Hamid CA, Corton MM, Schaffer JI (eds.). William’s Gynecology. 4th ed. New York: McGraw-Hill Education; 2020.

  4. Centers for Disease Control and Prevention. The United States Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/mec/summary.html

  5. Centers for Disease Control and Prevention. 2016 U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). Available from: https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/summary.html


Please note: the information we provide to you here is for educational purposes only. If you’re experiencing any discomfort or have any complaints or questions about your health, please contact your doctor or other relevant health professional. We don’t provide medical advice.

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