Two New Contraceptives Reach Store Shelves
Two new contraceptives are making a splash in drugstores this week, adding to the ever expanding array of options. After being absent for over a decade, the Today Sponge—made famous by Elaine in the TV show Seinfeld—is now widely available again, retailing over the counter for $8 to $10 for a pack of three. And Lybrel, the oral contraceptive that stops periods, is now stocked behind the counter, available by prescription. A four-week supply of 28 tablets costs about $57 at CVS and Wal-Mart, similar to the cost of other brands that allow monthly periods.
Inserted into the vagina like a diaphragm, the foam Sponge is coated with the spermicide nonoxynol-9 and contains no hormones. It's the same one that was taken off the market in 1995 (because of production problems), dressed up in new packaging and produced by a new manufacturer. Like other contraceptives, it has its pluses and minuses. On the plus side, women don't need a prescription. "It appeals especially to younger women who might otherwise not use any contraception," says Andrew Kaunitz, professor and assistant chair of obstetrics and gynecology at the University of Florida College of Medicine-Jacksonville.
On the minus side, he adds that "it has an intrinsically high failure rate." The manufacturer's clinical trials found a pregnancy rate of 13 to 16 percent per year in typical users of the sponge—they may not use it every time they have sex or may not leave it in for the recommended six hours afterward. Pregnancy rates were about 9 to 11 percent in those who used the sponge correctly every time. This compares with a pregnancy rate of about 1 percent (for perfect use) to 7 percent (for typical use) for those who use the pill or patch.
Lybrel, the first pill approved in May for continuous use, is being marketed as the pill that ends periods. But while women won't have any scheduled days that they'll bleed each month, they usually have unpredictable spotting and bleeding, especially during the first few months of use. Even after a year, about 20 percent of Lybrel users still had intermittent spotting and another 20 percent had bleeding heavy enough to require the use of a sanitary napkin or tampon, according to Wyeth, manufacturer of Lybrel.
"Women may find themselves always wearing a minipad because they don't know when spotting will occur," says Kaunitz. But he says the pill might offer a hidden advantage in the form of reduced pregnancy rates. Those who have to pick up their pill prescription every month sometimes start the pack a day or two late, which means they've been off the hormones for beyond the placebo week—enough time to start the ripening of the egg for ovulation. Being a day or two late with Lybrel, which has no placebo days, won't present this problem.
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