“I’m just really trying to find a birth control that doesn’t involve hormones,” a patient shared with me just the other day. “I’ve heard about the cervical cap – is it something I should consider?” It’s a great question, and one I discuss with women in my practice quite a bit. If you’re looking for a contraceptive method you can manage yourself, without daily pills or hormonal side effects, the cervical cap might indeed be an option worth exploring. Let’s chat about it, just like we would in the clinic.
So, What Exactly Is a Cervical Cap?
Think of a cervical cap as a small, thimble-like cup, usually made of silicone or soft rubber. You place it inside your vagina before you have sex. Its job? To cover your cervix – that’s the opening to your uterus – so sperm can’t swim through to meet an egg. It stays in place with a bit of natural suction.
Here in the U.S., the most common one you’ll hear about is called FemCap®. It’s not something you can just pick up off the shelf, though. You’ll need to see a healthcare provider, like me or a gynecologist, to get it fitted and prescribed.
Some folks say it looks a bit like a tiny sailor’s hat – it has a dome and a brim. There’s even a little strap on it to help you take it out.
How Does It Work to Prevent Pregnancy?
The cervical cap is what we call a barrier method of birth control. It physically blocks sperm. Simple as that, mostly.
Now, to give it an extra boost of effectiveness, many women (and I usually recommend this) add spermicide to the cap before inserting it. Spermicide is a gel or cream that stops sperm in their tracks – either by immobilizing them or killing them. So, you get a physical barrier and a chemical one. Double protection, you see.
These caps come in a few different sizes, because, well, everyone’s anatomy is a bit different. That’s why the fitting with your provider is so important. We need to make sure it’s snug and secure.
How Effective Is a Cervical Cap, Really?
This is where we need to be really honest. Like any birth control, the cervical cap only works well if you use it correctly, every single time you have sex. And that snug fit I mentioned? Super important. If it’s loose, sperm might find a way around.
Its effectiveness can also change depending on a couple of things. For women who haven’t given birth vaginally, it’s about 86% effective with typical use. That means, out of 100 women using it for a year, about 14 might get pregnant.
For women who have had a vaginal birth, the effectiveness drops to about 71%. Childbirth can stretch the cervix and vagina, making the fit a bit trickier.
It’s good to know that cervical caps aren’t quite as effective as some other methods out there, like birth control pills, patches, rings, or IUDs. We can always talk through all the numbers for different methods.
Finding Your Fit: Sizing and Refitting
Since one size doesn’t fit all, getting the right cervical cap is key. They generally come in small, medium, or large. Your doctor or nurse will help determine the best size for you during an exam.
And listen, our bodies change! So, you’ll need to get refitted if:
- You give birth vaginally.
- You have a miscarriage or an abortion.
- You have any kind of pelvic surgery.
- You gain or lose a significant amount of weight.
Remember, if the fit isn’t right, it won’t work as well, and that could mean an unplanned pregnancy.
Using Your Cervical Cap: A Little How-To
It might take a little practice to get the hang of inserting your cervical cap. Don’t worry, that’s normal! Your provider can show you, or you can follow the instructions that come with it. The goal is to have it cover your cervix completely.
Before you use it each time: Give it a quick check for any holes or tears. If it’s damaged, don’t use it.
You can put the cap in up to six hours before you plan to have sex. Here’s a general guide:
- Wash your hands well with soap and water.
- It helps to find your cervix first. You can do this by inserting a finger into your vagina. Your cervix feels firm, a bit like the tip of your nose, and it’s at the top of your vagina.
- Apply spermicide (if you’re using it) into the dome of the cap and on the flat part of the brim. Some also goes in the little groove between the dome and brim.
- Get comfy. Squatting, or putting one leg up on a chair, often works well.
- Gently separate the lips of your vulva with one hand. With the other, squeeze the brim of the cap and slide it into your vagina, dome up, strap facing downwards.
- Push it up until it covers your cervix. You can check with your finger to make sure it’s in place and feels secure.
Taking it Out
You need to leave the cervical cap in for at least six hours after you last had sex.
To remove it:
- Get into a comfortable position again, like squatting.
- Reach in and find the removal strap with your finger.
- Gently push on the dome of the cap to break the suction.
- Hook your finger under the strap and pull it down and out.
After you take it out, wash it with mild soap and warm water. Let it air dry completely, then pop it back in its storage case.
How Long Can It Stay In?
You need that 6-hour minimum after sex. But, don’t leave it in for longer than 48 hours total. If you have sex again while it’s in, you’ll need to add more spermicide without removing the cap (though check your specific product instructions on this, as some may require removal and reapplication of spermicide for subsequent acts).
How Long Does a Cervical Cap Last?
With good care, your cervical cap can last up to two years.
- Always wash it with mild soap and warm water. No harsh chemicals.
- Let it air dry.
- Don’t use oil-based lubricants with it, as they can damage the material. Stick to water-based if you use lube. Spermicide is fine, of course.
- Keep it in its case, away from super hot or cold temperatures.
- A good tip: fill it with water sometimes to check for leaks.
Will It Be Painful?
Nope, it really shouldn’t be. If you feel pain or discomfort, it might be the wrong size, or perhaps not inserted quite right. Have a chat with your provider if this happens; we can check the fit or explore other birth control methods.
The Upsides: What Are the Benefits?
Many women like the cervical cap because:
- It’s small, pretty affordable over time, and reusable.
- You can have sex multiple times within that 48-hour window (remembering spermicide reapplication if needed).
- Most partners don’t feel it during sex.
- It’s easily reversible – stop using it, and your fertility returns right away.
- It’s hormone-free! This is a big one for many.
- You can insert it hours before sex, so it doesn’t interrupt the moment.
The Downsides: What to Keep in Mind
Of course, there are also some disadvantages:
- It needs that consistent, correct use every single time.
- It can sometimes get dislodged during sex, especially if the fit isn’t perfect.
- You need a prescription and a fitting.
- Spermicide can be a bit messy for some.
- It might cause some vaginal irritation in sensitive individuals.
- You have to remember to take it out within 48 hours.
- Crucially, it does not protect against sexually transmitted infections (STIs). You’ll still need condoms for that.
Important Safety Notes: Are There Risks?
While generally safe, using a cervical cap might slightly increase your risk of:
- Bladder or urinary tract infections (UTIs).
- Cervicitis (inflammation of your cervix).
- Toxic Shock Syndrome (TSS). This is rare, but it’s a serious condition. To reduce this risk, never leave the cap in for more than 48 hours, and do not use it during your menstrual period.
If you ever have trouble removing your cap, please see your healthcare provider. Complications are uncommon, but it’s always good to be aware.
Who Might Need a Different Option?
A cervical cap isn’t the best choice for everyone. We’d likely look at other methods if you:
- Have a history of certain abnormal Pap test results.
- Currently have cervicitis or Pelvic Inflammatory Disease (PID).
- Have active reproductive system infections.
- Have had TSS before.
- Have a cervix that’s an unusual shape.
- Have had surgery on your cervix or vagina that might affect the fit.
- Are not comfortable inserting fingers into your vagina.
- Are allergic to silicone or spermicide.
- Are currently on your menstrual period (don’t use it then).
Cervical Cap vs. Diaphragm: A Quick Look
You might also hear about diaphragms, another barrier method. They’re similar but not quite the same:
- Diaphragms are generally a bit larger and shaped more like a shallow dome.
- Cervical caps are smaller, fit more snugly right over the cervix, and often have that distinctive “sailor hat” brim.
- You can typically leave a cervical cap in for a longer period (up to 48 hours) than a diaphragm (usually up to 24 hours, including 6 hours post-sex).
- Some find one easier to insert or remove than the other. It’s personal.
We can discuss which might suit you better if you’re considering a barrier method.
How Do I Get a Cervical Cap?
As I mentioned, you need a prescription. So, the first step is an appointment with your family doctor, a gynecologist, or a women’s health clinic. They’ll do the fitting and write you a prescription, which you can then take to a pharmacy.
When to Call Your Doctor
If you’re using a cervical cap and notice any of these, please give your provider a call:
- Pain in your pelvis or abdomen.
- Vaginal discharge that smells unusual or unpleasant.
- Your vulva (the outside parts) is swollen, itchy, or red.
- Your vagina feels sore or very uncomfortable.
- You can’t get the cap out, or it feels stuck (again, this is rare, but it can happen).
And, very importantly, be aware of the signs of TSS, though it’s rare with cervical caps:
- Sudden high fever.
- A rash that looks like a sunburn.
- Diarrhea or vomiting.
- Flu-like aches and pains.
- Feeling dizzy, faint, or very weak.
If these occur, remove the cap if you can and seek medical attention right away.
Take-Home Message: Key Things About the Cervical Cap
Alright, let’s sum up the main points about the cervical cap:
- It’s a hormone-free, reusable barrier method of birth control you insert yourself.
- It needs to be fitted by a healthcare provider and requires a prescription.
- Effectiveness is higher if you haven’t had a vaginal birth and when used with spermicide.
- Proper use every time and a good fit are essential.
- Leave it in for at least 6 hours after sex, but no more than 48 hours total.
- It does not protect against STIs.
- There are benefits, but also some drawbacks and potential risks to consider.
Choosing birth control is a very personal decision. There’s no one “best” method for everyone. It’s all about finding what works for your body, your lifestyle, and your peace of mind.
You’re not alone in figuring this out. We’re here to help you weigh the pros and cons of all your options, including the cervical cap.