Cervical Cap

Sexual and Reproductive Health

What is the cervical cap?
Closely related to the diaphragm is the cervical cap, which is smaller and made from rubber or hypoallergenic silicone, covering the cervix only and held by suction. The cervical cap helps to prevent pregnancy by acting as a barrier, stopping the sperm and ovum from meeting. The cervical cap is currently not available in Malta.

How does the cervical cap work?
The cap is fitted in a similar way to the diaphragm. The cervical cap fits in your vagina and covers your cervix. A person wanting to use the cap would need to first have a vaginal examination and then be taught how to use it for the first time by a health professional. Routine visits and examination by a professional should take place every 6 months.

Types of cervical caps:

  • The vault cap, suitable for persons with short cervices.
  • The cervical cap, suitable for persons with a long parallel-sided cervix.
  • The vimule cap, which is a combination of a vault and a cervical cap which adheres to the vaginal wall.


What is the efficacy of the cervical cap?
With careful and consistent use the cervical cap is 80% effective in preventing pregnancy in the first year of use in persons who have given birth in the past, and 91% effective in persons who have never given birth, when used with a spermicide. With typical use, where a person does not use this method carefully, the efficacy is 68% effective in persons who have given birth in the past and 84% effective in persons who have never given birth, when used with a spermicide.

How do I put a cap in?
Discuss your doctor or nurse to show you how to put it in before starting to use it.

  • Wash your hands with soap and water.
  • Follow the instructions provided with the cap.
  • Get into a comfortable position, like when you are putting in a tampon. You may want to squat or put one foot on a chair.
  • Put spermicide on the upper surface of the cap and on the groove between the rim and the dome.
  • Squeeze the sides of the cap together and hold it between your thumb and first two fingers.
  • Push the cap deep into your vagina.
  • For the cap to be effective it needs to cover the cervix. It stays in place by suction.


How do I take my cap out?
The cap should be left inside the vagina for a minimum of 6 hours after sexual intercourse but not more than 48 hours to avoid the risk of toxic shock syndrome and pressure ulcers forming. The application of spermicidal cream or gel is indicated with the use of the cervical cap. This will give contraception protection for 3 hours. After 3 hours, if no sexual intercourse has taken place, more spermicide will need to be inserted, such as in vaginal pessary form. Follow the instructions on the information sheet provided with the cap. Take it out by gently hooking your finger under the rim or strap and pulling downwards.

What are the advantages and disadvantages of the cervical cap?
Advantages


Disadvantages

  • Requires motivation.
  • Needs to be used carefully and consistently for optimum efficacy.
  • Needs to be used with a spermicide which may be perceived as messy.
  • May be harder to insert and remove than a diaphragm.
  • No protection against HIV and other STIs.


Who cannot use the cervical cap?

  • Clients unable to locate their cervix.
  • Those with a cervix which is unsuitable for the method e.g. shape, position.
  • Pregnant mother.
  • Persons with undiagnosed genital tract bleeding which must first be investigated and treated.
  • Persons with abnormalities of the vagina or the cervix existing since birth (congenital).
  • Those allergic to rubber or spermicide.
  • People with vaginal, cervical, or pelvic infections, which must be investigated and treated first.
  • Persons with a history of toxic shock syndrome.
  • Persons who feel unable to touch their genital area because of personal or religious reasons.


What are the side-effects of the cap?

  • Urinary tract infection.
  • Toxic shock syndrome – associated with diaphragms/caps being worn for more than 30 hours.
  • Vaginal irritation.


I have just had a baby. Can I use a cervical cap?
Yes, but wait until at least six weeks after the birth. You may need a different size of caps after you have had the baby. Speak to a doctor or a nurse to check that the size is correct.

Can I use a cap after a miscarriage?
Yes, but you may need a different size of cap after a miscarriage. Speak to a doctor or a nurse to check that the size is correct.

I have lost/gained weight. What do I have to do?
If you have gained or lost 3 kgs, you may need a different size of cap.

Can I have a bath when I have a cap inside?
No. Water can dislodge it or wash away the spermicide.

Sexually Transmitted Infections
This contraceptive does not protect you from any STI. Only condoms can help against STIs.