Return of the Sponge

This post was originally published in the June 2005 edition of “Emma’s Journal”, the newsletter of the Women’s Health project.

This spring was host to a long anticipated event that was celebrated by many. No, I’m not talking about the final installment of the Star Wars series. I’m referring to the April 22nd announcement that the Today Sponge was re-approved by the FDA and will soon be back on American shelves.

A long time ago, in an America that now may feel far, far away, the Today Sponge was the most popular over-the-counter, female birth control method on the market. Eleven years ago, this method was suddenly absent from American womens’ list of birth control choices, but now the makers of the Today sponge are planning a triumphant return.

The Today sponge is a polyurethane sponge that contains the spermicide nonoxynol-9. When placed in the vagina, it absorbs sperm released during intercourse and prevents pregnancy. Despite its relatively low effectiveness as a birth control method (81-91% compared to the male condom’s effectiveness of 90-97%), it quickly became popular after its original release in 1983. One of its main benefits was its wide availability. It was always available over-the-counter and without a prescription, making it available to young women. Some women preferred it to hormonal birth control, because of its lack of side effects.  It also allows for spontaneity in love-making, because it can be inserted long before sex and is effective for 24 hours. The sponge was very commonly used in conjunction with condoms for heightened contraceptive effectiveness.

American women were shocked in 1994 when its contraceptive was taken off the market. After an FDA inspection of the sponge-making facilities found several problems in production, the makers of the Today Sponge, Whitehall-Robin Healthcare, decided to stop production rather than fix the problems. This was commemorated by the now infamous episode of Seinfeld, where New York women scrambled to stockpile sponges, only to realize that many of their partners were not “sponge-worthy”.

In 1998, Allendale Pharmaceuticals bought the rights to the Today Sponge from its original makers, and planned on re-releasing the sponge right away. However, between 1995 and 1998, the FDA adopted some new guidelines that slowed the sponge’s reintroduction. Since then, they have been working to updated the production and make it available again. The Today Sponge has been available in Canada since 2003, as well as other contraceptive sponges that have never been released in the United States.

Since the Today Sponge was taken off the market here, there have been new concerns raised about the spermicide nonoxynol-9. Studies have shown that the chemical can be very irritating to the vagina and rectum, and this irritation can make people more susceptible to sexually transmitted infections (STIs) including HIV. New guidelines from the United States Centers for Disease Control (CDC) and the World Health Organization (WHO) say that, while nonoxynol-9 can be effective as a contraceptive, it should not be used by individuals who are at high risk for acquiring STIs and HIV, which could be anyone in a non-monogamous or new relationship. (In addition, according to these guidelines, nonoxynol-9 should never be used rectally.) It is unclear if the way the nonoxynol-9 is placed in the sponge has any affect on this risk.

Even though new birth control methods have been introduced since the Today Sponge left American markets eleven years ago – like new lower-hormone birth control methods and the female condom – Allendale Pharmaceuticals is anticipating strong customer demand for the sponge. “Daily call and emails from women confirm there is still a great need for the Today Sponge”, said Gene Detroyer, president and CEO of Allendale Pharmaceuticals. Allendale plans to begin US production immediately, and will begin national distribution during the summer of 2005.