May 18, 2009

The Femcap:  The Miracle Birth-Control Option You’ve Never Heard Of

I hated birth control.  Initially, I was on the patch.  I was frequently nauseous and had all-night vomiting spells once a month.  Hearing it took the body a few months to adjust, I stayed with it, not wanting to start the whole process over again with another kind of birth control.  But on month number eleven of spending nights with my face against the toilet seat, I switched to Cyclessa, a low-dose, “low side-effect” pill.  The vomiting stopped but I had heavy spotting throughout the month and felt constantly crabby and high-strung.  When I linked grumpiness with birth control, my boyfriend raised his eyebrows at me, as though this was all in my head.  I didn’t want to be one of those girls who blamed wench-like behavior on hormones, so I just got better at dealing with the rush of rage I felt over small things.  But then my upper lip turned brown.  It looked like I’d been sloppily eating chocolate.  When I visited my brother and he stopped mid-hug to say, “Damn sis, looks like you got a moustache,” that was the end for me. When I looked it up on the internet, there it was:  birth control, common cause of melasma (dark pigmentation).  I was quitting, no matter what.

Desperate to find some other way to avoid pregnancy, I was scrolling through dismal option after dismal option on the Planned Parenthood website.  What I wanted was some magical option that kept you from getting pregnant without screwing up your whole body in the process. When I reached “Cervical Cap (Femcap),” I clicked on it, expecting some kind of archaic device; instead, to my great shock, I found exactly what I was hoping for but hadn’t thought existed:  a prevent-pregnancy-without-whacking-out-your-hormones, how-have-I-never-heard-of-this, miracle option.  It’s a reusable silicone cup shaped like a sailor’s hat that you insert in your vagina over your cervix…like a little plug that blocks the sperm from swimming into your vaginal canal.   I had no idea such a thing was out there.

Apparently, neither do most doctors; I read several blogs about women trying to talk to clueless physicians who knew nothing about it.  Even when I went to Planned Parenthood—the place where I’d heard about the thing in the first place—my doctor did everything she could to talk me out of it, citing UTIs as the deterring factor, even though actual research shows that while diaphragms have high UTI rates, Femcaps do not.  I was hell-bent on this non-hormonal option and convinced her to write me a prescription anyway.  Once I had the prescription in hand, the hard part wasn’t over—I now had to find a pharmacy that carried it.  Of the umpteen pharmacies in LA, I found one willing to order it for me—and they were going to charge me way more than the $75 price mentioned on Planned Parenthood.  Finally I ordered directly from, faxing in my prescription.  There are three sizes—small (never been pregnant), medium (have had a caesarian) and large (vaginally-delivered a baby).  Less than a week later, I received my good-for-one-year Femcap, complete with it’s own carrying case (which doesn’t look much different than my old retainer case.)


How to
Holding the mini sailor’s cap in your hand, you put a little spermocide on the inside and outside of the cap to further stop the sperm from moving.  Spermocide initially alarmed me—sounded disgusting and full of chemicals.  But when I got the tube, it was harmless, clear jelly-looking stuff that didn’t cause any irritation and actually helped lube me up, making it easier to glide the Femcap all the way up to my cervix.  Unlike the condom, where you get all riled up only to have to pause while he gets set, the Femcap can be inserted up to six hours before sex.  After sex, you have to leave it in for at least six hours to insure maximum effectiveness.  This was easy and usually involved me leaving it in overnight, adding Femcap removal to my morning routine.  Plus, you could leave it in for up to 48 hours, having sex as many times as you want—though you do want to check to make sure the Femcap hasn’t slipped out of place.  After taking it out, wash it with antibacterial soap and then let it air dry.

Learning curve

It does take a while to get the hang of.  It comes with a learning DVD—a pretty graphic learning DVD—that I watched several times through.  Then I laid down on my bed with my how-to brochure, studying the pictures and working on first feeling my cervix and then scooting the slippery little sucker all the way up there.  Possibly not as familiar with my own anatomy as I should be, I wasn’t sure if it was in there ok—was it all the way up there, covering my cervix completely?  This turned out to be me being paranoid; if you can’t feel it, it means it’s in the right place, and if you can feel it, it means it’s not in the right place.  The more I did it, the more comfortable I felt and the more sure I became that it was where it was supposed to be.  I guess it just took me a while to believe it’s as simple as it is.
The Femcap is designed to remain in place, no matter how hard you go or what position you’re in; as a result, it can take a while to get the hang of removing it.  This kind of gave me peace of mind—if it slid right out, I’d worry it could also slide right out during sex.  It doesn’t slide right out and for the first couple weeks, I experienced mild panic as I tried to wrap my finger under the handle and yank.  But, as with insertion, it got easier the more I did it.  Try different positioning—from laying down, one leg up, one leg down, to squatting like a frog (which worked best for me)—until you find what makes it easiest for you to remove it.  It eventually becomes easy and routine.

Could he feel it?

The first few times, after sex, I’d roll over and ask, “Sooo…could you feel it?”
“No,” he said, shrugging.  “Not at all.”  While hyper-alert for any signs of it, neither one of us could tell it was in there.  He doesn’t have a small penis, so I think this would be the case for most men.


Excerpted from The Handbook of Contraception:

Based on the small studies to date, the typical failure rate is estimated to be 7.6%.  For perfect use, it is estimated that the failure rate is 2-4%.  Perfect use includes using Femcap correctly every time, applying spermocides with each act of intercourse, and using emergency contraception as back-up if the cap is used incorrectly (Shoupe).

STD prevention

While birth control pills and other hormonal contraception do nothing to guard against STDs, the Femcap mechanically covers the cervix, making it harder for bacteria and viruses to enter.  This potential for protection against STDs is further enhanced when you use the Femcap with a Microbicide (a type of spermocide that protects against STDs).  This Femcap trait has the device up for a Priz Galien Award (regarded by the industry as the equivalent to the Nobel Prize).


While the disadvantages listed for hormonal birth control cover everything from weight gain to increased risk of stroke, the only disadvantage I can think of is that the Femcap cannot be used during menstruation.  This didn’t bother me, as it’s highly unlikely for you to get pregnant while on your period anyway (see


While it sounds too good to be true, it’s not.  It’s a huge mystery to me why no one’s ever heard of this.  Once you get the hang of inserting and removing it, it’s smooth sailing.  It should be one of the most popular forms, well-known by women and their doctors.  If you are looking for a non-hormonal option—with no side effects—this is the answer.