Spermicide effects questioned by FDA panel.

Abstract

Spermicides clearly work better than no contraceptive at all, but there's no way to say how effective they are or whether women should opt for a gel, foam, suppository, or film, a scientific panel concluded. The advisors to the US Food and Drug Administration (FDA) heard disturbing evidence that women who rely on spermicides as their sole contraceptive have anywhere from a 9% to a 57% chance of becoming pregnant within a year. Spermicides appear to work best when used just 30 minutes before intercourse, said Dr. James Trussell of Princeton University. Nobody knows for sure how well spermicides work, and which work best, because the only studies ever performed were flawed. The manufacturers never proved how well their products work because they hit the market in 1950, before the FDA required such proof. The US National Institutes of Health (NIH) plans to begin a study comparing one brand of each type of commercially available spermicide to see how effective they are. The results will not be available for at least 4 years, so the FDA is debating what to tell consumers in the meantime and if that study will be enough. The FDA may soon change spermicide labels at least to rank the products as less effective than other contraceptives, Dr. Lisa Rarick, FDA reproductive health chief, said. Spermicides also should bear a warning that they may cause vaginal irritation, a condition one study suggests might increase a woman's chances of catching HIV, the scientific panel told the FDA. The same panel agreed, however, that spermicides can help protect women against two other sexually transmitted diseases, gonorrhea and chlamydia.