The cervical cap is a form of barrier contraception for women that offers a non-hormonal and user-controlled method for preventing pregnancy. It is a small, soft, thimble-shaped cup, typically made of medical-grade silicone, that is designed to fit snugly over the cervix. The cervix is the lower, narrow end of the uterus that opens into the vagina. The cervical cap works in two ways: first, it acts as a physical barrier that blocks sperm from entering the cervix and reaching an egg. Second, it is used in conjunction with a spermicide, a gel or cream that kills sperm, which is placed inside the cap before insertion. This dual mechanism provides an effective, on-demand method of birth control that a woman can insert hours before intercourse and that contains no hormones.

Unlike some other contraceptive methods, the cervical cap requires a prescription from a doctor, as it comes in different sizes and must be properly fitted to your individual anatomy. It is an option that appeals to women who are looking for a reusable, discreet, and hormone-free method of family planning, or for those who cannot or prefer not to use hormonal contraception due to medical reasons or side effects. While its effectiveness is highly dependent on correct and consistent use, for the diligent user, the cervical cap can be a safe and empowering choice in managing her reproductive health. This guide provides an in-depth exploration of how the cervical cap works, its effectiveness, the detailed steps for use, and its place among modern contraceptive options.

Understanding the Science: Reproductive Anatomy and How the Cervical Cap Works

To fully appreciate the function of a cervical cap, it is essential to understand the basic anatomy of the female reproductive system and the process of conception it is designed to prevent.

The Female Reproductive Anatomy

• The Vagina: A muscular canal that connects the cervix to the outside of the body.
• The Cervix: A crucial gateway located at the bottom of the uterus. It has a small opening called the cervical os. During most of the menstrual cycle, this opening is plugged with thick mucus that is inhospitable to sperm.
• The Uterus: A pear-shaped organ where a fertilized egg implants and a fetus develops.
• The Fallopian Tubes: Two thin tubes that extend from the ovaries to the uterus. Fertilization of an egg by a sperm typically occurs within a fallopian tube.
• The Ovaries: The organs that produce and release eggs during ovulation and produce key hormones like estrogen and progesterone.

The Process of Conception

For pregnancy to occur, a series of events must happen. During intercourse, sperm are ejaculated into the vagina. The sperm must then travel from the vagina, through the cervical os, swim through the uterus, and enter a fallopian tube. If this occurs during the woman's fertile window around the time of ovulation, the sperm may meet and fertilize an egg. The fertilized egg then travels down the fallopian tube and implants in the wall of the uterus, beginning a pregnancy.

The Cervical Cap's Dual Mechanism of Action

The cervical cap is designed to interrupt this process right at the gateway of the cervix.

• The Physical Barrier: The primary function of the cap is to create a physical seal directly over the cervix. When inserted correctly, it fits snugly and is held in place by suction. This barrier physically blocks the cervical os, preventing sperm from beginning their journey into the uterus and fallopian tubes.
   
• The Chemical Barrier: Before insertion, a small amount of spermicidal gel or cream is placed in the dome of the cap and in the groove along its rim. This spermicide is a chemical agent that immobilizes and kills any sperm that may come into contact with the cap, providing a second layer of protection.

The modern cervical cap available in many parts of the world, the FemCap, is made of silicone and has a distinctive shape like a sailor's hat, with a brim and a removal strap to make it easier to use. It is designed to be reusable for up to one to two years with proper care.

Effectiveness: An Honest and Detailed Discussion

The effectiveness of the cervical cap is a critical point of discussion. Like many user-controlled methods, there is a significant difference between "perfect use" and "typical use." Its effectiveness also varies greatly depending on whether a woman has ever given birth.

• Perfect Use: This refers to using the method correctly and consistently with every act of intercourse, as defined by the instructions.
• Typical Use: This reflects how effective the method is for the average person, accounting for human errors such as incorrect insertion, forgetting to use spermicide, or inconsistent use.

Effectiveness Rates

For Women Who Have Never Given Birth (Nulliparous):

• With perfect use, the cervical cap is about 86% effective. This means that out of 100 women who use it perfectly for one year, about 14 may become pregnant.
• With typical use, the effectiveness rate drops. The failure rate is higher in this group.

For Women Who Have Given Birth Vaginally (Parous):

• The effectiveness is significantly lower for women who have had a baby. This is because childbirth can change the shape and size of the cervix, making it more difficult for the cap to achieve a perfect, reliable seal.
• With perfect use, the effectiveness is around 71%. This means that out of 100 women in this group who use it perfectly for one year, about 29 may become pregnant.
• With typical use, the failure rate is considerably higher.

Due to this lower effectiveness rate compared to other methods like IUDs, implants, or hormonal pills, the cervical cap is best suited for women who are highly motivated, diligent in its use, and who would be accepting of a potential pregnancy should the method fail.

When is the Cervical Cap a Good Option | Candidacy

The cervical cap can be a suitable choice for women who:

• Are seeking a non-hormonal method of contraception due to medical reasons or personal preference.
• Want a method that is controlled by the user and used only at the time of intercourse.
• Wish to have a method that does not interrupt the spontaneity of sex, as it can be inserted hours beforehand.
• Are in a monogamous relationship, as the cap offers no protection against sexually transmitted infections.
• Are comfortable with their own body and with the process of inserting and removing a device from their vagina.
• Are diligent and committed to following the instructions for use precisely with every act of intercourse.
• Are in a position where a potential pregnancy would not be a personal crisis.

The cervical cap is not a good option for women who have a history of Toxic Shock Syndrome, have a known allergy to silicone or spermicide, or have certain anatomical variations of the cervix.

The Fitting and Prescription Process

You cannot buy a cervical cap over the counter. It must be prescribed by a healthcare professional after a fitting.

• The Consultation: Your journey begins with a detailed consultation with a gynecologist. You will discuss your medical history, reproductive health goals, and all your contraceptive options.
• The Pelvic Exam: To be fitted for a cervical cap, the doctor will perform a pelvic examination. They will assess the health, shape, and position of your vagina and cervix.
• Sizing: The modern FemCap comes in three sizes, determined by your obstetric history. The smallest size is for women who have never been pregnant, the middle size is for women who have had a miscarriage, abortion, or a caesarean section, and the largest size is for women who have had a full-term vaginal delivery. Your doctor will confirm the correct size for you.
• The Prescription and Education: Your doctor will provide you with a prescription for the cap. Crucially, they or a nurse will provide you with detailed instructions on how to insert, check the placement of, and remove the cap. You may be asked to practice inserting and removing it in the clinic to ensure you are comfortable and proficient with the technique.

How to Use the Cervical Cap: A Meticulous Step-by-Step Guide

Correct use is the single most important factor in the effectiveness of the cervical cap.

Step 1: Preparation Before Insertion

• Always wash your hands thoroughly with soap and water before handling the cap.
• Check the cap for any holes, tears, or signs of deterioration by holding it up to a light.
• Apply about a quarter to a half teaspoon of spermicide to the dome of the cap on the side that will face the cervix. Spread a small amount into the groove on the rim as well.

Step 2: Insertion

• Find a comfortable position, such as squatting, lying down with your knees bent, or standing with one foot on a chair.
• Separate the lips of your vagina with one hand.
• With the other hand, squeeze the rim of the cap to fold it in half.
• Gently slide the folded cap into your vagina, dome side down, as far as it will go, similar to inserting a tampon.
• Once it is fully inside, press on the rim of the cap with your fingertip to push it up and onto your cervix until you feel the cervix is completely covered. The cap should feel secure and held in place by suction.

Step 3: Checking the Placement

• After insertion, you must check to ensure the cap is correctly placed. Slide your finger around the rim of the cap to make sure you can feel your cervix covered underneath the dome and that there are no gaps. It should feel like a small, firm donut or the tip of your nose.

Step 4: Timing Rules After Intercourse

These rules are absolutely critical for the method to be effective.

• You must leave the cervical cap in place for at least six hours after the last act of intercourse. This gives the spermicide enough time to kill any remaining sperm.
• You must remove the cervical cap within 48 hours of initial insertion. Leaving it in for longer than 48 hours increases the risk of unpleasant odor, vaginal irritation, and the very rare but serious risk of Toxic Shock Syndrome TSS.

Step 5: Removal

• Wash your hands. Find a comfortable position.
• Bear down with your pelvic muscles to help dislodge the cap.
• Reach into your vagina, find the removal strap, and hook your finger under it. If you cannot find the strap, gently press on the dome of the cap to break the suction seal.
• Slowly and gently pull the cap out of your vagina.

Step 6: Care and Maintenance

• After removal, wash the cap with mild, unscented soap and warm water.
• Rinse it thoroughly and let it air dry completely.
• Store it in its provided case, away from extreme temperatures.
• With proper care, a silicone cervical cap can be reused for up to two years before it needs to be replaced.

Our Specialists

Choosing a contraceptive method is a significant health decision. Our team of experienced and compassionate obstetricians and gynecologists is here to provide you with comprehensive counseling on all family planning options.

Dr. Anjila Aneja

SENIOR DIRECTOR OBSTETRICS & GYNAECOLOGY | Fortis La Femme GK

Dr. Meenakshi Ahuja

SENIOR DIRECTOR OBSTETRICS & GYNAECOLOGY | Fortis La Femme GK

Dr. Neena Bahl

SENIOR DIRECTOR OBSTETRICS & GYNAECOLOGY | Fortis La Femme GK

Patient Stories

"I had tried several hormonal birth control pills, and they all gave me side effects that I couldn't tolerate. I was looking for a non-hormonal option that I was in control of. My gynecologist at Fortis discussed the cervical cap with me. There was definitely a learning curve for the first couple of weeks to get comfortable with inserting and removing it, but now it's second nature. I love that it's hormone-free and I only have to think about it when I need it." - Riya Sobti, 28, Delhi

"My husband and I used the cervical cap for birth control in the years between our two children. We knew we wanted another child eventually, so we didn't want a long-acting method. The cap was a good fit for us. It required me to be diligent, especially with using the spermicide and following the timing rules, but it worked well for our needs at that time. It's a method that requires you to be very comfortable and familiar with your own body." Anjali Kumar, 35, Gurugram

Myths vs Facts

Take the Next Step

Choosing a method of contraception is a decision that should be based on your individual health, lifestyle, relationship status, and reproductive goals. The cervical cap offers a unique, hormone-free, and user-controlled option for women who are seeking an alternative to hormonal methods and are highly motivated to use it correctly. It fosters a deep sense of body awareness and can be an effective part of your family planning strategy.

A detailed discussion with your gynecologist is the best way to explore if the cervical cap is a suitable and effective choice for you. Our specialists can provide you with comprehensive counseling on all available methods, ensuring you can make an informed decision that you are comfortable and confident with.

CTA: Book an Obstetrics & Gynaecology Consultation / Get a Second Opinion

Frequently Asked Questions

Q1. How long does a cervical cap last?

Ans. With proper care, a modern silicone cervical cap, like the FemCap, is designed to be reusable and can last for up to two years before it needs to be replaced. You should regularly inspect it for any signs of damage or deterioration.

Q2. Can I use a cervical cap during my period?

Ans. No, you should not use the cervical cap during your menstrual period. This is to reduce the already very low risk of Toxic Shock Syndrome TSS. You should use a backup method of contraception, like condoms, during this time.

Q3. Does the cervical cap protect against sexually transmitted infections STIs?

Ans. No, absolutely not. The cervical cap only covers the cervix and offers no protection against the transmission of STIs like HIV, chlamydia, or gonorrhea. Condoms are the only method of contraception that also provides effective protection against STIs.

Q4. What is Toxic Shock Syndrome TSS?

Ans. TSS is a very rare but serious bacterial infection. The risk is slightly increased with the use of barrier methods that are left in the vagina for an extended period. To minimize this risk, it is crucial that you never leave the cervical cap in for more than 48 hours.

Q5. What should I do if the cap becomes dislodged during intercourse?

Ans. If you suspect the cap has been dislodged, you should apply more spermicide into your vagina immediately and may need to consider using emergency contraception. You should also have your doctor re-check the fit of your cap.

Q6. Can I use lubricants with the cervical cap?

Ans. Yes, you can use water-based or silicone-based lubricants with a silicone cervical cap. You should avoid using oil-based lubricants, as they can damage the silicone over time.

Q7. Do I need to reapply spermicide if I have sex more than once?

Ans. No. As long as the cap remains in place, you do not need to remove it or reapply spermicide for repeated acts of intercourse within the 48-hour time limit.

Q8. What are the most common side effects?

Ans. The most common side effects are vaginal irritation or an increased risk of urinary tract infections UTIs for some women. These can sometimes be related to the spermicide. An unpleasant odor can also occur if the cap is not cleaned properly or is left in for too long.