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Please visit www.jewishwomenshealth.org for a wide range of articles and case studies on the topic of women's health and Jewish Law. This website is designed to assist medical practitioners in providing optimal care to their observant Jewish patients. |
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Spermicides Abstract: Many authorities allow the use of spermicides when contraception is halachically permitted. Spermicides should be used to increase the efficacy of the diaphragm when that method is recommended and halachically approved. They should be considered for use in combination with the Lactational Amenorrhea Method, or for short term use instead of condoms. Discussion: Jewish law proscribes the purposeful emission of semen outside the context of marital relations. The halachic term for this prohibition can be translated as destruction of sperm. Nevertheless, most halachic authorities permit the use of spermicide when delaying pregnancy is halachically permitted, as their mechanism of action is creation of a hostile environment for sperm prior to intercourse.[1] Spermicides exist in many different forms. Those that dissolve on contact such as gel and film present no additional halachic considerations. Some authorities feel that foam and, even more so, the spermicide-impregnated sponge [2] are more problematic because they present a physical barrier to the progression of the sperm. The main drawback of spermicides is their limited efficacy [3]. However, they are a useful supplementary method, such as when used in combination with a diaphragm. As a combined method for breastfeeding women relying on the Lactational Amenorrhea Method (LAM), they can be considered a viable option that avoids the breakthrough bleeding common with progesterone only preparations. They are also an option when short term contraception is needed for halachically approved reasons, but the consequences of unintentional pregnancy are not life threatening. This is particularly important because condoms cannot be used for this purpose in this patient population. Implications for Patient Care: Many authorities permit spermicide use where delaying pregnancy is halachically permitted. Spermicides should be considered for use as a backup method in combination with LAM. Because condoms are halachically prohibited, spermicides should also be considered for short-term contraception in this patient population. Medical References [1] Grimes DA, Lopez L, Raymond EG, Halpern V, Nanda K, Schulz KF. Spermicide used alone for contraception. Cochrane Database Syst Rev 2005 Oct 19;(4):CD005218. [2] Kuyoh MA, Toroitich-Ruto C, Grimes DA, Schulz KF, Gallo MF, Lopez LM. Sponge versus diaphragm for contraception. Cochrane Database Syst Rev. 2002 Jul 22;(5):CD003172. [3] Trussell J. Contraceptive Efficacy. In Hatcher RA, Trussell J, Nelson AL, Cates W, Kowal D, Policar M. Contraceptive Techology: Twentieth Revised Edition. New York NY: Ardent Media, 2011 Users of Internet filtering services: This site discusses sensitive subjects that some services filter without visual indication. A page that appears 100% complete might actually be missing critical Jewish-law or medical information. To ensure that you view the pages accurately, ask the filtering service to whitelist all pages under jewishwomenshealth.org. This material is intended for general information purposes only. The patient's individual circumstances should be considered when making specific treatment decisions. Reproduction of the contents of this article for other than personal use |