Bareback Swingers - The risks of Nonoxynol-9
Its a popular over-the-counter contraceptive used by
millions of women. Now, the government and leading health officials are
warning: Nonoxynol-9 may increase your risk of contracting a sexually
transmitted disease, including H-I-V, if you use it frequently.
The F-D-A
is proposing warning labels on all products containing Nonoyxnol-9.
Several groups, including Planned Parenthood and the National Aids
Council, are no longer giving out condoms with N-9, yet they still fill
the shelves in every corner drugstore!
Its a popular ingredient in many over-the-counter contraceptives used by
more than a million American women. Its in everything from contraceptive
foams, gels, even condoms.
Now, the government, scientists and leading health officials are warning:
Nonoxynol-9 (N-9) may increase your risk of contracting sexually
transmitted diseases, including HIV, if used frequently.
The FDA is now proposing warning labels on all vaginal contraceptives
containing N-9, and is discussing whether condoms should contain warnings
as well.
Recently, the Food and Drug Administration (FDA) proposed new warning
labels for all over-the-counter (OTC) vaginal contraceptive products
containing Nonoxynol-9 (N-9).
These warning statements would advise consumers that vaginal
contraceptives containing Nonoxynol-9 do not protect against:
-
Infection from the human immunodeficiency virus (HIV), the virus that
causes AIDS
-
Other sexually transmitted diseases (STDs)
The proposed labels also warn that frequent use of vaginal contraceptives
containing Nonoxynol-9 can increase vaginal irritation. Increased vaginal
irritation from use of Nonoxynol-9 may increase the possibility of
transmission of the AIDS virus (HIV) and STDs from infected partners.
According to the FDAs proposal:
Nonoxynol-9…works as a vaginal
contraceptive by damaging the cell membrane of sperm. It has been shown in
certain studies to damage the cell wall of certain STD pathogens and to
have activity against certain bacterial and viral STD pathogens, including
HIV.
However, based on data the agency believes that this
same cell membrane damaging effect can damage the vaginal and cervical
epithelium (cell lining.) Thus, Nonoxynol-9 can have a negative impact
on the vaginal lining and may increase the user's risk of getting
STD/HIV and other genital infections.
Condoms are not included in the current FDA label proposal, although the
agency is in discussions about whether condoms should contain warnings as
well.
The Center for Disease Control and Prevention also urges people at high
risk of STDs (i.e., those not in a monogamous relationship) to avoid
contraceptive products with nonoxynol-9.
The World Health Organization:
On June 28, 2002, the World Health
Organization (WHO) issued revised public health guidelines for the use of
Nonoxynol-9 for HIV and STD prevention and for pregnancy prevention in
populations at high risk for HIV. The guidelines were based on a review of
current clinical safety and effectiveness data on Nonoxynol-9.
The WHO
guidelines advised that:
The guidelines also advised women
at high risk of HIV infection against using Nonoxynol-9 spermicide for
contraception.
The study: Considerable research has been undertaken on the safety and
effectiveness of Nonoxynol-9 for HIV prevention. A large multi-country
study sponsored by the World Health Organization (WHO) and conducted by
UNAIDS, reported preliminary results in July 2000 and the final report was
published in The Lancet in September 2002.
The study, which was conducted by Dr. Lut Van Damme, showed that women
using Nonoxynol-9 had a higher incidence of HIV infection than women using
a placebo gel.
Prompted by the data, the WHOs Department of Reproductive Health and
Research, in partnership with the CONRAD (Contraceptive Research and
Development Program) convened a Technical Consultation in October 2001 to
review the implications of the new data on the use of Nonoxynol-9 as a
spermicide.
Some key conclusions from the Technical Consultation include:
Nonoxynol-9 offers no protection against sexually transmitted infections
such as gonorrhoea or Chlamydia.
There is no evidence that condoms lubricated with Nonoxynol-9 are any
more effective in preventing pregnancy or infection than condoms
lubricated with silicone, and such condoms should no longer be promoted.
Although Nonoxynol-9 has been shown to increase the risk of HIV
infection when used frequently by women at high risk of infection, it
remains a contraceptive option for women at low risk.
There was an increase in the risk of HIV among women who were using
Nonoxynol-9… Nonoxynol-9 causes irritation. Irritation means you are more
sensitive to being infected with HIV. Definitely the product is not
preventing you from getting HIV. says Dr. Van Damme.
Dr. Van Damme adds that, it is a good idea that the Food and Drug
Administration is proposing warning labels.
N-9 companies say they are committed to protecting
customers
Johnson and Johnson, the maker of the Ortho Options line of
contraceptives, says its products are designed and marketed for pregnancy
protection, not infection prevention, and will follow any safety
requirements to keep users safe. The company says:
-
As always we will work with the FDA to continue offering safe, effective,
over-the-counter, non-hormonal birth control options. All Ortho Options
products will include any label changes deemed necessary by the FDA to
ensure the safety of the women who use them.
The maker of Trojan condoms says N-9 offers an important
option for some users. The company says
Armkel, the maker of Trojan condoms, is committed to supporting and
protecting the public health through responsible public health policy.
Among sexually active individuals, condoms are a very effective means to
prevent unwanted pregnancy and the only means available to reduce the risk
of getting sexually transmitted diseases, including HIV/AIDS.
The Trojan brand offers a variety of condoms. Some of these condoms are
lubricated with the spermicide nonoxynol-9 (N-9). N-9 has been used as an
effective spermicide for over 50 years and has been used on condoms for
over 15 years. Condoms lubricated with N-9 offer an important option for
family planning where pregnancy protection is the primary need. Many
consumers prefer the extra measure of pregnancy protection that N-9
spermicidal lubricant is intended to provide.
In light of our commitment to protecting the public health, we feel
consumers should be allowed to choose the products that best meet their
needs. We are currently working with the FDA on revised labelling for
condoms lubricated with the spermicide N-9 to ensure they are used
appropriately.
Be informed, but not alarmed.
Dr. David Soper is Vice Chairman and Professor of OB-GYN at the Medical
University of South Carolina.
He says, If [irritable symptoms] were to be noticed by patients using
N-9, our recommendation would be for them to stop using the product and
for them to call their doctor and possibly be examined for any evidence
of inflammation of the lower genital track,
Occasional use OK?
He adds, When I council patients about the use of N-9,
currently given this new information, I'm recommending that they use N-9
less than once per day. By decreasing the frequency of use, they decrease
their risk of having an adverse reaction to the topical contraceptive and
decrease their risk for inflammation and ulcer formation.
He says not everyone needs to be alarmed. If you are using
N9, just make sure you are using it infrequently and everything should be
fine.
My best advice to patients that are using N-9 now for
contraception is to seek the advice of their health care provider.
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