Nonoxynol-9
Encyclopedia
Nonoxynol-9, sometimes abbreviated as N-9, is an organic compound
that is used as a surfactant
. It is a member of the nonoxynol
family of nonionic surfactants. N-9 and related compounds are ingredients in various cleaning and cosmetic products. It is widely used in contraceptives for its spermicidal properties. However, its use in STD
prevention is controversial.
, it attacks the acrosomal
membranes of the sperm
, causing the sperm to be immobilized.
Nonoxynol-9 is the active ingredient in most spermicidal creams, jellies, foams, gel, film, and suppositories.
A 2004 study found that over a six-month period, the typical-use
failure rates for five nonoxynol-9 vaginal contraceptives (film, suppository, and gels at three different concentrations) ranged from 10% to 20%.
with solutions containing nonoxynol-9. In this role, it has been promoted as a backup method for avoiding pregnancy and a microbicide for sexually transmitted diseases
in the event of condom failure. However, the 2001 WHO
/ CONRAD
Technical Consultation on Nonoxynol-9 concluded that
jelly contain nonoxynol-9 as the active ingredient. This jelly may also be used for a cervical cap
. Most contraceptive sponge
s contain nonoxynol-9 as an active ingredient.
-sponsored study conducted in several locations in Africa
followed nearly 1,000 sex workers who used nonoxynol-9 gels or a placebo. The HIV infection rate among those using nonoxynol-9 was about 50% higher than those who used the placebo; those using nonoxynol-9 also had a higher incidence of vaginal lesions, which may have contributed to this increased risk. Whereas these results may not be directly applicable to lower-frequency use, these findings combined with lack of any demonstrated HIV-prevention benefit from nonoxynol-9 use have led most major health agencies to recommend that it no longer be used by women at high risk of HIV infection. The WHO further notes that "Nonoxynol-9 offers no protection against sexually transmitted infections such as gonorrhoea, chlamydia."
Regular use of nonoxynol-9 appears also to increase the risk of infection with sexually transmitted human papillomavirus
es (HPVs) that can cause cervical cancer
. In one of the studies, researchers at the National Cancer Institute also reported that the increased likelihood of HPV infection caused by N-9 was mitigated through the use of carrageenan
-based lubricants mixed 1:1 with N-9. Two consumer products containing carrageenan, Divine 9 and BIOglide, prevented detectable HPV infection in the study.
Organic compound
An organic compound is any member of a large class of gaseous, liquid, or solid chemical compounds whose molecules contain carbon. For historical reasons discussed below, a few types of carbon-containing compounds such as carbides, carbonates, simple oxides of carbon, and cyanides, as well as the...
that is used as a surfactant
Surfactant
Surfactants are compounds that lower the surface tension of a liquid, the interfacial tension between two liquids, or that between a liquid and a solid...
. It is a member of the nonoxynol
Nonoxynols
Nonoxynols or nonylphenol ethoxylates are mixtures of nonionic surfactants used as detergents, emulsifiers, wetting agents, defoaming agents, etc. nonoxynol-9, the compound with approximately 9 repeating ethoxy groups, is a spermatocide, formulated primarily as a component of vaginal foams and creams...
family of nonionic surfactants. N-9 and related compounds are ingredients in various cleaning and cosmetic products. It is widely used in contraceptives for its spermicidal properties. However, its use in STD
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
prevention is controversial.
Spermicide
As a spermicideSpermicide
Spermicide is a contraceptive substance that eradicates sperm, inserted vaginally prior to intercourse to prevent pregnancy. As a contraceptive, spermicide may be used alone. However, the pregnancy rate experienced by couples using only spermicide is higher than that of couples using other methods...
, it attacks the acrosomal
Acrosome
The acrosome is an organelle that develops over the anterior half of the head in the spermatozoa of many animals. It is a cap-like structure derived from the Golgi apparatus. Acrosome formation is completed during testicular maturation. In Eutherian mammals the acrosome contains digestive enzymes...
membranes of the sperm
Spermatozoon
A spermatozoon is a motile sperm cell, or moving form of the haploid cell that is the male gamete. A spermatozoon joins an ovum to form a zygote...
, causing the sperm to be immobilized.
Nonoxynol-9 is the active ingredient in most spermicidal creams, jellies, foams, gel, film, and suppositories.
A 2004 study found that over a six-month period, the typical-use
Effectiveness
Effectiveness is the capability of producing a desired result. When something is deemed effective, it means it has an intended or expected outcome, or produces a deep, vivid impression.-Etymology:...
failure rates for five nonoxynol-9 vaginal contraceptives (film, suppository, and gels at three different concentrations) ranged from 10% to 20%.
Condoms
Many models of condoms are lubricatedPersonal lubricant
Personal lubricants are specialized lubricants to reduce friction between body parts, or between body parts and other objects...
with solutions containing nonoxynol-9. In this role, it has been promoted as a backup method for avoiding pregnancy and a microbicide for sexually transmitted diseases
Microbicides for sexually transmitted diseases
Microbicides for sexually transmitted diseases, are pharmacologic agents and chemical substances that are capable of killing or destroying certain microorganisms that commonly cause human infection, for example the human immunodeficiency virus....
in the event of condom failure. However, the 2001 WHO
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
/ CONRAD
CONRAD (organization)
CONRAD is a non-profit organization which seeks to improve reproductive health, especially in developing countries. It does this by promoting clinical research, particularly that research which involves microbicides for sexually transmitted diseases....
Technical Consultation on Nonoxynol-9 concluded that
- There is no published scientific evidence that N-9-lubricated condoms provide any additional protection against pregnancy or STDs compared with condoms lubricated with other products. Since adverse effects due to the addition of N-9 to condoms cannot be excluded, such condoms should no longer be promoted. However, it is better to use N-9-lubricated condoms than no condoms. Compared to regular lubricated condoms, condoms containing nonoxynol-9 present another disadvantage — they have a shorter shelf life.
Cervical barriers
Almost all brands of diaphragmDiaphragm (contraceptive)
The diaphragm is a cervical barrier type of birth control. It is a soft latex or silicone dome with a spring molded into the rim. The spring creates a seal against the walls of the vagina.-Use:...
jelly contain nonoxynol-9 as the active ingredient. This jelly may also be used for a cervical cap
Cervical cap
The cervical cap is a form of barrier contraception. A cervical cap fits over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus, called the os.-Terminology:...
. Most contraceptive sponge
Contraceptive sponge
The contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.Sponges work...
s contain nonoxynol-9 as an active ingredient.
Shaving cream
Nonoxynol-9 is sometimes included in shaving creams for its properties as a nonionic surfactant; it helps break down skin oils that normally protect hair from moisture, so that they become wet and, hence, softer and easier to shave. Gillette formerly used nonoxynol-9 for this purpose in its Foamy products, but has discontinued the practice.Sports cream
Nonoxynol-9 is also found in Bengay Vanishing Scent as an inactive ingredient.Poison ivy creams
Nonoxynol-9 is also found in Zanfel poison ivy cream. It effectively helps to break up the oil urushiol that causes the rash.Side effects
From 1996 to 2000, a UNUnited Nations
The United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and achievement of world peace...
-sponsored study conducted in several locations in Africa
Africa
Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...
followed nearly 1,000 sex workers who used nonoxynol-9 gels or a placebo. The HIV infection rate among those using nonoxynol-9 was about 50% higher than those who used the placebo; those using nonoxynol-9 also had a higher incidence of vaginal lesions, which may have contributed to this increased risk. Whereas these results may not be directly applicable to lower-frequency use, these findings combined with lack of any demonstrated HIV-prevention benefit from nonoxynol-9 use have led most major health agencies to recommend that it no longer be used by women at high risk of HIV infection. The WHO further notes that "Nonoxynol-9 offers no protection against sexually transmitted infections such as gonorrhoea, chlamydia."
Regular use of nonoxynol-9 appears also to increase the risk of infection with sexually transmitted human papillomavirus
Human papillomavirus
Human papillomavirus is a member of the papillomavirus family of viruses that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes...
es (HPVs) that can cause cervical cancer
Cervical cancer
Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. One of the most common symptoms is abnormal vaginal bleeding, but in some cases there may be no obvious symptoms until the cancer is in its advanced stages...
. In one of the studies, researchers at the National Cancer Institute also reported that the increased likelihood of HPV infection caused by N-9 was mitigated through the use of carrageenan
Carrageenan
Carrageenans or carrageenins are a family of linear sulfated polysaccharides that are extracted from red seaweeds. There are several varieties of carrageen used in cooking and baking. Kappa-carrageenan is used mostly in breading and batter due to its gelling nature...
-based lubricants mixed 1:1 with N-9. Two consumer products containing carrageenan, Divine 9 and BIOglide, prevented detectable HPV infection in the study.
Alternatives
Three alternatives to nonoxynol-9 spermicide are:- ContraGel Green: Manufactured by DeltaMed GmbH in Germany and approved for use in Europe with the CE0124 mark.
- Menfegol: Available as a foaming tablet in Europe.
- Benzalkonium chlorideBenzalkonium chlorideBenzalkonium chloride, also known as alkyldimethylbenzylammonium chloride and ADBAC, is a mixture of alkylbenzyldimethylammonium chlorides of various even-numbered alkyl chain lengths. This product is a nitrogenous cationic surface-acting agent belonging to the quaternary ammonium group...
: The active ingredient in one brand of contraceptive spongeContraceptive spongeThe contraceptive sponge combines barrier and spermicidal methods to prevent conception. Three brands are marketed: Pharmatex, Protectaid and Today. Pharmatex is marketed in France and the province of Quebec; Protectaid in the rest of Canada and Europe; and Today in the United States.Sponges work...
, available only in France.
External links
- Safety of Nonoxynol-9 when used for contraception World Health OrganizationWorld Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(October 2001) - Vaginal Spermicide: Nonoxynol Family Practice Notebook.com
- Docs: 'Nonoxynol-9 Doesn't Work' Wired News: Lite, Jordan (May 13, 2002)
- Femprotect alternative to nonoxynol-9
- ContraGel Green alternative to nonoxynol-9
- Info on microbicides
- Condoms containing nonoxynol-9, present a risk to users.
- ChemSub Online: Nonoxynol-9