The Birth Control That Nobody Talks About

Sometime after my 30th birthday, my unfailingly on-time and painless cycles started going haywire. I was having paralyzing migraines once a month, weeklong bouts of moodiness, and a host of PMS symptoms that, up until then, I was lucky to have never experienced before. I’d been committed to the pill since the early aughts and had to wonder if, after all this time together, the chemistry between us was just gone. “Well, you are getting older,” my husband so helpfully pointed out. “Maybe your hormones are changing.” I was sure my gynecologist would point a finger at the estrogen I was ingesting, instead.

Much like Scout Perry, who detailed her adventures quitting birth control last month, I asked my lady doc about pursuing non-hormonal options. Rather than engage in my blame game, she recommended going off the pill for at least two months to see what my body would do when left to its own reproductive devices. Other than reproduce, that is. I was still trying to keep the babies at bay. So, how could I go back to nature, so to speak, while still being safe? Were condoms my only option short of making another long-term commitment?

They were not. She suggested I head to any pharmacy and there, hidden in plain sight among the condoms, lubes, and various “personal” accoutrements would be a plain white box with three bold letters: VCF. Never heard of it? Neither had I.

VCF, or Vaginal Contraceptive Film, is a roughly two-inch square plasticky sliver that feels a lot like the sheets you peeled Fruit Roll-Ups off of as a kid (or as an adult — no snack shaming here). It’s totally soluble and turns into a spermicidal gel when inserted up near the cervix “by either the woman or her partner,” according to the product’s website. Romantic. The fold-and-stuff insertion method is similar to using the NuvaRing, but this only needs to go in 15 minutes prior to sex and is good for three hours of protection during which time the gel is almost completely undetectable. Of course, like any other non-barrier method, VCF offers no protection against STIs and, thus, it should only be used with trusted partners and when both parties have been tested.

So, why don’t we know about this readily available, easier than easy, no-commitment-necessary contraceptive? Is this some kind of conspiracy to turn 17% of women aged 15 to 44 into hormone-ravaged monsters that are beholden to pharmaceutical companies for decades at a stretch? I think it is. But, maybe it just comes down to marketing.

Dr. Deborah Nucatola, senior director of medical services at Planned Parenthood Federation of America, says simple semantics could be shrouding this product in mystery. "Most people are probably more familiar with the term 'spermicide.' They may not realize that these are the same types of contraception." Though, stamping the box with that descriptor might be a deterrent, too. "Some women find spermicide a little messy," she adds [ed note: the films are not], along with the warning that, "Some people are allergic to spermicides or get skin irritations from them — and since skin irritations increase your risk of sexually transmitted infections, including HIV, spermicides are not recommended for men and women at high risk of STIs."

When I asked my own gynecologist how solid of an option VCF really was, her response was something like, "Well, that depends on how terrible it would be for you to get pregnant." In fact, this handy chart from Planned Parenthood puts it in the least-effective category. Birth control pills — and other hormonal methods — are extremely reliable. For an on-par alternative, she recommended combining forms, like condoms plus spermicide, spermicide plus withdrawal (another method that’s having a moment), or withdrawal plus rhythm. "Even if you don't use another method along with spermicide," Dr. Nucatola adds, "your chance of getting pregnant is much less than if you use no birth control at all."

When used alone and completely correctly, spermicide (like Nonoxynol-9, the active ingredient in VCF) prevents 85% of pregnancies. But, Dr. Nucatola cautions against relying on that level of efficacy. "Like all birth control methods, spermicide is more effective when you use it correctly. Typically, for women who use spermicide, 29 out of 100 will become pregnant each year," she says. Even though we might all like to think we’re geniuses in the sack, that number leaves us feeling somewhere shy of totally secure.

"But, many women do find spermicide a simple and convenient form of birth control," the doc concedes. "It's easy to get and easy to insert, it doesn't require a prescription, [and] it doesn't affect your hormones." And, it's right there at the local CVS for $12.99 (for a pack of nine!).

Dr. Nucatola underscores that it's important to consult your own doctor to decide if this super-secret film could be right for you. "Birth control methods aren't one-size-fits-all," she says. "There are many contraceptive options for women — and all come with different advantages and disadvantages." As for my completely anecdotal experience: I haven’t had a migraine during my break from the pill, have exited the emotional tilt-a-whirl, and, at present, am not with child. There are certainly reasons that VCF may be the wrong choice for you, but not knowing it exists shouldn’t be one of them.