Medical Examiner

My Body, My Sponge?

It was a wildly popular contraceptive in the 1980s. And then it disappeared.

Two people in hairnets and white lab coats posing with boxes that say "Today" on them in purple-pink swooping letters
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Allendale Pharmaceuticals president Gene Detroyer, left, and chief scientific officer Robert J. Staab pose with the Today Sponge boxes in 2002. Jim McKnight/AP Photo

The sponge first captured Caitlin’s attention when she was a teen. A hormone-free birth control option that she could wear for multiple uses sounded “super intriguing,” says Caitlin, now 26 and working as a nurse in North Carolina.

But when Caitlin worked up the nerve to try the sponge in 2019, she learned it was suddenly off the market—and indefinitely out of production. While it was once on pharmacy shelves for $3 a pop, the sponge now seems to have all but vanished (sometimes it can be found on eBay for many times the original price).

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When it comes to current birth control options, the sponge likely doesn’t come to mind before the pill, the IUD, the NuvaRing, and the “male” condom. But for prior generations of birth control users, the sponge made the top of the list: It was used by 6.4 million women between 1983 and 1995 alone (around 12 percent of reproductive-aged women) and was regarded as the most popular over-the-counter female contraceptive.

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The sponge, also known as the Today Sponge for U.S. markets, is a round piece of foam filled with spermicides that its user inserts into the vagina and over the cervix—much like a menstrual cup. The Today Sponge was invented by Bruce Vorhauer after seven years of clinical trials, and was finally approved by the FDA in 1983. It’s a modern iteration of a rudimentary sea sponge wrapped in silk or cotton netting, which medical historians regard as the most effective birth control before the diaphragm was developed.

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Like all contraceptive methods on the market, the sponge isn’t perfect; its efficacy rate stalled at around 89–91 percent, and it carries a slight risk of toxic shock syndrome. However, what it did offer was control. The sponge is 100 percent hormone-free, does not require a doctor’s visit, and the user has full say over its insertion and removal. It can also be worn for 24 hours and used multiple times. Consider the alternatives: The IUD can involve an incredibly painful insertion (and then removing it can be a whole other hassle). There’s the all-too-common experience of begging a partner with a penis to use a condom. And then there’s the slew of side effects our culture has normalized as part of hormonal contraception. In this landscape, the sponge was a very good and somewhat unique option.

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No matter what method you land on, the autonomy that a particular birth control method might offer can always be taken away. After Dobbs overturned the constitutional right to abortion, experts warned that birth control could likely be next. And just a couple of weeks ago, a Trump judge in Texas seems to have taken that first step by “weaponizing the Constitution against birth control” in the case of minors. The current state of access to reproductive health services, then, up in the air and at the whim of broader forces at play, harks back to sponge users’ turbulent experiences with an otherwise tried-and-true method.

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The sponge’s chaotic journey began in 1994, when its original manufacturer, seemingly overnight, canceled the production of the Today Sponge—indefinitely. Though rumors buzzed about the sponge being pulled due to safety concerns, the FDA never revoked its approval. Instead, its manufacturer deemed it not profitable enough to update its factory equipment to new FDA standards. Millions of women in the U.S. who relied on the sponge as their primary or backup birth control method were sent into a tailspin. This contraceptive turmoil is best memorialized by the iconic Seinfeld episode in which Elaine desperately bought the last case of sponges she could find, and subsequently began to carefully screen dates to determine if they were truly “sponge-worthy.”

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In 2005, Miss Sponge quietly came back, then briefly disappeared due to bankruptcy, and yet again reappeared in 2009. Many may have missed news of the sponge’s return: Its new manufacturer Mayer backed it with a measly marketing budget of a million dollars. This go-around of the sponge lasted a decade nonetheless. Then, once again, the sponge vanished. This time, it was during the COVID twilight zone between 2019 and 2020, during which Mayer’s lab announced “major mechanical failures” with no return date available. The website still laments that “regrettably, we were unable to repair the equipment … we are unable to advise when or if this situation will change.”

There is a cloud of uncertainty around access to reproductive services, and whether they’ll exist when you need them, says Krystale Littlejohn, a sociology professor at the University of Oregon and author of Just Get on the Pill. This goes beyond the mounting probability post-Dobbs that hormonal birth control could soon be heavily restricted in certain states. When it comes to birth control, “choice” has always been illusory—many different “options” are the same repackaged hormones, for instance. User preferences and needs are continuously brushed aside at the whim of corporations and lawmakers. If it sounds reasonable that a manufacturer can stop making a product as it pleases, consider what it ends up meaning: Birth control is a commodity, not a right.

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Consider too that women spend about a third of their lives preventing pregnancy, as Littlejohn’s book shows. “It’s not just about a person trying to prevent pregnancy for the next year or the next two years or with this particular partner,” she explains. “People are compelled to use methods designed for their bodies to try and prevent pregnancy for 30 years or more. It’s a really intense burden that we don’t talk about enough.” Having access to one’s preferred birth control flicker in and out of existence adds another layer of exhaustion.

What’s so notable about the sponge is how little it interfered with one’s body, or sex itself. Jenny Higgins, a professor of obstetrics and gynecology at UW–Madison, has found that the No. 1 predictor of being happy with one’s birth control of choice is sexual satisfaction. Even when accounting for side effects and type of birth control, people who find that their birth control had a negative impact on their sex life had eight or nine times the odds of being dissatisfied and discontinuing that type of birth control. It’s difficult to find that satisfaction, however, when the majority of options use the same two hormones linked to diminished testosterone and subsequently lower libido and sexual satisfaction.

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“All birth control methods can work and not work for people. And so really, it’s about just helping someone find a method that works for them sexually,” says Higgins. “And for some people, that’s going to be the sponge.”

Indeed, despite the sponge’s disappearance, there seems to be a growing interest in on-demand, hormone-free birth control that offers the user full control, versus relying on a partner. Evidence of this includes the Gates Foundation’s recent investments in expanding on-demand methods like an over-the-counter oral contraceptive pill and a new vaginal ring, as well as non-hormonal methods still under development. Then there’s also the new and exciting Phexxi, a contraceptive vaginal gel that’s inserted like a tampon up to an hour before sex. The diaphragm is also allegedly making a comeback; it’s a lot like the sponge but requires spermicides and a doctor’s prescription.

No variety of contraceptive methods on the market, however, can replace widespread access to abortion; all birth control is fallible and pregnancy continues to be dangerous. But given the increased uncertainty post-Roe, the more on-demand methods, the better. Let’s just hope their future is less tumultuous than the sponge’s past.

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