283:. These secondary ingredients are not mainstream in the United States, where nonoxynol-9 alone is typical. Preventing sperm motility will inhibit the sperm from travelling towards the egg moving down the fallopian tubes to the uterus. The deep proper insertion of spermicide should effectively block the cervix so that sperm cannot make it past the cervix to the uterus or the fallopian tubes. A study observing the distribution of spermicide containing nonoxynol-9 in the vaginal tract showed “After 10 min the gel spread within the vaginal canal providing a contiguous covering of the epithelium of variable thickness.” The sole goal of spermicide is to prevent fertilization.
1974:
455:
statistically significant reduction in risk of HIV and STIs, but found a small statistically significant increase in genital lesions among nonoxynol-9 spermicide users. And in a high-risk population using a nonoxynol-9 vaginal gel more than three applications per day on average, the risk of HIV acquisition was increased.
1267:
Currently available spermicides containing nonoxynol-9 are ineffective as microbicides, in particular as HIV-preventive measures. Thus, spermicides used alone are not recommended to prevent HIV or other STIs. Furthermore, frequent use (more than 2 times a day) of spermicide causes more vulvovovaginal
1282:
Temporary skin irritation involving the vulva, vagina, or penis caused by either local toxicity or allergy to the formulation is the most common problem associated with spermicide use... Although vaginal epithelial disruption has been associated with frequent use (twice a day or more) of spermicides
431:
Laboratory testing of substances to see if they inhibited sperm motility began in the 1800s. Modern spermicides nonoxynol-9 and menfegol were developed from this line of research. However, many other substances of dubious contraceptive value were also promoted. Especially after the prohibition of
454:
studies of nonoxynol-9 and other spermicides showed inactivation of STI pathogens, including HIV. But a 2002 systemic review and meta-analysis of nine randomized controlled trials of vaginal nonoxynol-9 for HIV and STI prevention involving more than 5,000 women (predominantly sex workers) found no
321:
Lemon juice solutions have been shown to immobilize sperm in the laboratory, as has Krest Bitter Lemon drink. While the authors of the Krest Bitter Lemon study suggested its use as a postcoital douche, this is unlikely to be effective, as sperm begin leaving the ejaculate (out of the reach of any
1496:
Wilkinson, David; Tholandi, Maya; Ramjee, Gita; Rutherford, George W. (October 2002). "Nonoxynol-9 spermicide for prevention of vaginally acquired HIV and other sexually transmitted infections: systematic review and meta-analysis of randomised controlled trials including more than 5000 women".
343:
have also been proposed as spermicides based on laboratory studies. Animal studies of creams and pessaries derived from neem have shown they have contraceptive effects; however, trials in humans to determine its effectiveness in preventing pregnancy have not yet been conducted.
1017:
195:. Spermicides containing nonoxynol-9 are available in many forms, such as jelly (gel), films, and foams. Used alone, spermicides have a perfect use failure rate of 6% per year when used correctly and consistently, and 16% failure rate per year in typical use.
416:
from approximately 1500 BCE. It recommended mixing seed wool, acacia, dates and honey, and placing the mixture in the vagina. It probably had some effectiveness, in part as a physical barrier due to the thick, sticky consistency, and also because of the
160:. 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. Usually, spermicides are combined with contraceptive
1268:
epithelial disruption, which theoretically could increase susceptibility to HIV. In a high-risk population using a vaginal gel with nonoxynol-9 more than three applications per day on average, the risk of HIV acquisition was
322:
douche) within 1.5 minutes of deposition. No published studies appear to have been done on the effectiveness of lemon juice preparations in preventing pregnancy, though they are advocated by some as 'natural' spermicides.
318:) in Chemistry was awarded to Sheree Umpierre, Joseph Hill, and Deborah Anderson, for discovering that Coca-Cola is an effective spermicide, and to C.Y. Hong, C.C. Shieh, P. Wu, and B.N. Chiang for proving it is not.
428:, a 2nd-century Greek physician, contained formulations for a number of acidic concoctions claimed to be spermicidal. His instructions were to soak wool in one of the mixtures, then place near the cervix.
362:
Spermicides used alone are only about 91 percent effective. When spermicides are used in conjunction with condoms and other barrier methods there is a 97 percent effective rate for pregnancy prevention.
1232:
Cates, Willard Jr.; Harwood, Bryna (2011). "Vaginal
Barriers and Spermicides". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.).
492:
Grimes, David A; Lopez, Laureen M; Raymond, Elizabeth G.; Halpern, Vera; Nanda, Kavita; Schulz, Kenneth F (30 September 2013). Halpern, Vera (ed.). "Spermicide used alone for contraception".
1149:
447:
intercourse, too late to affect all the sperm. Medical estimates during the 1930s placed the pregnancy rate of women using many over-the-counter spermicides at seventy percent per year.
378:
containing spermicide is inadvisable if STI/HIV exposure is likely, because in this situation there is increased vulvovaginal epithelial disruption and increased risk of HIV acquisition.
1018:"U.S. FDA Approves Evofem Biosciences' Phexxi (lactic acid, citric acid and potassium bitartrate), the First and Only Non-Hormonal Prescription Gel for the Prevention of Pregnancy"
1082:
Talwar G, Raghuvanshi P, Misra R, Mukherjee S, Shah S (1997). "Plant immunomodulators for termination of unwanted pregnancy and for contraception and reproductive health".
2004:
440:—were marketed only as "feminine hygiene" products and were not held to any standard of effectiveness. Worse, many manufacturers recommended using the products as a
1550:
1698:
1303:"FDA mandates new warning for nonoxynol 9 OTC contraceptive products. Label must warn consumers products do not protect against STDs and HIV/AIDS (news release)"
359:
says that spermicidally lubricated condoms should no longer be promoted. However, they recommend using a nonoxynol-9 lubricated condom over no condom at all.
1283:
containing N-9, this is usually asymptomatic. In a low risk population, long-term use of N-9 containing methods was not associated with epithelial disruption.
1859:
329:
328:
preparations have also been shown to have some spermicidal effect, and commercial lactic acid-based spermicides are available. A contraceptive containing
292:
was previously a common spermicide, but was removed from the U.S. market in 2002 after manufacturers failed to perform new studies required by the FDA.
1382:
1731:
355:
However, condoms that are spermicidally lubricated by the manufacturer have a shorter shelf life and may cause urinary tract infections in women. The
1043:
Sharma S, SaiRam M, Ilavazhagan G, Devendra K, Shivaji S, Selvamurthy W (1996). "Mechanism of action of NIM-76: a novel vaginal contraceptive from
1352:
618:
Barnhart, K.T. (1 June 2001). "Distribution of a spermicide containing
Nonoxynol-9 in the vaginal canal and the upper female reproductive tract".
1157:
1751:
1289:
N-9 spermicides are inadvisable if STI/HIV exposure is likely in situations that would involve frequent use defined as 2 times or more a day.
1241:
932:
1896:
1604:
1574:
1543:
736:
707:
1708:
1693:
371:
Temporary local skin irritation involving the vulva, vagina, or penis is the most common problem associated with spermicide use.
570:
1594:
1723:
1536:
113:
1326:"Final rule. Over-the-counter vaginal contraceptive and spermicide drug products containing nonoxynol 9; required labeling"
653:
1713:
961:
1964:
1999:
1202:
382:
800:
Hong, C.Y.; Shieh, C.C.; Wu, P.; Chiang, B.N. (September 1987). "The spermicidal potency of Coca-Cola and Pepsi-Cola".
271:
is the primary chemical in spermicides to inhibit sperm motility. Active secondary spermicidal ingredients can include
765:
Umpierre, Sharee A.; Hill, Joseph A.; Anderson, Deborah J. (21 November 1985). "Effect of 'Coke' on sperm motility".
861:
207:
1918:
1883:
262:
212:
1390:
1125:
1796:
1741:
425:
356:
165:
1404:
Tone, Andrea (1996). "Contraceptive
Consumers: Gender and the Political Economy of Birth Control in the 1930s".
1302:
1649:
450:
A misconception about spermicides existed in the 1980s and 1990s. A 1988 literature review article noted that
1811:
242:
217:
1891:
1683:
1674:
1638:
1773:
1736:
1630:
1449:"Condoms, spermicides, and the transmission of human immunodeficiency virus: a review of the literature"
386:
296:
276:
1364:
389:(OTC) contraceptive products carry a new warning saying they do not protect against STDs and HIV/AIDS.
1801:
805:
469:
300:
177:
1994:
1926:
1901:
1703:
1615:
1951:
1906:
1826:
1579:
1421:
1107:
940:
543:
464:
153:
222:
1179:
526:
Kestelman P, Trussell J (1991). "Efficacy of the simultaneous use of condoms and spermicides".
2009:
1931:
1514:
1478:
1429:
1255:
1247:
1237:
1099:
1064:
999:
914:
817:
782:
635:
551:
505:
280:
247:
180:. Combined methods are believed to result in lower pregnancy rates than either method alone.
744:
1506:
1468:
1460:
1413:
1091:
1056:
906:
809:
774:
627:
535:
497:
232:
683:"Status of Certain Additional Over-the-Counter Drug Category II and III Active Ingredients"
286:
Menfegol is a spermicide manufactured as a foaming tablet. It is available only in Europe.
1978:
715:
161:
1831:
1657:
1473:
1448:
1433:
307:
183:
Spermicides are typically unscented, clear, unflavored, non-staining, and lubricative.
1510:
1060:
1988:
1841:
1786:
1589:
1559:
1325:
910:
682:
593:
433:
413:
398:
145:
1836:
1791:
1759:
1619:
1111:
501:
257:
173:
149:
352:
Spermicides are believed to increase the contraceptive effectiveness of condoms.
1864:
1851:
778:
661:
418:
375:
325:
315:
289:
272:
268:
192:
969:
860:
Roger Short; Scott G. McCoombe; Clare Maslin; Eman Naim; Suzanne Crowe (2002),
813:
631:
1821:
1624:
237:
31:
1259:
1251:
303:. Benzalkonium chloride might also be available in Canada as a suppository.
1663:
1634:
252:
157:
1518:
1417:
1003:
836:
639:
509:
17:
1482:
1353:"Evolution and Revolution: The Past, Present, and Future of Contraception"
1103:
1068:
918:
821:
786:
555:
1584:
1464:
870:
340:
1528:
1095:
1425:
547:
402:
227:
1781:
840:
441:
311:
169:
539:
405:
of crocodile dung and fermented dough. It is believed that the low
1236:(20th revised ed.). New York: Ardent Media. pp. 391–408.
437:
1044:
336:
332:(Phexxi) was approved for use in the United States in May 2020.
1532:
1383:"4,000 years of contraception on display in Toronto museum"
990:
Stone H (1936). "Contraceptive jellies: a clinical study".
406:
401:, an Egyptian document dating to 1850 BCE. It described a
397:
The first written record of spermicide use is found in the
1389:. Centennial College journalism students. Archived from
203:
This list of examples was provided by the Mayo Clinic:
893:
Nwoha P (1992). "The immobilization of all spermatozoa
897:
by bitter lemon drink and the effect of alkaline pH".
1962:
933:"MoonDragon's Contraception Information: Spermicides"
806:
Macmillan
Publishers, Scientific and Medical Division
191:
The most common active ingredient of spermicides is
1944:
1915:
1880:
1873:
1850:
1810:
1772:
1750:
1722:
1682:
1673:
1648:
1603:
1567:
863:
Lemon and Lime juice as potent natural microbicides
131:
123:
112:
107:
99:
91:
86:
78:
70:
65:
57:
49:
44:
39:
1305:. Silver Spring, Md.: Food and Drug Administration
330:lactic acid, citric acid, and potassium bitartrate
1357:Contraception Online (Baylor College of Medicine)
103:More effective if combined with a barrier method
1203:"Spermicide for Birth Control - Topic Overview"
409:of the dung may have had a spermicidal effect.
521:
519:
1544:
1227:
1225:
1223:
487:
485:
421:(a known spermicide) formed from the acacia.
8:
1447:Feldblum, P J; Fortney, J A (January 1988).
1347:
1345:
1343:
962:"Femprotect - Lactic Acid Contraceptive Gel"
436:, spermicides—the most popular of which was
689:. Food and Drug Administration. May 9, 2002
385:(FDA) mandated that labels for nonoxynol-9
1877:
1679:
1585:Preventing sexually-transmitted infections
1551:
1537:
1529:
374:Frequent use (two times or more a day) of
2005:Drugs acting on the genito-urinary system
1472:
1376:
1374:
1969:
494:Cochrane Database of Systematic Reviews
481:
432:contraception in the U.S. by the 1873
412:Further formulations are found in the
36:
835:Mikkelson, Barbara (March 16, 2007).
654:"Spermicides: Neo-Sampoon (Menfegol)"
7:
1590:Over-the-counter oral contraceptives
837:"Killer Sperm: Coca-Cola Spermicide"
712:Cervical Barrier Advancement Society
299:and sodium cholate are used in some
1575:Comparison of birth control methods
1182:. Geneva: World Health Organization
767:The New England Journal of Medicine
594:"WHO/Conrad Technical Consultation"
1952:Male contraceptives in development
1363:(6). February 2000. Archived from
25:
1453:American Journal of Public Health
1381:Towie, Brian (January 19, 2004).
27:Contraceptive that destroys sperm
1972:
1595:Oral contraceptive formulations
1180:"HIV/AIDS Topics: Microbicides"
1156:. February 2005. Archived from
966:Woman's Natural Health Practice
502:10.1002/14651858.CD005218.pub4
208:VCF Vaginal Contraceptive Film
152:, inserted vaginally prior to
1:
1511:10.1016/S1473-3099(02)00396-1
1061:10.1016/S0010-7824(96)00204-1
743:. August 1997. Archived from
263:Vagi-Gard Douche Non-Staining
213:VCF Vaginal Contraceptive Gel
1024:(Press release). 22 May 2020
937:MoonDragon Birthing Services
911:10.1016/0010-7824(92)90118-D
571:"Spermicide (Vaginal Route)"
383:Food and Drug Administration
108:Advantages and disadvantages
1902:Fertility awareness methods
1150:"Condoms: Extra protection"
804:. Vol. 6, no. 5.
779:10.1056/NEJM198511213132111
592:World Health Organization.
381:In 2007, the United States
2026:
1499:Lancet Infectious Diseases
1278:Disadvantages and cautions
1126:"Spermicide (Nonoxynol-9)"
814:10.1177/096032718700600508
66:Failure rates (first year)
29:
1897:Calendar (rhythm) methods
1406:Journal of Social History
1324:FDA (December 19, 2007).
1301:FDA (December 18, 2007).
939:. c. 1997. Archived from
357:World Health Organization
1234:Contraceptive Technology
1032:– via PR Newswire.
632:10.1093/humrep/16.6.1151
148:substance that destroys
30:Not to be confused with
1812:Emergency Contraception
737:"Spermicides (Vaginal)"
187:Types and effectiveness
1732:Multi-month injections
1675:Hormonal contraception
1639:Levonorgestrel implant
1605:Long-acting reversible
1367:on September 26, 2006.
1291:
1285:
1274:
1272:compared with placebo.
714:. 2004. Archived from
243:First-Progesterone VGS
218:VCF Contraceptive Foam
1860:Vaginal pH modulation
1837:Low-dose mifepristone
1737:Progestogen-only pill
1631:Contraceptive implant
1393:on February 25, 2004.
1287:
1276:
1265:
496:(12): CD005218.pub3.
301:contraceptive sponges
297:benzalkonium chloride
277:benzalkonium chloride
1892:Breastfeeding method
1802:Contraceptive sponge
1686:estrogen–progestogen
1635:Etonogestrel implant
1465:10.2105/ajph.78.1.52
1418:10.1353/jsh/29.3.485
470:Contraceptive sponge
135:Provides lubrication
2000:Personal lubricants
1927:Non-penetrative sex
1919:vaginal intercourse
1884:vaginal intercourse
1704:Contraceptive patch
1699:Extended cycle Pill
1616:Intrauterine device
1580:Male contraceptives
1336:(243): 71769–71785.
1154:ConsumerReports.org
1130:Other disadvantages
1096:10.1038/icb.1997.27
335:Extractives of the
1827:Ulipristal acetate
1815:(Post-intercourse)
1709:Monthly injections
1022:Evofem Biosciences
808:. pp. 395–6.
620:Human Reproduction
528:Fam Plann Perspect
465:Personal lubricant
1960:
1959:
1940:
1939:
1768:
1767:
1243:978-1-59708-004-0
1084:Immunol Cell Biol
534:(5): 226–7, 232.
199:Spermicide brands
139:
138:
16:(Redirected from
2017:
1977:
1976:
1975:
1968:
1878:
1724:Progestogen-only
1680:
1553:
1546:
1539:
1530:
1523:
1522:
1493:
1487:
1486:
1476:
1444:
1438:
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1401:
1395:
1394:
1378:
1369:
1368:
1349:
1338:
1337:
1330:Federal Register
1321:
1315:
1314:
1312:
1310:
1298:
1292:
1280:Local irritation
1263:
1229:
1218:
1217:
1215:
1213:
1198:
1192:
1191:
1189:
1187:
1175:
1169:
1168:
1166:
1165:
1160:on June 26, 2006
1146:
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1136:
1122:
1116:
1115:
1079:
1073:
1072:
1040:
1034:
1033:
1031:
1029:
1014:
1008:
1007:
987:
981:
980:
978:
977:
968:. Archived from
958:
952:
951:
949:
948:
929:
923:
922:
890:
884:
883:
882:
881:
875:
869:, archived from
868:
857:
851:
850:
848:
847:
832:
826:
825:
802:Human Toxicology
797:
791:
790:
762:
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755:
753:
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733:
727:
726:
724:
723:
704:
698:
697:
695:
694:
687:Federal Register
679:
673:
672:
670:
669:
660:. Archived from
650:
644:
643:
626:(6): 1151–1154.
615:
609:
608:
606:
604:
598:
589:
583:
582:
580:
578:
566:
560:
559:
523:
514:
513:
489:
387:over-the-counter
348:Use with condoms
295:The spermicides
37:
21:
2025:
2024:
2020:
2019:
2018:
2016:
2015:
2014:
1985:
1984:
1983:
1973:
1971:
1963:
1961:
1956:
1936:
1917:
1911:
1882:
1869:
1846:
1814:
1806:
1787:Internal condom
1782:External condom
1774:Barrier Methods
1764:
1746:
1718:
1685:
1669:
1644:
1606:
1599:
1563:
1557:
1527:
1526:
1505:(10): 613–617.
1495:
1494:
1490:
1446:
1445:
1441:
1403:
1402:
1398:
1380:
1379:
1372:
1351:
1350:
1341:
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1308:
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1281:
1279:
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1221:
1211:
1209:
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1199:
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1176:
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1163:
1161:
1148:
1147:
1143:
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1132:
1124:
1123:
1119:
1081:
1080:
1076:
1042:
1041:
1037:
1027:
1025:
1016:
1015:
1011:
989:
988:
984:
975:
973:
972:on June 1, 2006
960:
959:
955:
946:
944:
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926:
892:
891:
887:
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873:
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845:
843:
834:
833:
829:
799:
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794:
764:
763:
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750:
748:
747:on July 8, 2006
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540:10.2307/2135759
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369:
350:
201:
189:
162:barrier methods
35:
28:
23:
22:
15:
12:
11:
5:
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1868:
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1862:
1856:
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1848:
1847:
1845:
1844:
1839:
1834:
1832:Levonorgestrel
1829:
1824:
1818:
1816:
1808:
1807:
1805:
1804:
1799:
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1706:
1701:
1696:
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1677:
1671:
1670:
1668:
1667:
1661:
1658:Tubal ligation
1654:
1652:
1646:
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1643:
1642:
1628:
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1612:
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1600:
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1582:
1577:
1571:
1569:
1568:Related topics
1565:
1564:
1558:
1556:
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1548:
1541:
1533:
1525:
1524:
1488:
1439:
1412:(3): 485–506.
1396:
1387:torontObserver
1370:
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1141:
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998:(12): 209–13.
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885:
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741:MayoClinic.com
728:
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569:Clinic, Mayo.
561:
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394:
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349:
346:
339:plant such as
308:Ig Nobel Prize
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1650:Sterilization
1647:
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1608:
1607:contraception
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1560:Birth control
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1049:Contraception
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943:on 2006-08-13
942:
938:
934:
928:
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920:
916:
912:
908:
905:(6): 537–42.
904:
900:
899:Contraception
896:
889:
886:
876:on 2006-08-21
872:
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718:on 2009-01-14
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664:on 2016-06-10
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573:. Mayo Clinic
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414:Ebers Papyrus
410:
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399:Kahun Papyrus
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174:cervical caps
171:
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147:
146:contraceptive
143:
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118:
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98:
94:
92:Reversibility
90:
85:
81:
77:
73:
69:
64:
60:
56:
52:
48:
43:
38:
33:
19:
1945:Experimental
1792:Cervical cap
1760:Ormeloxifene
1742:Vaginal ring
1714:Vaginal ring
1620:Hormonal IUD
1502:
1498:
1491:
1459:(1): 52–54.
1456:
1452:
1442:
1409:
1405:
1399:
1391:the original
1386:
1365:the original
1360:
1356:
1333:
1329:
1319:
1307:. Retrieved
1296:
1288:
1277:
1269:
1266:
1233:
1210:. Retrieved
1206:
1196:
1184:. Retrieved
1178:WHO (2002).
1173:
1162:. Retrieved
1158:the original
1153:
1144:
1133:. Retrieved
1129:
1120:
1090:(2): 190–2.
1087:
1083:
1077:
1055:(6): 373–8.
1052:
1048:
1038:
1026:. Retrieved
1021:
1012:
995:
992:J Contracept
991:
985:
974:. Retrieved
970:the original
965:
956:
945:. Retrieved
941:the original
936:
927:
902:
898:
894:
888:
878:, retrieved
871:the original
862:
855:
844:. Retrieved
830:
801:
795:
773:(21): 1351.
770:
766:
760:
749:. Retrieved
745:the original
740:
731:
720:. Retrieved
716:the original
711:
702:
691:. Retrieved
686:
677:
666:. Retrieved
662:the original
657:
648:
623:
619:
613:
601:. Retrieved
587:
575:. Retrieved
564:
531:
527:
493:
451:
449:
444:
434:Comstock Act
430:
424:Writings by
423:
411:
396:
380:
373:
370:
367:Side effects
361:
354:
351:
334:
324:
320:
316:Nobel Prizes
305:
294:
288:
285:
267:
258:Today Sponge
202:
190:
182:
141:
140:
1865:Nonoxynol-9
1852:Spermicides
419:lactic acid
376:nonoxynol-9
326:Lactic acid
290:Octoxynol-9
273:octoxynol-9
269:Nonoxynol-9
193:nonoxynol-9
156:to prevent
154:intercourse
124:Weight gain
79:Typical use
71:Perfect use
18:Spermicidal
1995:Spermicide
1989:Categories
1932:Abstinence
1907:Withdrawal
1874:Behavioral
1822:Copper IUD
1625:Copper IUD
1275:p.399–400:
1164:2006-08-06
1135:2008-04-23
976:2006-09-17
947:2006-08-13
880:2006-08-13
846:2008-10-03
751:2006-10-16
722:2006-09-17
693:2006-08-18
668:2006-10-01
658:RemedyFind
476:References
238:Endometrin
223:Conceptrol
166:diaphragms
142:Spermicide
116:protection
53:Spermicide
45:Background
40:Spermicide
32:Spertacide
1881:Including
1797:Diaphragm
1694:Oral pill
1664:Vasectomy
1434:A18498205
1309:April 16,
1270:increased
1260:781956734
1252:0091-9721
1186:August 6,
708:"Sponges"
306:The 2008
253:Prochieve
158:pregnancy
95:Immediate
58:First use
2010:Biocides
1979:Medicine
1916:Avoiding
1684:Combined
1660:(female)
1519:12383611
1212:April 1,
1004:12259192
895:in vitro
640:11387285
603:April 1,
599:. Geneva
577:April 1,
510:24307556
459:See also
452:in vitro
341:neem oil
281:menfegol
248:Gynol II
164:such as
132:Benefits
1562:methods
1483:3276230
1474:1349207
1426:3788942
1286:p. 401:
1264:p. 399:
1201:WebMD.
1112:7402936
1104:9107574
1069:8968666
919:1493713
822:3679247
787:4058526
556:1743276
548:2135759
426:Soranus
403:pessary
393:History
314:of the
228:Crinone
178:sponges
170:condoms
61:Ancient
1965:Portal
1666:(male)
1609:(LARC)
1517:
1481:
1471:
1432:
1424:
1258:
1250:
1240:
1110:
1102:
1067:
1047:oil".
1028:22 May
1002:
917:
841:Snopes
820:
785:
638:
554:
546:
508:
442:douche
312:parody
233:Encare
176:, and
1752:SERMs
1422:JSTOR
1207:WebMD
1108:S2CID
874:(PDF)
867:(PDF)
597:(PDF)
544:JSTOR
445:after
438:Lysol
150:sperm
144:is a
87:Usage
1515:PMID
1479:PMID
1430:Gale
1311:2014
1256:OCLC
1248:ISSN
1238:ISBN
1214:2014
1188:2006
1100:PMID
1065:PMID
1045:neem
1030:2020
1000:PMID
915:PMID
818:PMID
783:PMID
636:PMID
605:2014
579:2014
552:PMID
506:PMID
337:neem
279:and
50:Type
1507:doi
1469:PMC
1461:doi
1414:doi
1092:doi
1057:doi
907:doi
810:doi
775:doi
771:313
628:doi
536:doi
498:doi
310:(a
114:STI
82:16%
1991::
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1451:.
1428:.
1420:.
1410:29
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1355:.
1342:^
1334:72
1332:.
1328:.
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1246:.
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1205:.
1152:.
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1088:75
1086:.
1063:.
1053:54
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994:.
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935:.
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903:46
901:.
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816:.
781:.
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624:16
622:.
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542:.
532:23
530:.
518:^
504:.
484:^
407:pH
275:,
172:,
168:,
127:No
119:No
74:6%
1967::
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1059::
1006:.
996:1
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950:.
921:.
909::
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812::
789:.
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671:.
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20:)
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