Thirteen confirmed cases of toxic shock syndrome temporally related to use of the vaginal contraceptive sponge have been reported. The observed risk of toxic shock syndrome in sponge users may be elevated above estimated background rates, but this risk remains very low. Traumatic manipulation of the sponge, use during menstruation or the puerperium, and prolonged retention of the sponge may additionally increase toxic shock syndrome risk. As with all contraceptives, risks must be balanced against benefits.
Faich G, Pearson K, Fleming D, Sobel S, Anello C. Toxic Shock Syndrome and the Vaginal Contraceptive Sponge. JAMA. 1986;255(2):216–218. doi:10.1001/jama.1986.03370020062028