Barrier Methods of Contraception
Barrier methods physically block access of sperm to the uterus. They include male and female condoms; diaphragms; cervical caps; and spermicidal foams, creams, gels, and suppositories.
A male condom is a thin, transparent, latex sheath that covers the erect penis and prevents sperm from entering the vagina. Male condoms are the most widely used nonprescription contraceptive, and they are 90 to 97 percent effective when used properly. Although there are no side effects from using condoms, some men claim that condoms dull the physical sensation and tend to interrupt sexual inter- course. Some of these complaints may only be a matter of becoming accustomed to using condoms. To learn how to use a condom correctly.
A female condom was approved by the US Food and Drug Administration in 1992, but it has had limited appeal in the United States. The device is inserted into the vagina and held in place by a ring. However, because the female con- dom has a higher failure rate, the male condom is preferred.
A diaphragm is a dome-shaped, latex cup with a ﬂexible rim that ﬁts over the cervix to block sperm from entering the uterus. Diaphragms come in different sizes and must be ﬁtted by a doctor or a nurse to be sure the diaphragm covers the entire cervix without causing discomfort. If properly ﬁtted, neither the man nor the woman should notice its presence. A diaphragm should always be used with a spermicidal jelly or foam, which not only lubricates the diaphragm for insertion but also offers some protection against pregnancy if the diaphragm is dislodged during intercourse. The diaphragm should be left in place for 6 to 8 hours after intercourse. When used with spermicidal jelly or foam, the diaphragm is about 85 to 90 percent effective.
A cervical cap is similar to a diaphragm, only smaller and more rigid. It also is available in various sizes and must be ﬁtted over the cervix. A cervical cap is more difﬁcult to insert than a diaphragm; therefore a woman needs to be trained to insert it correctly. Although some women leave the cap in place for days or weeks, it must be removed during menstruation to allow menstrual blood to ﬂow from the body.
A great variety of spermicidal gels, foams, creams, and suppositories are available in pharmacies without prescription. Basically they all work the same way—by killing sperm before they can reach the egg. No single type of spermi- cide has been found to be more effective than another. By themselves, however, spermicides are not as effective as other contraceptive products and may be only about 70 percent effective. To be effective, the product must be inserted into the vagina as close to the time of intercourse as possible, but no more than an hour before. After an hour, spermicides start to disintegrate. For best results, they should be used with a diaphragm or a condom. No serious side effects are associated with these products, but some people have experienced skin or vagi- nal irritation.