Barrier methods are less effective than hormonal methods, but cause fewer side effects and are associated with less risk. The effectiveness of barrier forms of contraception can be increased when used with spermicide.
The male condom is a thin sheath that is placed over an erect penis to keep sperm from entering a woman's body. A new condom must be used every time you have sex. Condoms can be made of latex, polyurethane, or "natural/lambskin."
Latex condoms, when used consistently and correctly, provide the best available means of reducing the risk of transmission of many sexually transmitted diseases (STDs), including gonorrhea, chlamydia, HIV and trichomoniasis. Condoms also can reduce the risk of genital herpes, syphilis, chancroid, and human papillomavirus infection, but only when the infected areas are covered or protected by the condom, according to the Centers for Disease Control and Prevention. Those made of lambskin, however, do not offer such protection because they have microscopic holes that may stop sperm, but are large enough to allow viruses to pass through.
Condoms are either:
- Lubricated, which can make sexual intercourse more comfortable.
- Non-lubricated, which can also be used for oral sex. It is best to add lubrication to non-lubricated condoms if you use them for vaginal or anal sex. You can use a water-based lubricant, such as K-Y jelly. Oil-based lubricants like massage oils, baby oil, lotions, or petroleum jelly will weaken the condom, causing it to tear or break.
Keep condoms in a cool, dry place. If you keep them in a hot place (like a wallet or glove compartment), the latex breaks down increasing the likelihood that the condom will tear or break.
The FDA approved the female condom in 1993. It is a soft, thin, polyurethane sheath with two flexible rings, one that contains the closed end of the sheath and is inserted into the vagina. The other ring stays outside the vagina.
The female condom can be inserted up to 8 hours before having sex. Use a new condom each time you have intercourse. And don't use it and a male condom at the same time.
Spermicides are nonprescription, non-hormonal chemical products containing the active ingredient nonoxynol-9 (N-9) or octoxynol-9 (0-9). They can be used alone or in combination with other barrier contraceptives. Spermicides are available as foam, cream, gel, suppository and film, and, when used with other barrier contraceptives, are more effective than either method used alone.
Diaphragm, Cervical Cap and Cervical Shield
These barrier methods block sperm from entering the cervix (the opening to your womb) and reaching the egg.
- The diaphragm is a shallow latex cup with a flexible rim that covers the cervix.
- The cervical cap is a thimble-shaped latex cup that fits snugly on the surface of the cervix. It often is called by its brand name, FemCap. About 10 percent of women can't use the cervical cap because they have an irregularly shaped cervix.
- The cervical shield is a silicone cup that has a one-way valve that creates suction and helps it fit against the cervix. It often is called by its brand name, Lea's Shield.
The diaphragm and cervical cap come in different sizes, and you need a doctor to "fit" you for one. If you choose one of these options, have your health care professional check once a year to make sure the device fits correctly; pregnancy and childbirth can change how these devices fit. The cervical shield comes in one size, and you will not need a fitting.
Carefully examine your diaphragm or cervical cap before each use to be sure it is not punctured or torn. Before having sex, add spermicide gel or foam to the devices. Then place them inside your vagina to cover your cervix.
All three of these barrier methods must be left in place for 6 to 8 hours after having sex to prevent pregnancy. The diaphragm should be taken out within 24 hours. The cap and shield should be taken out within 48 hours.
One benefit of the barrier method is availability: Condoms and spermicides can be purchased over the counter (without a prescription).
Possible side effects
Some women and men experience allergic reactions to certain spermicides, rubber or latex used in condoms, diaphragms or cervical caps. Consult with a health care professional if you develop any symptoms after using contraception. Symptoms might include:
- Respiratory distress
- Hay fever-type reactions such as itchy, swollen eyes, runny nose and sneezing
- Asthma-type symptoms such as chest tightness, wheezing, coughing and shortness of breath
Diaphragm and spermicide use has been associated with an increased risk of urinary tract infections (UTI) and yeast infections. Emptying your bladder immediately after intercourse and removing the diaphragm after six hours may decrease your chances of developing a UTI.
This barrier method is a soft, disk-shaped device with a loop for taking it out. It is made out of polyurethane foam and contains the spermicide nonoxynol-9. Women who are sensitive to the spermicide nonoxynol-9 should not use the sponge.
Before having sex, you wet the sponge and place it, loop side down, inside your vagina to cover the cervix. The sponge then releases the spermicide which is immediately effective for up to 24 hours. It needs to be left in for at least 6 hours after having sex to prevent pregnancy, but must be taken out within 30 hours after insertion.
Only one kind of vaginal sponge is sold in the United States--the Today Sponge, which had been withdrawn from the market and won FDA re-approval in April 2005. It is available over the counter, and is 84 percent to 91 percent effective in preventing pregnancy in women who have never given birth and in 68 to 80 percent of women who have.