CONTRACEPTIVES
BARRIER METHODS
Contraceptive barrier methods include all products which prevent pregnancy by blocking the sperm's passage from the vagina through the cervix into the uterus and Fallopian tubes. They are usually made of latex, silicone or some other supple plastic material. Barrier methods include condoms, the diaphragm, cervical cap and contraceptive sponge. Of all these methods, only condoms are able to effectively prevent transmission of STDs (sexually transmitted diseases). Moreover, methods such as the diaphragm and cervical cap work best in combination with topical contraceptives, such as spermicide or vaginal pH regulating gel.
Condoms
There are both male and female condoms. While male (traditional) condoms are applied over the penis prior to sexual activity, female condoms (which look essentially similar to male condoms, but larger) are inserted into the vagina, where they cover the entire vaginal lining from the labia (opening) to the cervix. Because condoms essentially prevent any direct contact between the skin of the penis and the vagina, they are the only contraceptive method that provides a level of protection against sexually transmitted diseases (STDs). When used correctly, condoms are about 95-98% effective. It is important not to use condoms which are past their expiration date, because the material in such condoms can become brittle, making them more prone to rupture and therefore less effective.
Diaphragm
The diaphragm is a round (about 7.5 cm in diameter) device with a rigid outer rim and a softer inside portion. It is inserted into the vagina prior to sexual activity and pushed up so it covers the cervix. In order to be effective, it must be treated with spermicide prior to insertion. If it is used for several occasions of intercourse before being removed, additional spermicide should be added before every new sexual activity (spermicide loses efficiency after 2 hours). After sexual contact, the diaphragm must remain in place and should not be removed for at least 6-8 hours. Usually, diaphragms are obtained from a healthcare provider and are fitted to a specific person. But there are also generic models available online. If used correctly (with spermicide), diaphragms are about 90-95% effective.
Cervical Cap
The cervical cap is a thimble-shaped device of about 2-3 cm in diameter. There are several sizes (usually small, medium, large), depending on the size of the cervix (which is often related to whether there is a history of prior vaginal birth). Because it is smaller than the diaphragm, the cervical cap fits around the entrance of the cervix more snugly. Like the diaphragm, it must be covered with spermicide and should not be removed for 6-8 hours after sexual intercourse. If used correctly, the cervical cap is about 70-80% effective.
Contraceptive Sponge
The contraceptive sponge is also a round (about 5.5 cm in diameter and 2.5 cm in depth) device inserted into the vagina and pushed up against the cervix. It's shape somewhat resembles that of a doughnut. The soft spongy material is soaked with spermicide, which is released once it is inserted into position and provides protection for a period of about 24 hours (without the need for reapplying spermicide). In addition to the spermicide, the sponge also acts as a barrier and absorbs sperm, thereby preventing it from entering the cervix. The sponge is available OTC in drug stores and should be disposed of after one-time use. If used correctly, it is about 70-90% effective.