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Birth Control Barrier Methods (cont.)

Female Condom

The female condom (brand name: Reality) is a polyurethane sheath intended for 1-time use, similar to the male condom. It contains 2 flexible rings and measures 7.8 cm in diameter and 17 cm in length. You can buy them at a drugstore without a prescription. The ring at the closed end of the sheath serves as an insertion mechanism and internal anchor that is placed inside a woman's vagina just before sex. The other ring forms the external edge of the device and remains outside of the canal after insertion. The female condom prevents pregnancy by acting as a barrier to the passage of semen into the vagina. Do not have a male partner use a condom at the same time because they may stick to each other, leading to slippage or displacement of either device. If you have a choice between the two, have the male use a condom for better protection.

  • How effective: Early tests show a pregnancy rate of 15% in 6 months. In August, 2002, the U.S. Food and Drug Administration (FDA) listed a higher failure rate of 21 pregnancies per 100 women per year. The proportion of women using this method of contraception in the United States is less than 1%.
  • Advantages: The female condom provides some protection to the labia and the base of the penis during intercourse. Although it may provide some protection, it is not as effective as a latex male condom in preventing STDs. The sheath is coated on the inside with a silicone-based lubricant. It does not deteriorate with oil-based lubricants. It can be inserted as long as 8 hours before intercourse.
  • Disadvantages: The lubricant does not contain spermicide (a substance that kills sperm). The device is difficult to place in the vagina. The inner ring may cause discomfort. Some users consider the female condom awkward. The female condom may cause a urinary tract infection (UTI) if left in the vagina for a long time.

Diaphragm

The diaphragm is a shallow latex cup with a spring mechanism in its rim to hold it in place in the vagina. Diaphragms are manufactured in various sizes. You need a pelvic examination and measurement of the diagonal length of your vaginal canal so your health care provider can determine the correct diaphragm size. You insert the diaphragm with spermicide before sex. The spermicidal cream or jelly is applied to the inside of the dome, which then covers your cervix. Your doctor will show you how to insert it and how to know it is in place. It prevents pregnancy by acting as a barrier to the passage of semen into the cervix. Once in position, the diaphragm provides effective contraception for 6 hours. After that time, if you have not removed the diaphragm, you will add fresh spermicide with an applicator. After intercourse, the diaphragm must be left in place for at least 6 hours after sex but not more than 24 hours.

  • How effective: Effectiveness of the diaphragm depends on the age of the user, experience with its use, continuity of use, and the use of spermicide. Typical failure rate within the first year is estimated to be 20%.
  • Advantages: The diaphragm does not use hormones. The woman is in control of her birth control. The diaphragm may be placed by the woman in anticipation of intercourse.
  • Disadvantages: Prolonged use during multiple acts of intercourse may increase the risk of UTI. Use for longer than 24 hours is not recommended due to the possible risk of toxic shock syndrome. The diaphragm requires professional fitting. Poorly fitted diaphragms may cause vaginal erosions. Diaphragms have a high failure rate. Use of a diaphragm requires brief formal training. The diaphragm may develop odor if not properly cleansed. This method does not protect against STDs.
Medically Reviewed by a Doctor on 8/28/2014
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