Birth Control Overview (cont.)
IN THIS ARTICLE
The male condom (also called a rubber) is a thin sheath placed over an erect penis. A man puts a condom over his penis before he places the penis in a woman’s vagina. A condom worn by a man prevents pregnancy by acting as a barrier to the passage of semen into the vagina. A condom can be worn only once. It is one of the most popular birth control barriers. You can buy condoms at most drugstores and grocery stores and dispensers can be found in public restrooms.
Condoms made from latex are the best at preventing pregnancy. They also protect against sexually transmitted diseases such as AIDS and gonorrhea. Do not use condoms with Vaseline or other brands of petroleum jelly, lotions, or oils. They can decrease the effectiveness of the condom and increase the chance of pregnancy and transmission of sexually transmitted diseases. They can be used with lubricants that don't have oil, such as K-Y Jelly.
Condom use has increased among all women of reproductive age because of their concern about getting HIV (the virus that leads to AIDS) and other sexually transmitted diseases.
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 long. 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.
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.
The cervical cap is a soft cup-shaped latex device that fits over the base of a woman’s cervix. It is smaller than a diaphragm and may be harder to insert. It too must be fitted by your doctor because it comes in different sizes. Its use is derived from the eighteenth- to twentieth-century European practice of placing the rind of a lemon or small orange against the cervix prior to intercourse.
A groove along the inner circumference of the rim improves the seal between the inner rim of the cap and the base of the cervix. Spermicide is needed to fill the cap one third full prior to its insertion. It is inserted as long as 8 hours before sexual activity and can be left in place for as long as 48 hours.
A cervical cap acts as both a mechanical barrier to sperm migration into the cervical canal and as a chemical agent with the use of spermicide.
The vaginal sponge, introduced in 1983 and taken off the market shortly after, is making a comeback.
The sponge is a soft circular polyurethane device that contains nonoxynol-9, a spermicide. It is disposable, and should be discarded after use. It is over the counter, and may be appealing to women who wish to avoid using hormones.
It offers an immediate and continuous presence of spermicide throughout a 24-hour period. The FDA lists the failure rate for the previously marketed sponge to be 14-28 pregnancies per 100 women per year.
Serious medical risks are rare and include irritation and allergic reactions and difficulty with removal. Toxic shock syndrome is a rare but serious infection that can occur if the sponge is left in place longer than recommended. Nonoxynol-9 provides some protection against pregnancy, but the sponge does not protect against STDs.
See Birth Control Barrier Methods for more information.
Medically Reviewed by a Doctor on 7/18/2014
Omnia M Samra, MD
Bryan D Cowan, MD
Francisco Talavera, PharmD, PhD
Lee P Shulman, MD
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