Barrier Methods

A.    Male condom
o    This is a thin sheath that covers the penis during sexual intercourse.
o    It can be made of latex, polyurethane, or natural membrane (such as lambskin).

o    Only water-soluble lubricants should be used with latex condoms to avoid breakage.
o    Male condoms are 98% effective at preventing pregnancy when used correctly and consistently.

B.    Female condom
o    This is a pouch that lines the inside of the vagina and partially covers the external genitalia.
o    It is made of nitrile (a nonlatex synthetic rubber) with flexible rings on both ends that hold it in place.

o    It is pre-lubricated with a spermicide (a substance that kills sperm).
o    Female condoms are 95% effective at preventing pregnancy when used correctly and consistently.

C.    Spermicide
o    This is a chemical barrier that destroys sperm before they enter the cervix (the opening of the uterus).
o    It also makes the vaginal flora more acidic, which inhibits sperm motility.
o    Spermicide should be inserted into the vagina 15 minutes before sexual intercourse and is only effective for one hour.
o    It should not be removed until six hours after intercourse, but no more than 24 hours later.

o    Spermicide can come in different preparations, such as suppositories, foams, creams, gels, or films.
o    Spermicide alone is 72% effective at preventing pregnancy when used correctly and consistently.
o    Spermicide is contraindicated (not recommended) in people with cervical infections or allergies to its ingredients.
o    Some spermicides contain nonoxynol-9 (N-9), which can cause lesions (sores) in the vaginal or rectal lining and increase the risk of HIV transmission if used more than twice a day.

D.    Diaphragm
o    A diaphragm is a dome-shaped cup that fits snugly over the cervix.
o    It acts as a physical barrier to prevent sperm from entering the uterus.
o    Its effectiveness is increased with the use of a spermicide or gel that is placed in the dome and around the rim of the diaphragm.
o    A diaphragm needs to be properly fitted by a healthcare provider and replaced every two years.

o    It also requires proper insertion and removal techniques.
o    A woman should empty her bladder prior to insertion and wash the diaphragm with warm water and mild soap after each use.
o    A diaphragm is not recommended for people who have a history of toxic shock syndrome (TSS), cystocele, uterine prolapse, or urinary tract infection (UTI).
o    Clinical findings of TSS include high fever, faint feeling, drop in blood pressure, watery diarrhea, headache, macular rash, and muscle aches.

E.    Cervical Cap
o    A cervical cap is a silicone rubber cap that fits tightly around the base of the cervix.
o    It also acts as a physical barrier to prevent sperm from entering the uterus.
o    It comes in three sizes and needs to be fitted by a health care provider.
o    It should be inserted at least 6 hours before intercourse and left in place for at least 6 hours after intercourse, but no more than 48 hours.

o    It should be replaced every two years.
o    A cervical cap is not suitable for clients who have abnormal Pap test results or a history of TSS.

F.    Contraceptive Sponge
o    A contraceptive sponge is a small, round, concave-shaped, polyurethane sponge that contains spermicide.
o    It acts as both a physical and a chemical barrier to prevent sperm from entering the uterus.
o    It is one-size fits all and does not require fitting by a health care provider.
o    It should be moistened with water before insertion and left in place for 6 hours after the last act of intercourse.
o    It provides protection for up to 24 hours and can be used for repeated acts of intercourse within that time frame.