It is a sheath or covering, made to fit
over a mans erect penis before penetration and prevents semen from
coming in contact with cervix and vagina. Various types of condoms
natural skin condom : made
from lamb intestine, rarely used nowadays. It provides better sensation,
but does not protect from infection. Most viruses can cross natural
latex condoms : 0.3 - 0.8
mm thick - sperms and organisms causing STIs cannot pass through
poly-urethane condoms : These
are odourless, have greater sensitivity and resistance to deterioration
from storage and lubricants. Individuals with latex allergy can
use poly-urethane condoms.
silicon rubber condoms :
thicker and less popular.
condom (vaginal pouch)
is a poly-urethane sheath with one flexible polyurethane ring at
each end. The open ring remains outside the vagina and the symphysis
like a diaphragm. It has a 0.6% breakage rate. The slippage and
displacement rate is about 3%
compared to 8% for male condoms. The pregnancy rate with perfect
use is 5% as compared to 3% with male condom. Female condom is also
available as a ‘Bikini Condom’ which covers the perineal
area and has a rolled up sheath which is pushed into the vagina
Foaming tablets or suppositories, melting
suppositories, soluble films, jellies, and creams are used as vehicles
for chemical agents that inactivate sperms in the vagina. Nonoxynol-9
is the commonest chemical agent used in these preparations.
is a soft rubber cup that covers the cervix to act as a barrier.
Efficacy increases when it is used with spermicidal jelly or cream.
is like the diaphragm but smaller and fits over the cervix. These
caps are not widely available outside North America, Europe, Australia
and New Zealand. It is less effective in parous women.
is a physical as well as a chemical barrier with a sustained release
system for spermicide. The sponge absorbs semen and blocks the cervical
canal. Commonest available preparation is TODAY containing 1 gm
of nonoxynol - 9. It may cause allergic reaction in about 4% of
users and vaginal dryness, soreness and itching in 8% of users.
It does not cause toxic shock syndrome. It may enhance HIV transmission
by damaging the vaginal mucosa.
3.2 Advantages of barrier
safe, non-hormonal methods that almost every couple can use easily
prevent some STIs and allied conditions
- pelvic inflammatory disease (PID), infertility, ectopic pregnancy
and possibly cervical cancer
offer contraception just when needed
prevent pregnancy effectively if used
correctly with every act of sexual intercourse
can be used by lactating mothers
can be used and discontinued without
seeking a health care provider
advantages of condom
encourages male participation in preventing pregnancy and infection
prevents HIV/AIDS when used correctly
and consistently with every act of intercourse
can be used immediately after childbirth
advantages of spermicide
be inserted as much as one hour before sex to avoid interrupting
may increase vaginal lubrication
can be used immediately after childbirth
advantages of diaphragm or
diaphragm can be inserted up to 6 hours
before sex to avoid interrupting sex. Cap may be inserted even
earlier since it protects for up to 48 hours after insertion.
3.3 Disadvantages of barrier
require a high degree of motivation for regular use
effectiveness requires having method
at hand and taking correct action before each act of sexual intercourse
difficult to conceal from partner
allergic reactions may occur in some
couples with use of spermicides, latex condoms, diaphragms and
urinary tract infections are more common
with the use of diaphragm and spermicides
accidents like slippage, breakage during
coitus necessitate a `back-up use of emergency contraception
careful storage is required from heat,
sunlight or excessive humidity
may embarrass some people to buy and
ask partner to use these methods.
diaphragms and cervical caps do not
protect against HIV/AIDS
diaphragm and cervical cap require pelvic
examination by family planning provider to assess size and fitting
which may change after childbirth.
• accidents like slippage
or breakage during coitus necessitate a ‘back-up’
use of emergency contraception
3.4 Contraindications to
diaphragm and cervical cap should not be fitted until 6-12 weeks
after childbirth or second trimester abortion. This relates to
the involution time of genital tract. These women can use spermicides
and/or partners can use condoms during this period.
latex condoms, diaphragm or cap should
not be used by couples with history of latex allergy
women with history of toxic shock syndrome
should not use diaphragm or cervical cap but may use spermicides.
women with anatomical defects of genital
tract may have higher failure rates with diaphragm and cervical
3.5 EC as back-up for barrier
main advantage of barrier methods like condom is protection against
sexually transmitted infections and HIV/AIDS. For individuals at
risk of STIs, the condom use is critical. Women and men may feel
more confident in relying on condoms for birth-control, if emergency
contraception is available to them as a back-up.
Instructions for use of vaginal methods 3
|Insertion before coitus, no longer
|After coitus, should be left in place for
Maximum wear time