These methods are amongst the oldest and the least effective. They consist of condoms (both male and female), diaphragms, sponges and cervical caps. Condoms are the only barrier method that can prevent sexually transmitted diseases.
Both male and female condoms are made up of latex, but polyurethane male condoms can also be found. They work as a barrier to sperm and are among the least effective, 85-92% effective at best. They can be used to not only prevent pregnancy but are the preferred method of preventing sexually transmitted diseases (STDs or STIs). Condoms may come with a spermicide, nonoxynol-9 but this spermicide may cause an allergic reaction and should be avoided with anal intercourse. Condoms have expiration dates and should be evaluated before use. Oil based lubricants should be avoided with condoms as they destroy the condom and decrease its contraceptive effectiveness.
What happens if a condom breaks?
Emergency contraception should be considered and you should consult with a healthcare provider within 24-72 hours.
These barriers are made of latex or silicone and can be used in conjunction with a spermicide. These are placed in the vagina prior to intercourse and should be fitted by your gynecologist. The most commonly used diaphragm is “Ortho All-flex” and a woman should practice inserting and removing this prior to having intercourse. They work as a barrier to sperm and if used with a spermicide, kill any sperm that get past the barrier. They are 92% effective and are generally thought to be more effective with a spermicide. They can be placed several hours prior to intercourse and can be left in up to 6-8 hours after intercourse. Generally it is recommended that they are left in place after intercourse for 2 hours and if repetitive episodes of intercourse occur, a woman may want to remove the diaphragm and place another teaspoon of spermicide. Toxic shock syndrome has been reported to occur but is rare and they are a good alternative for infrequent intercourse. To maintain their effectiveness they need to be inspected regularly and may need to be refitted after childbirth or weight gain. Diaphragms cannot be used to prevent STDs.
The “Today” sponge is combination of barrier and spermicide (nonoxynol-9) and are placed vaginally prior to intercourse. They are available over the counter and are 84-91% effective if used and placed correctly. Their effectiveness relies on preventing conception as a barrier to sperm and need to be placed over the cervix. They need to be soaked with water and can be placed up to 24 hours prior to intercourse. They should be left in place for 6 hours after the last episode of intercourse and should not be left in for more than 30 hours. The sponge cannot be used to prevent STDs.
Cervical caps are the least used contraceptive method and the least effective barrier method. They need to be fitted to cover the cervix and are generally made of silicone and need to be placed prior to intercourse and can be left in place for up to 72 hours. The contraceptive effectiveness ranges from 75-85%. Cervical caps cannot be used to prevent STDs.
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