BARRIER METHODS OF

CONTRACEPTION
 OBJECTIVES
Definition
Types of barrier contraception
Mode of action
Benefits, risks and side effects
Special considerations like HIV
Efficacy of the different methods
Emerging issues and research
 Definition
Barrier methods of contraception are physical or
chemical barriers that prevent sperm from passing
through the woman’s cervix into the uterus and fallopian
tubes to fertilize an egg
Some methods also protect against sexually transmitted
disease (STDs)
 Types of Barrier Contraceptives
Spermicides
Male condoms
Female condoms
Contraceptive sponges
Diaphragms
Cervical caps
Male and female condoms provide a barrier to the
ejaculate, pre-ejaculate and to cervico-vaginal secretions
Diaphragms, cervical caps and sponges provide a
physical barrier to sperm reaching the cervix. As only the
cervix is covered by these methods, they do not prevent
exposure of the vaginal mucosa to semen or exposure of
the penis to cervico-vaginal secretions
 Spermicides
A foam, cream, jelly, suppository or film
Contain non-oxynol 9 that kills sperms or immobilizes
them
Can be used with all other barrier methods except the
sponge which already contains a spermicide
Inserted to vagina close to cervix, no more than 30
minutes before intercourse
Remains in place for 6 to 8 hours after sex
Should be reapplied with each act of sex
Benefits and Risks of Spermicides
Benefits
◦ Easy to use
◦ Cheap and can be bought OTC
◦ No effect on hormones
◦ Can be used while breastfeeding
Risks
◦ When used alone they do not protect against STDs like HIV
◦ Frequent use can increase the risk of getting HIV from an infected
partner
◦ Possible side effects: allergic reactions and vaginitis
 Male Condoms
A thin sheet made of latex, polyurethane or natural animal membrane
that is worn over the erect penis
Acts by collecting sperms so they are not released into the vagina
Vary in sizes, color, thickness and style
Latex and polyurethane condoms provide the best available protection
against many STDs including HIV
Can be used with a lubricant to prevent from tearing or breaking and to
reduce irritation
Latex condoms should be used with water based or silicone lubricants
Oil lubricants can weaken the latex and increase the risk of condom
breakage
 Benefits, Risks and Side Effects
Benefits
◦ Cheap and can be bought OTC
◦ Protect against STDs
◦ Can be carried in a pocket or wallet
Risks: none
Possible side effects
◦ Allergic reaction to latex or polyurethane
 Female Condoms
A thin plastic pouch that lines the vagina
Held in place by a closed inner ring at the cervix and an
outer ring at the opening of the vagina
Can be inserted up to 8 hours before sex
Provides some protection against STDs
Female Condoms
 Benefits, Risks and Side Effects
Benefits
◦ Cheap and can be bought OTC
◦ Have no effect on a woman’s natural hormones
◦ Can be used while breastfeeding
◦ Can be carried in a pocket or purse
◦ Provide protection against STDs
Risks: none
Possible side effects
◦ Allergic reaction to latex or polyurethane
 Cervical Sponge
A doughnut shaped device made of soft foam coated with
spermicide
Inserted into the vagina to cover the cervix
Available without a prescription
Does not protect against STDs including HIV
A male or female condom should be used with the
sponge if at risk of getting an STD
Cervical Sponge
 Benefits of the Sponge
Can be bought OTC
Can be carried in a purse or pocket
No effect on a woman’s natural hormones
Each sponge contains enough spermicide for repeated
acts of intercourse during a 24 hour period
Can be used while breastfeeding beginning 6 weeks after
childbirth
 Risks and Side Effects
Risks
◦ Cases of toxic shock syndrome have occurred in a few women
using the sponge
◦ Should only be used if you are at low risk of HIV infection.
Frequent use of spermicides can increase the risk of getting HIV
from an infected partner
Possible side effects
◦ Vaginal irritation and allergic reactions to polyurethane,
spermicides, or sulfites (all of which are found in the sponge)
 Diaphragm
A small dome-shaped device that fits inside the vagina and covers the cervix
Used with spermicide
Made of latex or silicone, latex can remain in situ max 30 hrs, silicone 48hrs
Requires a prescription and needs to be fitted by a health care provider
If made of latex use water based lubricants only
Does not protect against STDs, a male or female condom should be used
with it if at risk of getting an STD
Additional spermicide should be applied before sex is repeated or if it has
been in situ more than 3hours before sex takes place
Must be left in situ for at least 6 hours after last episode of intercourse
Diaphragm
 Benefits, Risks and Side Effects
Benefits
◦ No effect on a woman’s natural hormones
◦ Can be used while breastfeeding beginning 6 weeks after childbirth
◦ Can be inserted up to 2 hours before sex. If more than 2 hours spermicide
must be reapplied
Risks
◦ Frequent use of spermicides increase risk of getting HIV from infected
partner
◦ Increased risk of toxic shock syndrome if diaphragm left in for more than
24 hours
◦ Possible side effects: allergic reaction to latex or spermicide
 Cervical cap
A small plastic dome that fits tightly over the cervix and stays in place
by suction
Used with a spermicide
May have a strap over the dome for removal
Must be fitted and prescribed by a health care provider
Does not protect against STDs including HIV
Should be used with male or female condom if at risk of getting an STD
Additional spermicide should be applied before sex is repeated or if it
has been in situ more than 3hours before sex takes place
Must be left in situ for at least 6 hours after last episode of intercourse
Cervical Cap
 Benefits, Risks and Side Effects
Benefits
◦ No effect on a woman’s natural hormones
◦ Can be used while breastfeeding beginning 6 weeks after childbirth
◦ Can be inserted up to 6 hours before sex
Risks
◦ Frequent use of spermicides increase risk of getting HIV from an infected partner
◦ To avoid increased risk of infection including TSS, it should not be used during
menses
◦ Use of cervical cap and spermicide may increase the risk of UTI
Possible side effects
◦ Allergic reaction to spermicide and vaginal irritation
 Efficacy
Method Number of women out of 100 who will become
pregnant during the first year of typical use
(when a method is used by the average person
who does not always use it correctly or
consistently)
Diaphragm 12
Sponge
Women who have not given birth 12
Women who have given birth 24
Cervical cap
Women who have not given birth 13
Women who have given birth 23
Male condom 18
Female condom 21
Spermicide 28
 Efficacy
Method Typical use Perfect use (consistently and
correctly)

Spermicide 28 18
Female condom 21 5

Male condom 18 2

Diaphragm 12 6
Considerations following barrier method failure
Emergency contraception should be considered if:
◦ Diaphragm or cap is dislodged or removed within 6 hours of sex
◦ Diaphragm has been left in for longer than 3 hours before sex
and no additional spermicide applied
◦ Condom splitting/breaking
◦ Condom slippage
Testingfor STIs
Post-exposure prophylaxis for HIV
THANK YOU