BARRIER METHODS
Effectiveness
The effectiveness of barrier methods depends first
and foremost on their regular and adequate use, during each and every
sexual relation, wherever you may be in the menstrual cycle, including
during your period. Failures due to contraceptive deficiencies rarely
occur. When in doubt, you can rely on the morning-after pill. It is
recommended to add spermicide to the female condom and every time you
use the diaphragm an the cervical cap. Some products (oil-based
lubricants) or vaginal treatments are incompatible with the diaphragm
and cervical cap. Your doctor will advise you. Spermicides are harmless
for the foetus, if used at the beginning of pregnancy.
Who are they for?
These methods are mostly designed for women whose
fertility rate is naturally reduced, that is women aged 40 and over,
women who breastfeed or women for whom pregnancy may be acceptable.
These contraceptives, who have the benefit of being controlled by women,
may also be used at mid-cycle in order to increase the effectiveness of
another birth control method or when taking antibiotics in combination
with oral contraceptives. Finally, anyone who is at risk of contracting
STDs should use condoms and be informed about the protective benefits of
spermicides.
Female condom
- Cost: around $14/package of three
-
Effectiveness: 80 to 99%
The female condom’s effectiveness can raise up to
99%, if used during each and every sexual relation.
It is provided in one model and size only. It is made of thin,
soft polyurethane and has one ring at each extremity.
The inner ring allows for the condom to be inserted and also ensures it
stays in place. Reality¬ also protects against STDs and HIV. Since it
covers a large part of the vulva, it is theoretically more effective
than the male condom in the presence of condyloma and herpes. Reality¬
lines the vagina and therefore it does not compress or constrict the
penis.
Since polyurethane warms up
instantly when in contact with the body, it provides improved and more
natural sensations. Reality¬ is a method designed for women and men.
Because it is more resistant than its latex counterpart, it is well
appreciated by both heterosexual and homosexual couples during anal
relations. In this case, the inner ring is removed for more comfort.
Diaphragm
- Cost: around $60 + cost of spermicide
- Effectiveness: 80 to 94%
It is a thin latex dome with a flexible steel ring adapted to the
size of the vagina. It must be used with a
spermicidal gel. A woman who chooses this method must consult a doctor
who will determine the required size (diameter of 55 to 90 mm) and teach
her how to put it in place. A weight variation of more than 3 kg or
childbirth can modify the size of the vagina and may require re-examination
of the diaphragm’s diameter. A yearly examination of its size
should also be conducted.
To prevent toxic shock syndrome and bad odour, it
is recommended to keep it in place for as short a time as possible,
while complying with the minimal six-hour delay after sexual intercourse
and not to use it during your period. In order to preserve the integrity
of the diaphragm, you simply need to clean it, to coat it with sodium
bicarbonate (baking soda) and to store it in a cool, unlit area.
Cervical cap
- Cost: around $50 + cost of spermicide
- Effectiveness: 80 to 94%
The cervical cap is a thimble-shaped device made of thick rubber that
fits over the cervix and that must be used with a spermicidal gel.
It is available in four sizes: 22, 25, 28 and 31 mm.
Approximately 75% of women can find a suitable size. Its use requires
some instruction that can be provided by a doctor or in some women’s
health clinics.
It is recommended not to use the cervical cap
during the six weeks following childbirth, if vaginal bleeding occurs
and during periods. Some sexual positions may dislodge the cap, which
then looses its effectiveness. To avoid bad odour, it is
important to clean and dry the cervical cap between each use and to
leave it in place for as less time as possible, while complying with the
minimal eight-hour delay after sexual intercourse. The cervical cap is
not available in Canada; it must be ordered in England, via Internet or
at Montreal’s La maison des femmes.
Contraceptive sponge
- Cost: around $12/package of four
- Effectiveness: 70 to 94%
There is two models on the market:
Protectaid and TODAY. The sponge is made of
soft polyurethane foam and its slotted design makes insertion and
removal easier. It is saturated with a spermicidal gel that disperses
efficiently, is not irritating and usually well tolerated. Its
effectiveness lasts for only one sexual relation.
The sponge can remain in place for a maximum of twelve hours and it
must stay in the vagina for at least six hours after sexual intercourse.
The sponge must not be used during periods.
Advantage 24
- Cost: around $12/package of three
- Effectiveness: 80 to 95%
Advantage 24¬ is a contraceptive gel supplied in a reusable
applicator that contains pre-measured doses of spermicide.
It can be inserted as much as 24 hours prior to
sexual activity but is most effective if inserted soon before.
This gel allows for more sexual spontaneity because of its immediate
action, long-term effectiveness (24 hours), lubricating power and
because it is tasteless and odourless. It is
eliminated naturally with vaginal secretions and may be useful to
protect against STDs.
VCF
- Cost: around $10/package of six
- Effectiveness: 70 to 97%
The vaginal contraceptive film (VCF¬) has recently been made
available in Quebec. It is a thin 5 X 5 cm film similar to waxed paper
and it contains spermicide. It is easy to use: you fold the film in four
and insert it into the vagina 15 minutes before intercourse.
It is comfortable and does not increase vaginal
secretions. It is naturally eliminated.
Foam, cream, gel
- Cost: between $16 and $22 per container/tube
(about 75˘ to $1 per application)
- Effectiveness: 70 to 97%
Foam is available in aerosol containers, while
cream and gel are packaged in tubes. These products contain spermicide,
are provided with a reusable applicator and inserted into the vagina 10
to 30 minutes before sexual activity. Foam, because it disperses more
rapidly and uniformly, is said to be more effective than cream or gel.
In order to increase their effectiveness, these products should be used
with another method such as the male condom, the female condom, the
diaphragm, or the cervical cap . They are naturally eliminated.
The above is translated from an excellent text produced by the family planning team at the Centre
hospitalier régional de Rimouski.
http://www.planningchrr.com/
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