Thursday 7 July 2011

Barrier Contraceptives

Barrier contraceptives have been making a comeback in recent years with the use of condoms being promoted to combat HIV and AIDS and also as more women turn their back on the pill and look for non-hormanal alternatives. With the introduction of natural alternatives to spermicide such as Contragel and the replacement of latex with silicone, barrier contraceptives are becoming popular once again.

The widespread use of latex in the 1950's was a huge leap forward in barrier contraception. Condoms became widely available all over the world and women were able to take control of their own contraception using diaphragms. After a while, pharmaceutical companies realised that monthly pills would bring in more revenue than diaphragms, which only have to be purchased once a year.

This reaslisation coupled with more and more people recognizing latex allergies, allergies related to chemical spermicides and Toxic Shock Syndrome (TSS) brought about the rise in hormonal contraception. As a result, barrier contraception became less popular and experienced a steady decline, now that's all starting to change. Could barrier contraceptives be right for you?

Choosing the right barrier contraceptive is often as difficult as choosing the right contraceptive method in the first place. There are many factors to consider and it’s completely dependent on your individual needs and lifestyle.

Choosing barrier contraception in the first place is actually only one part of your possible fertility strategy. It should be remembered that intercourse only has the risk of pregnancy for about 6 days per cycle during your Fertility Window. A healthy egg is only fertilisable for 18-24 hours and sperm can't survive for more than 5 days inside of you so that span of 6 day (5 days before ovulation and the day of ovulation) are really the only time when barrier contraception needs to be used for pregnancy protection.

fertility chart

Remember, for the purpose of contraception you need only use barrier contraceptives during your Fertility Window, the 6-8 days per cycle when intercourse could lead to pregnancy. Click here to learn more about identifying your Fertility Window for contraception

Read on to learn about the different barrier contraceptives available and learn which one is right for you.


Cervical Caps, Diaphragms, Condoms or Contraceptive Sponges?

If you have used spermicide in the past, you know that it is most effective when used in conjunction with contraceptive barriers. Spermicide can be used with cervical caps, diaphragms, and condoms. These types of barrier contraceptives are usually made with latex or more recently silicon, which works well for people who experience adverse reactions to latex based products.


About Cervical Caps


The cervical cap is a form of barrier contraception that fits snugly over the cervix and blocks sperm from entering the uterus through the external orifice of the uterus. The external orifice of the uterus is called the os. One of the most popular types of cervical caps is Fempcap. Femcap is made with medical grade silicon rubber, which is perfect for users who experience adverse reactions to latex. As of February 2009, after Prentif Cap was discontinued, FemCap was the only FDA approved cervical cap available in the United States.

FemCap Cervical Cap

Lea's Shield was a cervical barrier device which was discontinued in 2008. Some sources use ‘cervical cap’ to refer to FemcCap and Lea’s Shield while others classify Lea’s Sheild as a distinct type of device. Terminology on different sites can be confusing, so make sure you understand which device is being referred to in your research.


All cervical caps must be used in conjunction with a spermicide in order to be effective. Because of it's chemical-free, all natural ingredients, Ethical Family Planning recommends the use of ContraGel Green, the natural alternative to spermicide.


About Diaphragms


The diaphragm is shaped like a dome with a spring molded into the rim and is made of silicone or soft latex. The spring creates a seal against the walls of the vagina. As is the case with cervical caps, many women prefer silicon based diaphragms because of allergic or adverse reactions to latex.

According to contraceptive technology, the method failure rate of the diaphragm used with spermicide is 6% per year. Annual pregnancy rates of 10 to 39% of diaphragm users have also been reported. These however vary greatly between the populations being studied. One of the most interesting things to consider about diaphragms is that they are as equally effective for women who have given birth as they are for women who have not. This is a characteristic unique to diaphragms when compared to other forms of cervical barriers.

Using diaphragms has been known to increase the risk of contracting urinary tract infections (UTIs). Urinating before inserting the diaphragm and also after intercourse may reduce this risk. The increased risk of UTIs may be due to the diaphragm applying pressure to the urethra, which is common if the diaphragm is too large. This causes irritation by preventing the bladder from emptying completely. However, the spermicide nonoxynol-9 is itself associated with an increased risk of UTI, yeast infection, and bacterial vaginosis. For this reason, some advocate the use of lactic acid based spermicides, which may have fewer side effects.

For women who experience side effects from nonoxynol-9, some sources have suggested using diaphragms without spermicide. One study reported a 24% rate of actual pregnancy per year among women using the diaphragm without spermicide. The women in this study were not fitted individually by a clinician and were instead all given a 60mm diaphragm. There haven’t been enough studies to recommend using diaphragms without spermicide, so you should still use both products together for maximum protection. We suggest the use of ContraGen Green, especially for women who experience irritation as a result of nonoxynol-9.

Diaphragms also come with the risk of experiencing toxic shock syndrome (TSS) however the actual chance of this happening is quite low. Out of 100,000 diaphragm users, 2.4 will experience TSS. This happens almost exclusively when the diaphragm is left inside the vagina for over 24 hours.

Those allergic to latex are advised against using latex diaphragms. There are only a few non-latex diaphragms available on the market. One of the most popular silicon based diaphragm brands is Milex.


About Condoms

A condom is one of the most popular barrier devices on the market. It is a contraceptive used during intercourse, most often by males, to avoid pregnancy. A condom can also be used to reduce the risk of spreading or contracting sexual transmitted diseases (STDs) such as HIV, chlamydia and syphillis. Condoms are placed over a man’s erect penis and act as a physical barricade, preventing ejaculated semen from entering the body of the man’s sexual partner.

Male condoms are user-friendly, inexpensive, have few side effects and can reduce the risk of transmitting STDs. When used properly during each act of intercourse, the pregnancy rate of users is only 2% per year.
Because of their elasticity, durability, and waterproof quality, condoms can be used for other things unrelated to contraception. For example, condoms can be used to create waterproof microphones and also to collect semen for use in an infertility treatment. They can even prevent rifle barrels from clogging.

Some male condoms are made with materials such as polyurethane, polyisoprene or lamb intestine, but the vast majority are made from latex. Female condoms on the other hand, are most often made with polyurethane.

Some condoms come pre-lubricated with a small amount of nonoxynol-9 spermicide chemical. Consumer Reports have concluded that these spermicide-lubricated condoms don’t actually offer any additional benefits when it comes to preventing pregnancy. They also have a shorter lifespan than regular condoms and are believed to cause urinary-tract infections in women. On the other hand, applying separately packaged spermicide to condoms is believed to increase a condom’s efficiency.

Condoms

The failure rate of condoms varies depending on the population being studied and has been reported to be around 10-18% per year. The pregnancy rate of condoms used perfectly is 2% per year. For maximum protection, condoms may be used with other forms of contraception, such as spermicide.



About Contraceptive Sponges

Contraceptive sponges prevent contraception by combining barrier and spermicidal methods. These sponges cannot be reused or refilled and must be disposed of after use. The leading brands of contraceptive sponges on the market today are Pharmatex, Protectaid and Today sponge. Pharmax is available in France and Quebec; Protectaid in Canada and Europe; while Today is sold in the United States.

The Today sponge manufacturer reports a success rate of 89% to 91% for users who practice contraception with the sponge consistently and correctly. The success rate of users who do not follow the directions on the package prior to intercourse drop to 84% to 89%. Other sources report lower effectiveness for women who have given birth in comparison with those who have not (74% for perfect use and 68% during typical use).

The effectiveness of typical use of Protectaid has been reported at 77% to 91%, while perfect use has rates of over 99% per year. Studies of Pharmatex have shown typical use success rates of 81% per year. To further increase the effectiveness of condoms, implementing another method of birth control such as condoms could be beneficial.

Unlike Protectaid and Pharmatex sponges which come ready to use, you must run the Today sponge under water until it´s completely wet before insertion. Each sponge may be inserted 24 hours before intercourse. In order to be effective, it must be left in place for at least six hours after intercourse. Contraceptive sponges should not be worn for more than 30 hours straight.

Today Sponge

The contraceptive sponge acts as a physical barrier that prevents sperm from entering the cervix and going into the female reproductive system. Spermicide is an essential component of practicing contraception with sponges and each brand is manufactured using a different kind of spermicide.

The Today sponge contains 1,000 milligrams of nonoxynol-9. Protectaid contains 5,000 mg of F-5 gel, which contains three active ingredients (6.25 mg of nonoxynol-9, 6.25 mg of benzalkonium chloride, and 25 mg of sodium cholate). Pharmatex contains 60 mg of benzalkonium chloride. The abundance of nonxynol-9 is often a concern of potential users. If you've experienced any adverse reactions to nonoxynol-9 spermicide before, you will most likely be irritated by sponges and should therefore consider an alternative form of barrier contraceptives such as the cervical cap in conjunction with ContraGel.

Women who use the sponge have an increased risk of contracting yeast and urinary tract infections. Leaving the sponge in for over thirty hours can cause toxic shock syndrome, therefore it´s extremely important to use sponges with proper care and attention. If you experience any averse reactions to the sponge, you may be allergic to spermicide and should seek medical attention before continuing use.

Have a look at our video below and articles on Fertility Awareness, the Sypto-Thermal method of contraception and Contraceptive Monitors like Cyclotest to learn more about natural contraception and fertility.

No comments:

Post a Comment