Barrier Methods of Contraception

Some sexually transmitted infections (STIs) can be prevented and contraception made easier with barrier methods. Cervical caps, diaphragms and condoms (both male and female) are barrier techniques. They are available in latex, nitrile, silicone, and polyurethane among other materials. Barrier methods are user-dependent; thus, fertility rates and usage determine how effective they are. Known by another name, dental dams, dams are squares made of latex or polyurethane that, during oral intercourse, serve as a barrier between the mouth and the female genitalia, or anus. Not a kind of contraception, they can stop the spread of STIs. 

Male and female condoms

Technique of Operation for Barrier methods

The barrier methods keep semen out of the body and away from interacting with secretions from the vagina.  Both alone and in conjunction with other contraceptive methods, they can be utilized.

Female condoms are vaginal implants of lubricated sheaths. A ring or sponge fastens the device in the vagina at its closed end. The larger ring- or flexible-framed open end of the sheath stays outside the vagina during sexual contact. 

A contraceptive’s effectiveness

Condoms depend on their users; hence appropriate and ongoing use is necessary for them to work. 

Perfect use(efficacy)	Typical use
Male Condom: 98% effective	82% effective
Female Condom: 95% effective	79 % effective

Though the risks of conception are same, non-latex male condoms break more clinically than latex condoms. 

STI prevention

Correct use of latex male condoms lowers the risk of syphilis, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and HIV as well as hepatitis B and C.

Condom effectiveness in preventing HPV (Human tpapillomavirus) and herpes simplex virus transmission is disputed since these diseases can be spread by direct touch with infected skin or mucosal areas. 

Still, there is less chance of spreading these diseases if men use male latex condoms correctly and regularly. According to research, condoms for men and women that are not latex offer protection on par with those of male condoms that are. 

Lubricant and spermicide for Barrier methods

Condoms come pre-lubricated in most cases, both male and female. Using petroleum jelly or body oils with latex condoms is not advised as they may tear the latex and make it more brittle. The WHO has discontinued to advise condoms lubricated with spermicide because there is insufficient proof of their further protection against STIs and pregnancy. Moreover, because of disruption of the cell membrane, nonoxinol-9, the primary spermicide available in the UK, may raise the risk of genital sores. Slippage might result from gel charging—applying lubrication inside the condom. Keep away from this. 

Anal hookup

 To prevent cracking, apply non-oil-based lubrication to the condom’s outside and inside the anus before anal sex. According the study, thicker condoms—such as extra strong or extremely strong—do not improve anal intercourse breakage or slippage at all over regular condoms. 

Anal sex can be had with female condoms (removing the ring at the tip). 

Reactions

Latex condom use is deemed relative contraindication (UKMEC category 3) for those who are sensitive to latex proteins. 

Diaphragms and caps for Barrier methods

Mode of Action for Diaphragms and Caps

Spermicide is applied to coat the cervix in these procedures, erecting a chemical and physical barrier. Effectiveness as a contraceptive: When worn appropriately and regularly with spermicide, diaphragms and caps are thought to be 92%–96% effective in preventing pregnancy. 

Device categories in Barrier methods

Diaphragms

Thin, dome-shaped devices made of silicone or latex, diaphragms cover the cervix and extend from the posterior fornix to behind the pubic bone. In the UK, there are now three main options after the Reflexions® flat spring diaphragm was recently discontinued. Diameters of the diaphragms vary by 5 mm from 55 to 95 mm. Since late 2013, the silicone contoured diaphragm Caya® (formerly SILCS) has been sold in six European countries, including the UK and Germany. About 80% of women should find it to be suitable. As other diaphragms, this one needs spermicidal gel to work effectively. The FSRH recommends evaluating women to make sure their diaphragms fit properly, but no expert fitting is needed.

Caps

Littler than diaphragms, caps are held in place by suction and rest directly over the cervix. Only the Femcap is available in the USA and the UK. With three sizes—22 mm, 26 mm, and 30 mm—it is a silicone device.

Sponges

There is no longer any contraceptive vaginal sponge available in the UK. Available in the USA, the Today sponge is a polyurethane gadget soaked with N-9. 

Suggestion to consumers

The right device size to fully cover the cervix should be chosen by a trained healthcare professional during a vaginal examination. The weight of a user should be reevaluated following pregnancy or if it fluctuates by more than three kilograms.

One should offer the following advice:

• Read the manufacturer’s directions before using. 
• To apply spermicide to the device, fill one-third of the cap or insert two strips on the top side of the diaphragm. 
• Be sure the cervix is protected after insertion. In such case, take out and put back in. 
• Before sex, caps and diaphragms can be placed; but, if sex happens after three hours or if the procedure is repeated, extra spermicide (as a pessary or cream with an applicator) is needed. 
• The device should be worn for at least six hours following sex, but no longer than the manufacturer advises. Only 30 hours are allowed for the use of latex devices; 48 hours are allowed for non-latex devices. 
• Remove the device, then give it a gentle, unscented wash in warm water and let it air dry.
• Look for damage or perishing on the device often. 

Preventing STIs

The proof that diaphragms or caps stop the spread of HIV or STIs is scant. 

Barrier methods failure

If a barrier technique doesn’t work or is used wrong, think about emergency contraception.

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