Methods of Contraception

Contraception refers to methods to prevent pregnancy which range from devices to medications to procedures and can be either temporary or permanent. Temporary contraception methods include barrier and hormonal methods.

Barrier methods can be mechanical, like devices such as male and female condoms and diaphragms; or chemical, like spermicides.

Now, male condoms are a thin stretchable sheath, commonly made of latex, that’s applied over the penis.

Female condoms are a small pouch made of synthetic rubber with flexible rings at both ends; the closed end is inserted into the vagina and secured around the cervix, and the open end covers the labia. Both male and female condoms are single use and applied immediately prior to intercourse.

Diaphragms are dome-shaped silicone devices that cover the cervix and are usually used with a spermicide. They can be inserted six hours before intercourse and should remain in place for at least six hours following intercourse, but no longer than 24 hours. If they’re left in place longer than 24 hours or if they’re used during menses, there’s a risk of toxic shock syndrome.

Next, spermicides are chemical-based formulations that destroy sperm cell membranes and reduce sperm motility, reducing their ability to reach the cervix, and are available as foams, tablets, suppositories, vaginal films, creams or gels.

Spermicides should be inserted deep into the vagina about 15 minutes before intercourse and must be reapplied before repeat intercourse since they're only effective for about an hour. When used together with a mechanical barrier like a diaphragm, the contraceptive effectiveness is improved.

Now, with all barrier methods, there are some common advantages and disadvantages. The advantages are that they’re inexpensive, relatively easy to use, and effective when applied properly. Condoms and spermicides are readily available without a prescription, whereas diaphragms require a prescription and fitting by a health care provider to ensure they're large enough to fit snugly without causing pressure on the vagina.

In terms of protection against sexually transmitted infections, or STIs, condoms offer effective protection, diaphragms offer some protection, and spermicides offer no STI protection. Other disadvantages of barrier methods include interference with sexual spontaneity because they need to be applied before intercourse. Additionally, spermicides may cause irritation to the urethra and vagina.

Hormonal methods of contraception include oral pills, devices, or injections that contain a combination of estrogen and progestin, or progestin only. Oral contraceptives work by inhibiting ovulation, thickening cervical mucus to prevent sperm motility, and making the endometrium unfavorable for implantation. Depending on the brand, combination oral contraceptives are taken daily with some days containing either inactive pills or no pills.