this slide deals with the available barrier methods for contraception.

1. AJIL P ACHANKUNJU
Roll No. 7
2014 MBBS
GMC KOTTAYAM

2. CONTRACEPTIVE METHODS
Spacing methods
1. Barrier methods
2. Intra-uterine devices
3. Hormonal methods
4. Post-conceptional methods
5. Miscellaneous
 Terminal methods
1. Male sterilization
2. Female sterilization

3. Barrier methods
 Physical methods
1. Condom(male & female)
2.Diaphragm
3.Vaginal sponge
 Chemical methods
(a)foams (b) creams, jellies & pastes
(c) suppositories (d) soluble films
 Combined methods

4. Condoms( ) e.g. NIRODH
 No side effects
 Protects from STD
 Conventional contraceptive (action @ the time of
sexual intercourse)
 Used in conjugation with spermicidal jelly(combined)
 Highly effective but should be used correctly at every
coitus.
 Failure rates vary from 2-3/100 women to more than 14
per typical users.

5. Condom cntd..
Advantages Disadvantages
 Easily available
 Safe and inexpensive.
 Easy to use; no need of
medical supervision
 No side effects
 Light compact and disposable
 Protection from STD
 It may slip off or tear during
coitus due to incorrect use
 Interferes with sex sensation

6. Usage(condom)
 Fitted on the erect penis before coitus
 Air must be expelled from the teat end to make room
for the ejaculate
 The condom must be held carefully when withdrawing
from the vagina to avoid spilling seminal fluid into
vagina after intercourse

7. Male condom

8. Female condom
 Pouch made of polyurethane
 Lines the vagina
 Internal ring(at closed end) covers the cervix and
external ring remains outside the vagina.
 Is prelubricated with silicon
 Effective against STD
 High cost and poor acceptability are the major
problems
 Failure rate 5/100 women to 21/typical user

9. Female condom

10. Diaphragm(Dutch cap)
 Vaginal barrier
 Shallow cup made of synthetic rubber or plastic
material
 Diameter : 5 to 10cm
 has flexible ring made of spring or metal
 Held in position partially by spring tension partly by
vaginal muscle tone
 Diaphragm of proper size is important
 Failure rate vary b/w 6 to 12/100 women years

11. Diaphragm

12. Usage(diaphragm)
 Inserted before intercourse(conventional) & remain
there for not less than 6 hours after sexual intercourse
 Used along with spermicidal jelly(combined)
 Side effects are practically nill.
 Variants include cervical cap, vault cap & the vimule
cap

13. Diaphragm cntd.
Advantages Disadvantages
 No risks & medical
contraindications.
 Trained person needed for
demonstration.
 After delivery, used only after
involution of uterus.
 Lack of facilities for washing
and storing in privacy
precludes its use.
 Remote possibility of toxic
shock syndrome.

14. Vaginal sponge e.g. TODAY
 Device employed for hundreds of years as sponge
soaked with vinegar or olive oil
 TODAY is a small polyurethane foam sponge
measuring 5cm x 2.5cm, saturated with a spermicide,
nonoxynol-9.
 High failure rate 20-40/100 parous women & 9-20/100
nulliparous women.

15. Vaginal sponge(TODAY)

16. Chemical methods
 Spermicides are used widely before advent of IUDs &
OCPs
 includes; 1) foams: foam tablets, foam aerosols
2) creams, jellies & pastes – squeezed
formed tubes
3) suppositories- inserted manually
4) soluble films- C-film inserted manually
Modern spermicides are surface active agents which
attach themselves to spermatozoa and inhibit O2
uptake & kill sperms

17. Spermicides

18. Drawbacks of spermicides
 High failure rate
 Used immediately before coitus & repeated before
each sexual act.
 Must be introduced to the regions of the vagina where
sperms are likely to be deposited
 Cause mild burning and irritation
 Best used with other barrier methods than alone
 No spermicides which is safe to use is yet found.