Barrier methods of contraception

1. BARRIER CONTRACEPTIVES

2. • Methods which prevent the union of sperm and ovum, which is necessary for pregnancy
• They are oldest
• Widely used method

3. MALE CONDOMS
• Very popular method
• Oldest and widely used birth control method in the world
• Prevents STD including HIV
• Condom with hormonal contraceptive – maximal efficacy
• Types : latex, lubricated condoms and condoms containing spermicide nonoxynol-9
• Polyurethane , silicone –thin ,transparent and transmit body heat . Hence
sensitivity may be better
• Free supply by govt through family welfare clinics under the brand name nirodh

4. • EFFECTIVENESS
• Pregnancy rate 12 per 100 woman , due to slipping or bursting or partly due to
noncompliance
• ADVANTAGES
• Reduce risk of STD , protects against gonorrhoea,chlamydia,herpes virus type 2 ,
hepatitis B
• Considerable protection against HIV
• Protection from cervical neoplasia because they protect against human papilloma virus
infection
• DISADVANTAGES
• Full sexual satisfaction not obtained
• Allergy to the material
• Controlled by male and can be used only after erection

5. FEMALE CONDOM
• FEMIDOM
• vaginal pouch made of polyurethane
• Has 2 rings , the inner ring- used to insert the condom inside the vagina and outer ring cover
external genitalia
• It can be inserted 8 hours prior to intercourse but must be removed immediately after.
• ADVANTAGES
1. Female controlled method
2. No side effects or latex allergy
3. Breakage is less common
4. Better protection against herpes and HPV

6. DISADVANTAGES
Not aesthetic
Requires preplanning
Harder to dispose of than male condom
Requires practice
• Can get displaced to the side or slip
Not yet widely available
Expensive compared to male condom

7. VAGINAL SPERMICIDES
• NONOXYNOL -9
• Spermicide available in India
• Available as incorporated in a polyurethane sponge under the brand name of Today
• It is provided with a loop for easy removal , must be moistened with water and placed firmly against the cervix, it
must be placed high up in the vagina with concave side covering the cervix
• Can remain active for 24hrs, but can be inserted immediately before the act
• At least 6 hours should elapse after sexual intercourse before the sponge is removed
• It acts as a mechanical barrier preventing the entry of sperm into cervical canal, absorbs semen and is
spermicidal
• It is a non ionic surface active detergent that immobilises sperm
• Others: foaming tablets,cream, jelly and aerosol foam suppository

8. OTHER SPERMICIDAL AGENTS
• OCTOXYNOL-9
• BENZALKONIUM CHLORIDE
• MENFEGOL
• Women’s using nonoxynol-9 spermicides –increased chance of genital lesions,which can
increase the risk for STD and HIV
• Less effective than condoms; combined use increase effectiveness
• Not recommended along with condoms for HIV protection

10. VAGINAL BARRIERS
• DIAPHRAGM OR DUTCH CAP
• Circular spring covered with latex rubber
• Various types and sizes
• Proper fitting is essential,neither too loose nor too tight
• Pushed into vagina as far as possible, so that the leading edge is behind the cervix
and the front edge behind the symphysis pubis
• The diaphragm Should be inserted not longer than six hours Before intercourse and
should be left in place for about six hours after coitus
• Before insertion tablespoon Full of spermicidal jelly or cream should be placed in
the dome of the diaphragm and some of it should be spread around the rim with a
finger
• After removal the diaphragm should be washed with soap and water and dried,
periodically leaks should be checked for with water
•

11. • Some reports vaginal irritation
• UTI are common
• Cannot be used in cases of prolapse , as accurate fitting is not possible
• Reduce STD ; unlikely from HIV as vagina remain exposed
• Main advantage is low cost and durability

12. • CERVICAL CAP
• Thimble or dome shaped; over the cervix hence more difficult to
insert
• It can be placed for longer time (upto 48 hours) and need not be
used with spermicide ; with increase efficacy
• Good for woman with vaginal wall relaxation who cannot retain
diaphragm
• The woman must be taught to first identify the cervix and then
slide the cap into the vagina, up along the posterior vaginal wall
and then on to the cervix; must be left in place for atleast 8
hours after coitus to ensure that no motile sperms are left in the
vagina
• Reduce STD
• FemCap , Lea’s shield

13. • DUMAS OR VAULT CAP
• Cup shaped rubber cap with a thickened rim which
fits well into the vault of the vagina such that cervix
is enclosed

14. THANK YOU