Birth Control Options for Women - Spermicidal and Barrier Contraception

Spermicidal and Barrier Contraceptives

Barrier contraceptives are devices that provide a physical barrier between the sperm and the egg. Examples of barrier contraceptives include the male condom, female condom, diaphragm, cervical cap, and sponge. The condom is the only contraceptive method that helps prevent sexually transmitted diseases (STDs).

Spermicides

Vaginal spermicides are sperm-killing substances available as foams, creams, gels, films, or suppositories, and are often used in female contraception with barrier and other devices. Spermicides are usually available without a prescription or medical examination.

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The active ingredient in U.S.-made spermicides is usually nonoxynol-9, which attacks the surface of the sperm cell. Nonoxynol-9 does not provide any protection against sexually-transmitted diseases or HIV (the virus that causes AIDS). Research indicates that frequent use can cause vaginal and rectal irritation and abrasions that may actually increase the risk for HIV transmission in women. In addition, use of a spermicide with a barrier device may increase the risk for a urinary tract infection in women, regardless of whether the device is a condom or diaphragm. (Non-spermicidal lubricated condoms are safe to use.)

In general, spermicides may be an appropriate choice for women who have intercourse only once in a while, or need backup protection against pregnancy (for instance, if they forget to take their birth control pills). Spermicides should not be used alone as the primary method of birth control.

The Male Condom

The condom is still the only reversible form of male contraception currently available.

Pregnancy Protection. The condom should be put on before intercourse when the penis is erect, since the male can discharge sufficient semen to cause pregnancy before ejaculation occurs. With typical use, the average rate of pregnancy for couples that rely only on condoms for protection is high -- about 17%. For those who use a condom correctly each time, the annual risk for pregnancy is 2%.