Spermicidal and Barrier Contraception

Barrier contraceptives are devices that provide a mechanical barrier between the sperm and the egg. Examples of barrier contraceptives include the male condom, female condom, and the diaphragm. [For a description of the male condom, see Box Male Condom.] Barrier devices are the only contraceptive methods that can help prevent sexually transmitted diseases (STDs).

Spermicides

Spermicides are sperm-killing substances available as foams, creams, or gels, 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 US-made spermicides is usually nonoxynol-9, which attacks the surface of the sperm cell. Nonoxynol-9, however, does not provide any additional protection against sexually-transmitted diseases. In fact, research now suggests that frequent use may cause vaginal injuries and actually increase the risk for HIV transmission in women. In addition, use of a spermicide with a barrier device also poses a two- to three-fold risk for a urinary tract infection in women, regardless of whether the device is a condom or diaphragm. Spermicides are no longer recommended with male condoms. Some experts question their use with the diaphragm, suggesting that they may not even add much protection against pregnancies. A major analysis of current research found only one study that reported enhanced protection, but it had limitations.