Barrier Methods

Among the many ways of preventing pregnancy are the products known as barrier contraceptives: cervical caps, female condoms, male condoms, diaphragms, and vaginal spermicides. Barriers work by preventing the sperm from reaching the egg.

Sterilization, although not a product, also prevents sperm from reaching the egg. The procedures for sterilization are called a vasectomy (for men) and tubal ligation (for women).

The table here demonstrates the efficacy of each type of barrier method.

Barrier Methods

Cervical Cap

What is a Cervical Cap?

  • A cervical cap is a method of birth control. It is a small device made of soft latex rubber that fits over your cervix.

  • Cervical caps come in different sizes and must be fitted by a clinician.

  • Cervical caps are no longer made in Canada. Please call 1-800 SEX SENSE for information about clinicians who can supply and fit the cervical cap.

How does the Cervical Cap work?

  • Barrier method of birth control (similar to the diaphragm) used with spermicide.

  • It is held in place by suction so that sperm cannot enter the uterus.

  • The cap must be checked for correct placement after insertion and before every act of intercourse.

  • The cap must be left in place for at least 6 hours after the last act of intercourse but no longer than a total of 24 hours.

How effective is it?

  • In women who have not had children, the effectiveness of this method ranges from 84% (actual use) to 91% (perfect use)

  • In women who have had children, the effectiveness of this method ranges from 68% (actual use) to 74% (perfect use)

  • With consistent and correct usage, an average of 9% of women using this method of birth control will have pregnancies. The cervical cap must be used every time you have intercourse.

Advantages

  • Small and easy to carry

  • May be put in up to an hour before sex

  • Will work for 24 hours during which you can have sex as many times as you want

  • Your partner doesn’t have to know you are using it

Disadvantages

  • Must be fitted by a clinician

  • May interrupt sex

  • May increase your risk for inflammation of the surface of the cervix

  • May be difficult for some women to insert a cervical cap properly

  • Possible to dislodge during use and increase risk for pregnancy

  • New fitting is necessary after having a baby, abortion, miscarriage, or a weight gain or loss of 10 pounds

  • Latex (rubber) allergies may cause irritation

Recommendations

  • During the first 8 to 10 times you use the cap, also use a spermicide and condoms for back up. Check the cap before and after intercourse to make sure it stays in place.

  • Use the cap every time you have intercourse except during your period.

  • To avoid infections, including toxic shock, do not use the cap any time you have vaginal bleeding or have any vaginal, cervical or pelvic infection. Be careful to wash your hands and the cap as instructed.

When do I return to the clinic?

  • Two to four weeks after initial fitting to check the fit, and then annually. It is important to continue with regular Pap tests.

  • To re-fit the cap after having a baby, a miscarriage or late abortion, or a gain or loss of 10 pounds.

If you experience any of the following symptoms call your clinic or health care provider

C

concerns/problems with cap use (trouble putting it in or taking it out, it doesn’t feel right, comes off by itself, etc.)

A

Abnormal vaginal bleeding, discharge, bad smell, or other irritation

P

Pain or discomfort

 

Considerations

 

To date there has been no link between the use of the cap and toxic shock. However, to avoid this possibility, it is recommended that the cap:

  • Not be left in for more than 24 hours

  • Not be used during your period or if you are bleeding from your vagina for any reason. Use another method during these times.

  • Not be used if you have any vaginal, cervical or pelvic infection

     

     

What if I have sex and don’t use Birth Control?

Did you know that …for up to 120 hours (5 days)… after sex…you can take emergency pills to avoid becoming pregnant? (The sooner they are taken after an episode of unprotected intercourse the more effective they are)…AND for 7 days…after sex…you can have an IUD put in, so you won’t become pregnant. Not all doctors know about this. IF you need to know more or would like the phone numbers of doctors or clinics near you that have emergency birth control, call the SEX SENSE line 1-800-739-7367 or 731-7803 in the lower mainland.

Using the Cervical Cap

How do I insert the cap?

  1. Before inserting the cap, empty your bladder and wash your hands.
  2. Check the cap carefully for holes, tears, or cracks.
  3. Fill the cap 1/3 full of spermicidal cream or jelly.
  4. Find the position that is best for you to insert the cap (e.g., one foot on a chair, squatting...).
  5. Feel for your cervix with your longest finger. It will feel like the end of your nose. If you have trouble finding your cervix, bear down as if you are trying to have a bowel movement. This will help push it closer to your finger.
  6. Using one hand, open the lips of your vagina, and with the other hand squeeze the rim of the cap together firmly and put it into the vagina. Tip the cap so the open part is facing toward the back and aim for your cervix.
  7. Push the cap all the way up the vagina to the cervix. It should attach to the cervix easily. Most women feel nothing as it slips on but a few can tell when it takes hold.
  8. Press the rim of the cap around the cervix and pinch the rounded end to establish the suction that helps hold it in place.
  9. Check to see if your cervix is covered by pressing on the dome of the cap, then sweep your finger around the cap. You should feel your cervix through the cap, not beside it. Check the suction by tugging on it.
  10. If the cap is not in the right place, try to push it onto your cervix or take it out and try again.
  11. You may find it harder to insert the cap after sexual arousal, because the vaginal tissues are more puffed up and firmer. Think about putting the cap in earlier, even if you are not sure you will need it or keep some condoms handy.
  12. The cap should be in place ½ hour before intercourse for good suction to develop. If you have intercourse more than once, you do not have to put in more spermicidal cream or jelly.
  13. Be sure to check that the cap is still in place over your cervix before and after each act of intercourse.

CAUTION
Leave the cap in place for at least 6 hours after the last intercourse.
Do not leave the cap in place for more than a total of 24 hours.

How do I remove the cap?

  1. Empty your bladder and wash your hands.
  2. Take the cap out in the same position you used to put it in. It may be easier to sit on the toilet as it relaxes the muscles and lets the uterus and cervix move down so the rim of the cap is easier to reach.
  3. Insert your longest finger into your vagina and press on the rim of the cap until the suction is broken and you can tip it off the cervix. Once you've broken the suction, gently put your finger over the rim and inside the cap and pull it out.
  4. If you have trouble breaking the seal, bear down while trying. If it's too hard to get out stop trying for a while and try again later. Call your doctor if you can't remove it on the second try.
  5. Wash the cap with a mild soap and water.* Rinse well and examine it for any cracks or holes by holding it up to the light or seeing if it will hold water without leaking.
  6. Dust the cap with cornstarch and store in its box away from heat, oils, or inks.
  7. Be sure to rinse off the cornstarch before using again.


*If you have had a cervical or vaginal infection or if there's any bad cap odour, wash it in warm soapy water, soak it in isopropyl (rubbing) alcohol for 20 minutes, rinse well with water, and then dry it out.

Recommendations

  • During the first 8 to 10 times you use the cap, also use a spermicide and condoms for back-up. Check the cap before and after intercourse to make sure it stays in place.
  • Use the cap every time you have intercourse except during your period.
  • To avoid infections, including toxic shock, do not use the cap any time you have vaginal bleeding or have any vaginal, cervical or pelvic infection. Be careful to wash your hands and the cap as instructed.

When do I return to the clinic?

  • Two to four weeks after initial fitting to check the fit, and then annually. It is important to continue with regular Pap tests.
  • To re-fit the cap after having a baby, a miscarriage or late abortion, or a gain or loss of 10 pounds.

If you experience any of the following symptoms call your clinic, physician or go to the nearest emergency department

C

concerns/problems with cap use (trouble putting it in or taking it out, it doesn't feel right, comes off by itself, etc.)

A

Abnormal vaginal bleeding, discharge, bad smell, or other irritation

P

Pain or discomfort

Reviewed by Danielle Chard, RN, BSc Nursing, Director of Clinic Services 11/21/07

External (Male) Condoms

What are they and how do they work?

  • An external condom is a covering designed to fit over an erect penis, almost like a second skin and can be used for oral, vaginal and anal sex

  • The condom catches and holds ejaculated semen so that sperm cannot enter the vagina and uterus and cause a pregnancy.

What kinds of condoms are available?

There are 3 types of condoms

  • Latex condoms –most commonly available and are very effective in protecting against both pregnancy and sexually transmitted infections.

  • Polyurethane condoms –an alternative for people who have latex allergies. They are made of plastic and are as effective as latex condoms in preventing pregnancy and protecting against sexually transmitted infections.

  • Natural condoms –made from animal membrane. While they are effective in preventing pregnancy, they offer no protection against sexually transmitted infections.

Condoms come in many different types, sizes, colours and flavours. Condoms packaged with spermicidal lubricant do not have the same pregnancy protection as using condoms with a separate spermicide (such as foam, gels, film, or sponge). If you are using a non-lubricated (dry) condom, we recommend that you also use spermicidal or lubricating jelly, foam or saliva for lubrication. Do NOT use more than one condom at a time (no double bagging - 2 external or 1 external/1internal condom) as it may increase the risk of breakage.

How effective are they?

  • Used by themselves, external condoms are 85% (typical use) to 98% (perfect use) effective at preventing pregnancy. This means that from 2 up to 15 out of 100 couples who use condoms as their only birth control method for one year will experience a pregnancy. They are considered a very effective way to prevent sexually transmitted infections.

Caution: Spermicides with nonoxynol-9 have been shown to cause irritation to the vaginal lining, therefore increasing the risk of exposure to HIV. This concern is greater with the frequency of intercourse and increases with the number of sexual partners.

Advantages of condoms

  • Easy to use; available without a prescription; no hormones

  • Protects against sexually transmitted infections

  • A contraceptive method that men can use

  • Using this method, men have the opportunity to learn more about their own bodies and to share responsibility for contraception

  • Low cost or free

Disadvantages of condoms

  • If allergic to latex, may cause irritation in the vagina or on the penis.

  • May break if improperly stored or used incorrectly

  • Needs to be applied before each act of intercourse, reducing spontaneity

  • May reduce sensitivity during intercourse

  • Oil based products such as Vaseline, baby oil, massage oil or creams can cause latex condoms to tear or break

How do I use condoms?

  1. Talk openly with your partner and work together to be safe. Contraception is for the protection of both of you. Practice handling and using condoms like when masturbating before you need to use them with a partner. 

  2. Check the expiry date and that the air bubble is still present in the package.

  3. Open package carefully. Teeth or long fingernails can tear the condom.

  4. Pinch tip of condom and place on tip of penis

  5. Roll the condom down to the base of the penis. If the condom doesn’t have a reservoir end, leave about a 1/2 inch of space at the end for the semen.

  6. If you are using lubricant, now is the time to put lots of it on the outside of the condom before inserting the penis during sexual intercourse.

  7. After the man ejaculates (comes) he should pull his penis out before it gets soft, by holding the rim of the condom at the base of his penis so it doesn’t slip off while he withdraws.

  8. Check that the condom has not torn before throwing it away. If it has torn or if semen spills into the vagina, quickly insert a spermicide such as an applicator of foam and seek emergency contraception to help prevent pregnancy. You may also consider going for STI testing.

  9. Tie off the used condom and throw it away in the garbage (not the toilet), and use a new one for each act of intercourse.

  10. We recommend having ECP available (i.e., Plan B) on hand in case the condom breaks, leaks or slips off and you have no other back up contraception in place.

Health Canada has issued the following recommendations regarding the use of the spermicide nonoxynol-9 (N-9):
  • The benefit of any N-9 lubricated condom probably outweighs the risk of using no condom at all. However, the best STD and HIV barrier is a latex condom without N-9.
  • Condoms lubricated with N-9 should not be used for anal intercourse.
  • Those using N-9 lubricated condoms should be provided with information about the potential for irritation of the vaginal and cervical mucosa, which may in turn increase the risk of HIV.
  • The adverse affects of using N-9 may not apply to women who use N-9 less frequently and therefore the risks and benefits of using N-9 should be evaluated on an individual basis.
 
FS410
Revised March 2009
 

TIP: water based lubricants can increase sensation and decrease risk of breakage

Internal (Female) Condom

What is the internal condom?

  • Internal (Female) CondomThe internal, or female condom (e.g., FC2, RealityTM) is a condom made for internal use.
  • It is made from a soft, loose-fitting polyurethane plastic, shaped like a pouch, and has a soft ring at each end.
  • The ring at the closed end is used to put the device inside the vagina and holds it in place. The other ring stays outside the vagina and partly covers the outer lips or labia.

How does the internal condom work?

It prevents sperm from meeting the egg and acts as a barrier for protection against sexually transmitted infections (STIs).

How effective is it?

The internal (female) condom is 79% (typical use) to 95% (perfect use) effective at preventing pregnancy.

Advantages

  • One size fits all—relies on lining the vagina not on fitting snugly to the penis
  • Effective barrier to sexually transmitted infections including HIV infection
  • A woman can choose to use this condom herself
  • Available without prescription at all Opt clinics, some drug stores, and sex stores
  • Alternative for women or their partners who have latex allergies

Disadvantages

  • Expensive—costs about 3 times more than an external (male) condom (but can be picked up at Opt Clinics for no cost!)
  • May have some trouble inserting it correctly
  • May make a "rustling" noise during intercourse
  • Important to remove carefully to avoid the risk of semen spilling at vaginal entrance when condom removed

How do you use the internal condom?

  • Inserting the female condomInsert the internal condom before sexual intercourse.
    It can be inserted up to 6 hours before intercourse; however, most people insert it between 2 to 20 minutes before intercourse.
    • Squeeze the loose inner ring together to insert the closed end of the condom high in the vagina. The inner ring holds the condom in place.
    • The outside ring of the condom then lies against the outer lips of the vagina. Hold the outside ring when the penis is first inserted to ensure the penis goes inside the condom (not along the side) and to prevent the entire condom from being pushed in the vagina.
    • If you have trouble with noise from the condom during intercourse, try changing position, and/or adding lubricant inside the condom.

    How do you remove the internal condom?

    1. To remove, squeeze and twist the outer ring to keep the semen inside the pouch then pull out gently.
    2. This should be done after intercourse and before standing up.
    3. Throw the condom away in the garbage.

    EACH CONDOM SHOULD ONLY BE USED ONCE.

    Internal condoms are available at Opt Clinics for free.

    FS 404
    Revised March 2009

    How do I use condoms?

    Talk openly with your partner and work together to be safe. Contraception is for the protection of both of you. Practice handling and using condoms when masturbating before you need to use them with a partner.

    1. Check the expiry date and that the air bubble is still present in the package.
    2. Open package carefully. Teeth or long fingernails can tear the condom.
    3. Pinch tip of condom and place on tip of penis
    4. Roll the condom down to the base of the penis. If the condom doesn't have a reservoir end, leave about a 1/2 inch of space at the end for the semen.
    5. If you are using lubricant, now is the time to put lots of it on the outside of the condom before inserting the penis during sexual intercourse.
    6. After the man ejaculates (comes) he should pull his penis out before it gets soft, by holding the rim of the condom at the base of his penis so it doesn't slip off while he withdraws.
    7. Check that the condom has not torn before throwing it away. If it has torn or if semen spills into the vagina, quickly insert a spermicide such as an applicator of foam and seek emergency contraception to help prevent pregnancy. You may also consider going for STI testing.
    8. Tie off the used condom and throw it away in the garbage (not the toilet), and use a new one for each act of intercourse.

    Diaphragm

    Accessibility

    Access to the Diaphragm is limited in Canada. To find out who is still carrying the Diaphragm please call the Sex Sense line at 1 800 SEX SENSE

    What is a diaphragm?

    DiaphragmA diaphragm is a method of birth control used by women. It is a soft, thin, dome-shaped rubber cup with a flexible rim. Spermicidal jelly is placed inside the dome. The diaphragm is placed high in the vagina to hold the spermicide against the cervix. The diaphragm comes in various sizes and must be fitted by a clinician to be effective.

    The diaphragm acts as a barrier between the opening of the cervix and semen which contains sperm. The fit may not be tight enough to stop all the sperm from getting past the diaphragm; therefore, the spermicide is used to kill the sperm.

    • It can be inserted several hours before intercourse, but it must be left in the vagina for at least 6 hours following the last episode of intercourse. Additional spermicidal jelly should be inserted into the vagina before each act of intercourse without removing the diaphragm.

    • It can be left in for up to 24 hours total time.
    • You use it only when having intercourse. It is not meant to be used as a menstrual product.
    • The diaphragm is not considered to be an effective method of protection against sexually transmitted infections.

    How effective is it?

    The contraceptive effectiveness of this method of birth control ranges from 84% (actual use) to 94% (perfect use). Diaphragms must be used with spermicide to be effective.

    Advantages

    • It is female controlled and does not require partner assistance
    • There is an immediate return to fertility as it offers contraception only when needed
    • It can be used for 2–3 years (if cleaned and stored properly)
    • It can be inserted several hours before intercourse
    • It can be left in for up to 24 hours total time (intercourse may be repeated in that time frame, however, additional spermicide should be inserted into vagina while leaving the diaphragm in place. (Please read spermicide fact sheet for side effects, advantages, and disadvantages)

    Disadvantages

    • Reduces spontaneity
    • Need to be comfortable touching your vagina
    • Requires visit to clinic or physician for fitting

    Are there any problems using a diaphragm?

    • If you or your partner is allergic to latex, you will need to be fitted with a silicone diaphragm, which may be more costly.
    • The use of a diaphragm can increase the risk of getting a urinary tract infection in some women. The diaphragm should be carefully washed and dried after use to avoid infections.
    • The wrong-size diaphragm can cause cramping or pelvic pain, and will not provide effective protection against pregnancy. Refit your diaphragm after a 10 lb. weight gain or loss.
    • Although rare, cases of toxic shock syndrome (TSS) have been reported with diaphragm use during the menstrual period. It is recommended that a diaphragm not be used if you are bleeding from your vagina for any reason or have a vaginal, cervical or pelvic infection. Use another method of birth control such as condoms during your period.

    How do I care for my diaphragm?

    • After you take out your diaphragm, wash it with a mild soap like Ivory. Rinse and dry it well and put it away in its compact. Keeping your diaphragm away from heat and light will decrease the chance of weakening the rubber.
    • A regularly used diaphragm can last two to three years.
    • Products such as baby powder, body powder, or face powder seem to damage the rubber and should be avoided. You can dust your diaphragm with plain cornstarch, but be sure to wash it off before using again.
    • Oil-based products like Vaseline or hand cream damage the diaphragm

    Recommendations

    • Until you are sure the diaphragm is staying in place or until your first return visit to the clinic, use a back-up method of birth control such as condoms or oral contraceptive pills.
    • Cases of toxic shock syndrome (TSS) have been reported with diaphragm use during the menstrual period. It is recommended that a diaphragm not be used if you are bleeding from your vagina for any reason or have a vaginal, cervical or pelvic infection. Use another method of birth control such as foam and condoms during your period.

    When do I need to have my diaphragm checked?

    • Return to the clinic or healthcare provider for a fit check approximately four weeks after getting your diaphragm.
    • It is recommended to have a refitting yearly, and after a weight gain or loss of 10 or more pounds, after abortion, or after a pregnancy.
    • During a routine yearly exam and Pap test your healthcare provider will check the fit and examine the diaphragm.
    • If you feel irritation or discomfort, make a diaphragm check appointment.

    FS 406
    Revised March 2009

    Using the Diaphragm

    Process of Fitting

    1. Because the diaphragm comes in many sizes, a physician will fit the client with the correct size.
    2. During the fitting, the client will assume the Pap position; this enables the physician to take 'measurements'.
    3. The client will then get an opportunity to practice insertion and removal of the diaphragm; the physician will double check to ensure correct placement.

    How to insert the diaphragm

    Insert your diaphragm before intercourse. It can be inserted up to 6 hours before intercourse. Once inserted, it is immediately effective.

    1. Before inserting empty your bladder and wash your hands.
    2. Take the diaphragm and hold it up to the light. Check the diaphragm for any tears or holes in the cup or for cracks along the rim before each use.
    3. Squeeze at least a tablespoon of spermicidal jelly into the cup, and spread it around the rim and inside the cup with a clean finger.
    4. Press the rim of the diaphragm together with the spermicide inside the dome.
    5. While standing, squatting, or lying, gently push it all the way into the vagina with the dome side facing down and the jelly side directed toward the cervix.
    6. Push the diaphragm in as far as it will go, making sure that the front rim is tucked up under the pubic bone. It should cover the cervix, which feels like the end of your nose.
    7. Now you are ready to have intercourse. You can use more spermicide or lubrication if you want. For extra lubrication we recommend spermicidal jelly, or a water-based lubricant such as KY jelly.
    8. If you put your diaphragm in more than 6 hours before having intercourse, you should insert more spermicide (such as an applicator of contraceptive jelly or foam, VCF film or suppository) into your vagina without removing the diaphragm.
    9. Before each act of intercourse you should also insert more spermicide (as above) into your vagina, without removing the diaphragm.
    10. The diaphragm needs to be used with a spermicide every time you have intercourse.

    CAUTION

    • Leave the diaphragm in place for 6 hours after the last intercourse.
    • Do not leave the diaphragm in place for more than 24 hours.

    How do I care for my diaphragm?

    • After you take out your diaphragm, wash it with a mild soap like Ivory. Rinse and dry it well and put it away in its compact. Keeping your diaphragm away from heat and light will decrease the chance of weakening the rubber.
    • A regularly used diaphragm can last two to three years.
    • Products such as baby, body, or face powder seem to damage the rubber and should be avoided. You can dust your diaphragm with plain cornstarch, but be sure to wash it off before using again.
    • Oil-based products like Vaseline or cold cream damage the diaphragm.

    Recommendations

    • Until you are sure the diaphragm is staying in place or until your first return visit, use a back-up method of birth control such as condoms or oral contraceptive pills.
    • Cases of toxic shock syndrome (TSS) have been reported with diaphragm use during the menstrual period. It is recommended that a diaphragm not be used if you are bleeding from your vagina for any reason or have a vaginal, cervical or pelvic infection. Use another method of birth control such as foam and condoms during your period.

    When do I need to have my diaphragm checked?

    • Return to the clinic or doctor for a fit check approximately four weeks after getting your diaphragm.
    • It is recommended to have a refitting annually, and after a weight gain or loss of 10 or more pounds, after abortion, or after a pregnancy.
    • During a routine yearly exam and Pap test your clinic doctor will check the fit and examine the diaphragm.
    • If you feel irritation or discomfort, make a diaphragm check appointment.

    Other considerations

    If you experience any of the following symptoms call your clinic or healthcare provider, or go to the nearest emergency department:

    • Concerns or problems inserting and/or removing the diaphragm
    • If the diaphragm becomes dislodged during intercourse
    • Abnormal vaginal bleeding, discharge, bad smell or other irritation
    • Pain or discomfort
    • Signs of toxic shock syndrome, such as sudden high fever, dizziness, rash that looks like a sunburn, sore throat, weakness, achiness, vomiting, diarrhea, or redness of the eyes.

    Sterilization

    What does sterilization involve?

    Sterilization can be done for both men and women. Sterilization for men is called a vasectomy and sterilization for women is called a tubal ligation. Some physicians may refuse a client’s request for sterilization due to age and/or if s/he has never had children.

    How is sterilization done?

    For men: The tubes leading from the scrotum that join with the urethra are cut, clamped, cauterized, or tied. These tubes are called the vas deferens. It is a procedure that can be done in a doctor’s office using a local anaesthetic.

    For women: The tubes leading from the ovaries to the uterus are cut, clamped, cauterized, or tied. These tubes are known as the fallopian tubes. It is a surgical procedure usually performed in a hospital, using a general anaesthetic.

    How effective is it?

    Sterilization is a very effective method of contraception. Tubal ligation is 99.5% effective immediately. Vasectomy is 99.85% effective but is not immediately effective (see Special Considerations, below)

    Are there any adverse effects from these procedures?

    There are no effects on the sexual health of either men or women who have this procedure done.

    Advantages

    • No supplies or future clinic visits needed, once effective
    • Nothing to interrupt intercourse
    • Permanent
    • 40 % reduction in risk of ovarian cancer with tubal ligation
    • High effectiveness

    Disadvantages

    • Regret for decision
    • Permanent
    • Lack of protection against sexually transmitted infections
    • Need for a surgical procedure
    • Higher risk of ectopic pregnancy if failure occurs with tubal ligation
    • Vasectomy requires a backup method until effective

    Special Considerations

    • Vasectomies are not effective immediately. The male has to monitor his sperm count for approximately three months (or 20 ejaculations) following the procedure. Once his semen is examined to ensure there is no sperm in the ejaculate, the procedure is considered effective.
    • The surgical procedure for a tubal ligation is much more complicated than for a vasectomy and the recovery time is also longer for the patient.

    FS421
    Revised March 2009

    Spermicides

    What are spermicides and how do they work?

    Spermicides contain the sperm-killing chemical nonoxynol-9 and work by setting up a chemical block at the entrance to the uterus. Here, sperm are trapped by the foam or gel barrier and destroyed by the chemical. The amount of nonoxynol-9 varies depending on the type and brand of spermicide.

    What types of spermicides are available?

    *Note: THERE ARE CURRENTLY NO HEALTH CANADA APPROVED SPERMICIDES AVAILABLE FOR SALE IN CANADA.

    How effective are they?

    • Vaginal spermicides used alone are about 78% effective.
    • When spermicides are consistently used together with a condom, the combined effectiveness is 95% or greater—about the effectiveness of birth control pills.

    Advantages

    • Are non-hormonal
    • Available in several forms for personal convenience

    Disadvantages

    • May cause irritation to the vagina or penis or contribute to yeast and urinary tract infections
    • May be difficult or inconvenient to use because it must be applied immediately before intercourse
    • Possibly affects spontaneity
    • Effective for a limited time unless re-applied
    • Provides no protection against sexually transmitted infections
    • Need to be comfortable touching your vagina

    Considerations

    • Women may want to lie on their backs briefly after intercourse to be sure the foam, gel or film stays against the cervix to destroy sperm trying to enter.
    • Remember to re-insert another applicator of foam or gel or a new film for each act of intercourse.
    • There is no need to douche after using a spermicide, or at any other time unless recommended by your physician. If you want to douche, wait at least 8 hours after the last act of intercourse to allow the foam to destroy as many sperm as possible.
    • Keep an extra application of spermicide handy in case you need to use it.
    • Some people can have an allergic reaction to a spermicide. If an irritation develops, try changing brands.
    • Not recommended for frequent use in women who are at high risk of contracting HIV, as nonoxynol-9 may increase the risk of infection.
    • Condoms lubricated with nonoxynol-9 offer no more protection against pregnancy than those lubricated with silicone lubricants. To be effective, a spermicide must be used in a separate form as discussed above.

    Talk openly with your partner and work together to be safe.
    Contraception protects both of you.

    Health Canada has issued the following recommendations regarding the use of nonoxynol-9 (N-9)

    • The benefits of any N-9 lubricated condom probably outweigh the risk of using no condom at all. However, the best STI and HIV barrier is a latex condom without N-9.
    • Condoms lubricated with N-9 should not be used for anal penetration
    • Those using N-9 lubricated condoms should be provided with information about the potential for irritation of the vaginal and cervical mucosa, which may in turn increase the risk of HIV
    • The adverse effects of using N-9 may not apply to women who use N-9 less frequently and therefore the risks and benefits of using N-9 should be evaluation on an individual basis.