Barrier Methods of Birth Control

Treatment Overview
Barrier methods of birth control block sperm from entering the uterus. Using
a spermicide with a barrier method gives you the best possible barrier method
protection.

 The spermicide kills most of the sperm that enter the vagina.
 The barrier method then blocks any remaining sperm from passing
through the cervix to fertilize an egg.

Barrier methods include the diaphragm, cervical cap, male condom, and
female condom and spermicidal foam, sponges, and film. Unlike other methods
of birth control, barrier methods are used only when you have sexual
intercourse. Be sure to read the instructions before using a barrier method. It
is very important that you use a barrier method correctly every time you
have sex.
Sexually transmitted infection protection

Male or female condoms are the only birth control methods that protect
against sexually transmitted infections (STIs), including infection with
the human immunodeficiency virus (HIV). To help protect yourself and your
partner from STI infection, be sure to use a condom every time you have sex.

What To Expect After Treatment

Follow the directions for your choice of barrier method. After sexual
intercourse:

 A male or female condom is removed promptly and thrown away.

 A contraceptive sponge has to be left in for 6 or more hours, then
removed and thrown away.
 A diaphragm or cervical cap has to be left in for 6 or more hours, then
washed and stored for reuse.

Why It Is Done
Condoms are necessary when you need to protect yourself or your partner
from sexually transmitted infection (STI) or when you do not know that you
are both infection-free. Latex or polyurethane male condoms give you and your
partner the most effective possible protection from STIs, including infection
with HIV. Natural membrane (sheepskin) condoms do not protect you against
all STIs.
Barrier methods of birth control, such as a diaphragm, cervical cap, or condom,
are a good choice if:

 You want an option that does not require hormones or insertion of

an intrauterine device.
 You want an option that does not restrict when you have sexual
intercourse, such as natural family planning.
 You are planning to become pregnant soon and prefer a method you can
stop using anytime you want.
 You are breastfeeding.
 You have heavy menstrual periods. A diaphragm may be used for birth
control during a menstrual period and can contain the menstrual blood as
long as it is not left in for longer than 6 hours at a time.
 You and your partner find it easy to use the method every time you have
sex.

How Well It Works

Barrier methods of birth control vary in how effective they are in preventing
pregnancy.1, 2 They also vary in how effective they are at preventing STIs.

Barrier methods of birth control

Barrier Failure rate* Effectiveness in preventing STIs

Male condom 18 (spermicide further Most effective

lowers this failure rate)

Female condom 21 Somewhat effective

Diaphragm with 12 Limited effectiveness

spermicide

Spermicide 28 Not effective if used alone; may

actually increase risk of
getting HIV/AIDS

Sponge with 12 (no past Limited effectiveness

spermicide vaginal childbirth)

24 (past vaginal childbirth)

 Cervical cap with 16 (no past vaginal Limited effectiveness
spermicide childbirth)

32 (past vaginal childbirth)

Risks
Condoms

A condom can tear when it is too tight or fall off when it is too loose. If this
should happen while you are having intercourse, use emergency contraception.
If you are worried about exposure to a sexually transmitted infection (STI), get
tested.
Diaphragm or cervical cap

Using a diaphragm with spermicide may increase your risk of urinary tract
infections.
Leaving a diaphragm or cervical cap in for longer than 24 hours increases your
chances of getting toxic shock syndrome.
C O N TI N U E R EA D I N G B E L O W
YOU MIGHT LIKE
Spermicide

Some people are allergic to nonoxynol-9, which is the active ingredient in most
spermicides. They can develop sores in the vagina or on the penis, which make
it more likely that HIV can be transmitted from an infected partner during sex.
The U.S. Food and Drug Administration (FDA) warns that nonoxynol-9 in
vaginal contraceptives and spermicides may irritate the lining of the vagina or
rectum. This also increases the risk of getting HIV/AIDS from an infected
partner.

What To Think About

If you have a possible risk of giving or getting a sexually transmitted infection
(STI) and you want to effectively prevent pregnancy, combine condoms with a
more reliable method of birth control, such as the hormone pills, ring, patch,
implant, or shot or an intrauterine device (IUD).
If you think that your barrier method has failed or has been used incorrectly,
you can use emergency contraception to help prevent
pregnancy. Douching after intercourse does not prevent sperm from reaching
the fallopian tubes, where fertilization takes place. It may also increase your
chance of getting a pelvic infection.
Advantages of all barrier methods

Barrier methods of birth control:

 Do not affect a woman's or man's future fertility.

 Are only used at the time of sexual intercourse.
 Are safe for a woman to use while she is breastfeeding.
 Do not affect other health conditions, such as high blood
pressure or diabetes.
 Are less expensive than hormonal methods of birth control, and some are
available without a prescription.

Condoms and diaphragms may reduce the risk of cervical cancer, which is
caused by a sexually transmitted human papillomavirus. Condoms also are the
best method for reducing the risk of sexually transmitted infections, including
HIV.
Disadvantages of all barrier methods

Failure rates for barrier methods are higher than for most other methods of
birth control. If you are considering using a barrier method for birth control,
think through what the emotional and financial costs of an unintended
pregnancy would be if the method fails.
To prevent pregnancy with a barrier method, you and your partner must be
comfortable with using it and be prepared to use it every time you have sex.
For some couples, barrier methods are not a good choice because one or both
partners:

 Find it embarrassing to use.

 Do not want a barrier method to interrupt foreplay or intercourse.

Some people develop allergies to spermicides. But using spermicide is advised

with diaphragms or cervical caps. So if you can't use spermicide, you will need
to find a different form of birth control.
For people who have an allergy to latex, polyurethane condoms are available.
Latex condoms are slightly more dependable than polyurethane condoms.
Complete the special treatment information form (PDF)(What is
a PDFdocument?) to help you understand this treatment.
 Hormonal Implants

Success Rate with Typical Use: 99%

Pros Cons

 Long-term method of birth control (protects against pregnancy 
for 3 years after insertion–it can be removed by a health care 
provider when you want to or you can wait for 3 years when it’s
time for a change of implant)
 Very effective against pregnancy
 May cause light or no menstrual periods
Doesn’t protect against STIs
Requires minor surgery and insertion of
the tiny rod(s) underneath the skin
 Requires minor surgery to remove
device
 Can cause side effects such as
irregular menstrual periods,
depression, nervousness, hair loss,
and weight gain
 Could get infection at area where
capsule is implanted
 Can’t be used by women with certain
medical conditions and by women who
use certain medications

Intra-Uterine Device (IUD)

Success Rate with Typical Use: 99%

Pros Cons

 Very effective against pregnancy
 Provide protection against pregnancy as long as in place
in your uterus- protects as soon as inserted (so don’t
need to remember to use contraception if you have sexual 
intercourse)
 Doesn’t need daily attention- just need to check to make
sure in place at least once a month at time of menstrual
period
 Comfortable- you and your partner cannot feel the IUD, 
although you partner may feel the string
 The levonorgestrel IUD (Mirena, Skyla) lessens menstrual
flow and can be used to treat heavy periods
 Can be removed at any time and you can get pregnant
right after removal
 Doesn’t protect against STIs and shouldn’t be
selected if high risk of STI
 Needs to be inserted by a health care provider
Can fall out or can rarely puncture the uterus
 The copper IUD can have side effects such as
menstrual cramping, longer and/or heavier
menstrual periods, and spotting between
menstrual periods
Slightly higher risk for infection in the first 20
days after insertion
 Tubal Ligation (Female Sterilization)

Success Rate with Typical Use: 99%

Pros Cons

 Very effective against pregnancy  Need to have minor surgery

 One time decision that will provide
protection against pregnancy forever
 Permanent (although it is possible to undo sterilization with
major surgery, it’s not always successful)
 Only should be used by women who are absolutely sure
that they do not want any or any more children
 Expensive- ranges from $1000-$2500- but cost for
contraception spread over rest of life
 No protection against STIs

Depo-Provera Hormonal Injection

Success Rate with Typical Use: 94%

Pros Cons

 Each injection provides 3 months of protection against
pregnancy
 Very effective against pregnancy if used correctly
 Many women stop getting their menstrual period while getting
injections. (This is not a medical problem and menstrual
periods usually return 6-18 months after you stop taking
injections)
 Helps protect against uterine cancer
 Doesn’t interrupt sexual activity
 Doesn’t protect against STIs
 Need to see your health care provider
every 3 months for an injection
Depending on your insurance, your birth
control may be free or there may be a
co-pay
 May have side effects such as weight
gain, tiredness, and possibly a decrease
in bone density
 Many women have very irregular
menstrual bleeding or spotting for the
first 3 to 6 months and sometimes
longer

Birth Control Pills

Success Rate with Typical Use: 91%

 Pros Cons

 Very effective against pregnancy if used correctly Doesn’t protect against STIs
 Makes menstrual periods more regular and lighter Depending on your insurance, your birth control
 Decreases menstrual cramps and acne may be free or there may be a co-pay.

 Makes you less likely to get ovarian and uterine  Need to remember to take every day at the same
cancer, pelvic inflammatory disease, ovarian time
cysts, and anemia  Can’t be used by women with certain medical
 Doesn’t interrupt sexual activity problems or by women taking certain medications
 Can occasionally cause side effects such as
nausea, increased appetite, headaches, and, very
rarely, blood clots
 Need a prescription
 Still need condoms to lower the risk of STIs

Hormone Patch (Ortho-Evra) (Xulane)

Success Rate with Typical Use: 91%

Pros Cons

 Very effective against pregnancy if used  Doesn’t protect against STIs

correctly
 Makes menstrual periods more regular and
lighter
 Decreases menstrual cramps and acne
 Makes you less likely to get ovarian and
uterine cancer, pelvic inflammatory disease,
ovarian cysts, and anemia
 Doesn’t interrupt sexual activity
 Still need condoms to lower the risk of STIs
 Can’t be used by women with certain medical
problems or by women taking certain medications
 Can occasionally cause side effects such as nausea,
increased appetite, headaches, and irregular
bleeding in the first few cycles
 Increased risk of blood clots
 Need a prescription

Vaginal Hormonal Ring (Nuva-Ring)

Success Rate with Typical Use: 91%

Pros Cons

 Very effective against pregnancy if used correctly  Doesn’t protect against STIs
 Makes menstrual periods more regular and lighter  Still need condoms to lower the risk of STIs
 Decreases menstrual cramps and acne  Can’t be used by women with certain medical problem
 Makes you less likely to get ovarian and uterine cancer, pelvic or by women taking certain medications
inflammatory disease, ovarian cysts, and anemia  Can occasionally cause side effects such as nausea,
 Doesn’t interrupt sexual activity increased appetite, headaches
 Increased risk of blood clots
 Need a prescription

Diaphragm

Success Rate with Typical Use: 88%

Pros Cons

 Can be put in place right before intercourse or 2-3 hours before  Doesn’t protect against STIs
intercourse  Need to get fitted by a health care
 Don’t need to take out between acts of sexual intercourse provider and need a prescription
(protects against pregnancy for about 6 hours, but need to  May be difficult to find
reapply spermicide)
 Can’t take out until 6 hours after
intercourse
 Cost $25-$45, plus the cost of
spermicidal gel
 May get moved out of place during
sexual intercourse
 Some women may be allergic to the
diaphragm or to the spermicide
 Need to be re-fitted after a 10 pound
weight gain or loss and after pregnancy
 Can be messy
 Need to reapply spermicide with each
act of sexual intercourse
 Can cause an increase in urinary tract
infections

Cervical Cap

Success Rate with Typical Use: 86%

Pros Cons
 Can insert several hours before sexual intercourse  Doesn’t protect against STIs
 Can leave in place 24-48 hours, will give protected sex for up to Cost $30-$50, plus the cost of
48 hours spermicidal gel
 Use less spermicide with the cap than with the diaphragm, no  Need to be fitted by a health care
need to apply more spermicide with each act of intercourse provider and need a prescription
 Limited sizes available
 Can’t take out until 6-8 hours after
intercourse
 May get moved out of place
 Some women may be allergic to
material of cap or to spermicide
 Can’t be used by women with a
history of abnormal Pap tests
 Can cause increased urinary tract
infections

Male Condom

Success Rate with Typical Use: 82%

Pros Cons

 Lowers risk of STIs  Have to use a new one every time you have
 Contraception that provides the most protection sexual intercourse (can only be used once)
against sexually transmitted infections (latex condoms May disrupt/interrupt sexual activity as it
are best) needs to be put on just before penetration
 Don’t cost much (50 cents each), can buy at almost  Can break
any drug store (don’t need a prescription)  Women may be allergic to latex
 Men feel they can “last longer” when using a condom
 Allow men to have an active part in preventing
pregnancy

Female Condom

Success Rate with Typical Use: 79%

Pros Cons

 Provide protection against STIs (new product, so not clear how much protection  May move, be noisy, or uncomfortabl
given) and pregnancy
 Can be inserted well before intercourse so less interruption of sexual activity  Can only use for one act of sexual
 Male does not need to withdraw right after ejaculation, as he does with a male intercourse
condom  Cost about $2.50 each

Withdrawal

Success Rate with Typical Use: 78%

Pros Cons

 Natural, so no side effects  Doesn’t protect against STIs

 Doesn’t cost anything  Not very effective method of contraception
 Allows men to be an active part Difficult for male to always predict ejaculation
of preventing pregnancy  May decrease sexual pleasure of woman since need to always be
thinking about what is happening during sexual intercourse
 No control by women- need to rely completely on men to prevent
pregnancy

Contraceptive Sponge

Success Rate with Typical Use: 76-88%

Pros Cons

 Can insert right before or several hours before Doesn’t protect against STIs and may increase the
sexual intercourse and will provide protection risk of HIV infection in women who have sex multiple
against pregnancy for a total of 24 hours times daily because of irritation from the spermicide
 Don’t need a prescription  Can’t take out until 6 hours after sexual intercourse
 Can’t be used by women who are allergic to
nonoxynol-9 (in the spermicides)
 Increases urinary tract infections

Lactational Amenorrhea Method (LAM)

Success Rate with Typical Use (only applies if you meet all conditions): 98%
 Pros Cons

 Natural  Only effective in women who have given birth in last 6 months, who have not had a
 Costs menstrual period after childbirth and are feeding their babies only breast milk
nothing  Doesn’t protect against STIs
 No side  Only effective until menstrual period returns
effects  May need to use a lubricant with sexual intercourse because of vaginal dryness

Fertility Awareness Based Methods

Success Rate with Typical Use: 76%

Pros Cons

 Natural  Doesn’t protect against STIs

 Approved by many religions  Need to figure out when ovulating for each month, since this
 Woman gets to know her body and can differ from one month to the next and young women
menstrual cycles often have irregular periods

 Can be helpful for partners who are very 
careful and don’t have sex during
ovulation period and several days before 
and after
Requires a lot of work- need careful instruction and the
woman needs to figure out when ovulating
Can’t have sexual intercourse for at least a week each
month (during ovulation and several days before and after)
Teens and women with irregular periods should not use-
failure rate is high

Spermicide

Success Rate with Typical Use: 72%

Pros Cons

 Doesn’t cost much, available at many  Doesn’t protect against STIs and may increase the risk of HIV infection in
drug stores, don’t need a prescription women who have sex multiple times daily because of irritation from the
spermicide
 Effectiveness usually lasts only one hour (need to reapply each time have
sexual intercourse)
 Some women and men may be allergic to spermicides
 May interrupt sexual activity (some forms need to be inserted at 10-20 minute
before intercourse)
 Has a lower effectiveness against pregnancy than many other types of
contraception- should use with another form of contraception to increase
effectiveness
 Increases urinary tract infections