The purpose of all contraceptives is to prevent pregnancy. But how easily and effectively this is accomplished depends on the method. And medical experts say that not all methods are right for all couples. Their best advice: learn all you can about the options, then talk to your doctor.
There are pills and surgical options to consider, and there also are the four barrier methods. Doctors explain that these latter contraceptives work by placing a barrier between sperm and egg and are often supplemented by the use of a spermicide. Experts say that barriers don’t add anything to the bloodstream and they all are relatively safe. Doctors further explain that in the case of diaphragms, cervical caps, and condoms, the passage of semen into the cervix is restricted, which protects against sexually transmitted diseases (STDs). Medical records reveal that each of the four barrier methods offers further advantages as well:
1. Condoms. Latex condoms guard against gonorrhea, chlamydia, syphilis, and HIV, as well as sexually transmitted vaginal infections. They also offer some protection against genital warts, herpes, and hepatitis B. Condoms made of animal skin do not offer the same disease protection but are useful for people allergic to latex. Never use oil-based lubricants, such as petroleum jelly and baby oil, with condoms, since they cause the rubber to deteriorate. Lubricated condoms protect against urinary tract infections caused when friction makes small tears in the vaginal lining.
2. Diaphragms and cervical caps. A diaphragm is a rubber cup that is filled with spermicide and inserted into the vagina up to several hours prior to intercourse. It covers the upper portion of the vagina and the cervix. (Many are made of latex, a problem for women allergic to latex.) The device must remain in the body for six to eight hours after intercourse. Spermicide should be applied again before any additional acts of intercourse. Some women develop frequent urinary tract infections caused by the pressure of the diaphragm against the urethra. A better choice for these women (and for women who have given birth vaginally) is the cervical cap, which is smaller and is held in place by suction against the top walls of the vagina.
3. Female condoms. Also called vaginal pouches, these look like male condoms, only larger. The closed end is secured inside the vagina, the plastic ring covering the cervix. In one study, female condoms reduced the risk of STDs by an additional 34 percent over male condoms.
4. Vaginal spermicides. These are placed inside the woman’s body before intercourse. When combined with other birth-control methods, they are quite effective. Some couples report a contact allergy to the ingredients, but switching brands or types can help. Spermicides containing nonoxynol-9 may help protect against the transmission of chlamydia and gonorrhea.
Records surprisingly show that tubal ligation, or female sterilization, is the most prevalent form of contraception in North America. This method, according to doctors, means having one’s "tubes tied" so that sperm cannot reach the egg. Doctors either use an electric current to seal the Fallopian tubes or bind them with plastic clips. If a woman wants the tubal ligation reversed (this is considered major surgery), the clip method is slightly easier to undo; still, the success rate is low, and insurance companies often won’t cover it.