Contraception is designed to prevent fertilisation and implantation of the egg. It is used for many reasons: age-related, economic, medical, genetic or ideological. The ideal contraceptive method should be safe, effective, reversible, easy to use, cheap and readily available.
How does barrier contraception work?
Barrier contraception, or barrier contraception, creates a physical barrier that prevents spermatozoa from entering the cervical canal. Some barrier methods can be difficult to use and may cause uncertainty about their correct position.
Effectiveness of barrier contraception
The effectiveness of individual contraceptive methods is assessed using the Perle index. This is the number of unplanned pregnancies that will occur in 100 women using a given method of contraception in 1 year. The lower the Perle index, the more effective the method is.
The effectiveness of contraception is affected by many factors, including incorrect use of the method. For this reason, the Perl index is determined when used correctly and, in addition, the true Perl index, which takes into account errors in the use of a method.
In situations where pregnancy poses an unacceptable risk, two effective contraceptive methods are recommended.
Barrier methods are not suitable for people who will not use them consistently and correctly, as they then have a relatively high failure rate.
Types of barrier contraception
Male condoms
It is one of the most commonly used methods of contraception. Condoms are usually made of latex, but there are also latex-free condoms (such as nitrile condoms). According to research, latex condoms are more effective than non-latex condoms.
Their biggest advantages are their easy availability (they are available without prescription in most shops, pharmacies and drugstores), ease of use (only when needed), absence of side effects and the fact that, in addition to preventing pregnancy, they significantly reduce the risk of contracting venereal diseases. They are even 90-95% effective in preventing HIV transmission.
In this method, the lowest Perl index is 2 and the real one is 18.
Female condoms
They work similarly to those intended for men, are just as effective and safe, but are less popular. The female condom can be latex-free (e.g. made of nitrile) or latex. It resembles an oblong balloon with rings on both ends. It is coated with lubricant and sometimes with spermicide. It can be bought without a prescription, but availability is less than the male condom.
The Pearl Index is 5 for perfect use and 21 for normal use.
Neck cap
It is made of rubber or silicone and comes in different sizes. It is placed directly on the cervix before intercourse and left for 8 hours after intercourse. It is a barrier for sperm to enter the uterus. Cervical caps contain no hormones and are reusable.
The neck hood is not suitable for everyone. It should not be used in the presence of cervical intraepithelial neoplasia (CIN) or cervical cancer. An abnormal anatomical structure of the neck may also be a contraindication to the use of a cervical cap. After pregnancy in the second trimester, this method can only be used after 6 weeks. In addition, obese people may find it difficult to put on the cervical cap.
The actual Pearl Index is 20-40. This method is more likely not to help women who have already given birth.
Vaginal cap
Otherwise a vaginal sheath, diaphragm, pessary. It is a ring with a thin rubber membrane stretched over it. It is larger than the neck cap and has outlined edges. It is placed so as to cover both the cervix and the whole area around the cervix. Like the cervical cap, it is reusable and hormone-free. It should be left on after intercourse for at least 8 hours.
The effectiveness of this method is increased by smearing with spermicide. However, it should be remembered that its use carries the risk of irritation and intimate infections, as it disturbs the vaginal mucosa, which can increase the transmission of HIV to partners and increase the risk of urinary tract infections.
The limitations in the use of the vaginal cap are similar to those of the cervical cap: anatomical deformities and certain cases of genital prolapse, cervical intraepithelial neoplasia (CIN) or cervical cancer.
In ideal use, the Perl index is 6 and the actual Perl index is 12.1.
Vaginal sponge
It is made of polyurethane foam impregnated with spermicide (spermicide). It is round and shaped to better fit the cervix. The sponge should be placed in front of the cervix so as to cover its external opening, which constitutes a mechanical barrier.
Depending on the manufacturer’s recommendations, some sponges should be moistened before application to activate the spermicide. The vaginal sponge has a band or special loop to facilitate its removal. Remember, however, that it can only be removed after at least 12 hours of intercourse. The vaginal sponge is disposable. Its advantage is that it is usually not felt by either partner during intercourse.
The Perl index for ideal use in non-pregnant women is 9 and in re-pregnant women 20, whereas for typical use in non-pregnant women it is 12 and in re-pregnant women 24.
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