Barrier methods of family planning

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HealthWiki > Where Women Have No Doctor > Chapter 13: Family Planning > Barrier Methods of Family Planning

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In this chapter:

 

In this chapter:

Barrier methods prevent pregnancy by blocking sperm from reaching the egg. Some of these methods also protect against STIs, including HIV. Barrier methods do not change the way anyone’s body works, and they cause very few side effects. They are safe to use when breastfeeding. When someone wants to become pregnant, they simply stop using the barrier method.

Barrier methods include external (male) condoms, internal (female) condoms, diaphragms, cervical caps, and sponges.

External (male) condoms

If a condom breaks or comes off during sex, put spermicide in the vagina immediately, if you have it. Whether you have spermicide or not, use emergency contraception as soon as possible.

An external (male) condom is a narrow bag of thin rubber worn on the penis during sex. Semen collects in the condom and does not go into the partner’s body.

Condoms are the best protection against STIs and HIV. External condoms can be used alone or along with any other family planning method except internal (female) condoms. External condoms can be bought at many pharmacies and markets, and are often available at health posts and through HIV prevention programs.

Be careful not to tear the condom as you open the package. Do not use a condom if its package is torn, or if the condom is stiff, sticky, or dried out. It will not protect you from pregnancy or STIs.

An external condom must be put on the penis when it is hard, but before it touches a partner’s genitals. If the penis rubs a partner’s genitals or goes into the vagina without a condom, pregnancy or passing an STI can happen even without ejaculation.

How to use an external condom:

1.   For a penis that is not circumcised, pull the foreskin back. Squeeze the tip of the condom and put it on the end of the hard penis.	2.   Keep squeezing the tip while unrolling the condom, until it covers all of the penis. The loose part at the end will hold the sperm. If you do not leave space for the sperm, the condom might break.
3.   After ejaculating, hold on to the rim of the condom and withdraw the penis from the vagina while it is still hard	4.   Take off the condom. Do not let sperm spill or leak.	5.   Tie the condom shut and dispose of it away from children and animals.

If you use another family planning method and also need STI protection, you can use condoms at the same time.

For best STI protection:

• Use a condom every time you have sex.
• Do not use condoms made of “natural skin” (like lambskin). These do not protect against HIV. Use condoms made of latex, polyurethane, or polyisoprene for HIV protection.
• Keep condoms in a cool, dry place away from sunlight. Condoms from old or torn packages are more likely to break.
• Use a condom only once. A condom that has been used before is more likely to break.
• Keep condoms within reach. You are less likely to use them if you have to stop what you are doing to look for them.

More Information

encouraging your partner to use condoms

At first, some couples may not like using condoms. But once they get used to it, they may even recognize benefits besides protecting against unwanted pregnancies and STIs. For example, condoms can help some men last longer before they come.

Internal (female) condoms

Internal condoms are larger than external condoms and are less likely to break.

An internal (female) condom, which fits into the vagina and covers the outer lips of the vulva, can be put in the vagina any time before sex. It should be used only once, because it may break if it is reused. But if you do not have any other condoms, you can clean it and reuse it up to 5 times. An internal condom should not be used at the same time as an external (male) condom.

The internal condom is the most effective of the methods controlled by women in protecting against both pregnancy and STIs, including HIV. Several types of internal condoms made from various materials are now available.

As more people demand this method, it will become more available in more places.

How to use an internal condom:

1.    Carefully open the packet.		2.   Find the inner ring, which is at the closed end of the condom.	Outer ring
3.   Squeeze the inner ring together.	4.   Put the inner ring in the vagina.	5.    Push the inner ring up into your vagina with your finger. The outer ring stays outside the vagina.
6.   When you have sex, guide the penis through the outer ring.		7.   Remove the internal condom immediately after sex, before you stand up. Squeeze and twist the outer ring to keep the sperm inside the pouch. Pull the pouch out gently, and then dispose of it out of reach of children and animals

The diaphragm

Although less effective than many other methods, a diaphragm is moderately effective at preventing pregnancy and may also give some protection against STIs, like HIV.

The diaphragm is a shallow cup made of soft rubber or thin silicone that is put in the vagina before sex. It prevents pregnancy by covering the cervix so the sperm cannot get into the womb. The diaphragm should be used with spermicide. If you do not have spermicide, you can still use the diaphragm, but it may not work as well to prevent pregnancy.

Some diaphragms come in different sizes, and a health worker can help you find the right size. A “one size fits most” diaphragm (Caya) is becoming more available and does not require a fitting.

Diaphragms should be replaced about every 2 years. It is a good idea to check your diaphragm often. Replace it before the material gets dry, hard, or cracked, or when there is a hole in it.

You can put the diaphragm in just before you have sex or up to 6 hours before. If you have sex more than one time after you put the diaphragm in, put more spermicide in your vagina each time before you have sex, without removing the diaphragm.

How to use a diaphragm:

1.   If you have spermicide, put about 1 tablespoon (15 ml) into the cup of the diaphragm. Then spread a little bit around the edge with your finger	2.   Squeeze the diaphragm in half.	3.   Open the lips of your vagina with your other hand. Push the diaphragm into your vagina. It works best if you push it toward your back.
4.   Check the position of your diaphragm by putting one of your fingers inside your vagina and feeling for your cervix through the rubber of the diaphragm. The cervix feels firm, like the end of your nose. The diaphragm must cover your cervix.
5.   If the diaphragm is in the right place, you will not be able to feel it inside you.		6.   Leave the diaphragm in place for at least 6 hours after sex.

You can leave the diaphragm in for up to 24 hours

To remove the diaphragm:
Put your finger inside your vagina. Reach behind its front rim and pull the diaphragm down and out. Wash it with soap and water, and dry it. Check the diaphragm for cracks or holes by holding it up to the light. If there is even a tiny hole, get a new one. Store the diaphragm in a clean, dry place.

Spermicide

(contraceptive foam, tablets, jelly, or cream)

Foam

Tablets

Cream or Jelly

Spermicide comes in many forms—foam, tablets, and cream or jelly—and is put into the vagina just before having sex. Spermicide kills the sperm before it can get into the womb.

When used alone, spermicide is less effective than most other methods. But it is helpful as extra protection with another method, like the diaphragm or condom. Spermicide can be bought in many pharmacies and markets.

Spermicide does not provide protection against any STI. Spermicide can irritate the vulva, vagina, and penis and cause small cuts that allow HIV to pass into the body more easily.

When to insert spermicide:

Tablets or suppositories must be put in the vagina at least 10 minutes before sex so they have time to dissolve. Foam, jelly, and cream do not need to dissolve to work, and can be put in the vagina just before having sex.

If more than one hour passes between inserting spermicide and having sex, add more spermicide. Add a new tablet, suppository, or applicator of foam, jelly, or cream before each time you have sex.

How to insert spermicide:

1. Wash your hands with soap and water.

2. To use foam, shake the foam container rapidly, about 20 times. Then press the nozzle to fill the applicator.
   
   To use jelly or cream, screw the spermicide tube onto the applicator. Fill the applicator by squeezing the spermicide tube.
   
   To use vaginal tablets, remove the wrapping and wet them with water or spit on them. (DO NOT put the tablet in your mouth.)
3. Gently put the applicator or vaginal tablet into your vagina, as far back as it will go.

4. If you are using an applicator, press in the plunger all the way and then take out the empty applicator.
5. Rinse the applicator with clean water and soap.
6. Leave the spermicide in place for at least 6 hours after sex. Do not douche or wash the spermicide out. If cream drips out of your vagina, wear a pad or clean cloth to protect your clothes.

This page was updated:17 May 2024