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Patient education: Barrier methods of birth control (The Basics)

Patient education: Barrier methods of birth control (The Basics)

What are barrier methods of birth control? — For a person to get pregnant through sex, an egg must be fertilized by a partner's sperm (figure 1). "Barrier" methods of birth control prevent pregnancy by keeping sperm from getting to an egg. Condoms are the most commonly used type of barrier birth control.

Doctors use the term "pericoital birth control" to refer to any birth control used during sex. This includes condoms as well as other methods like diaphragms, sponges, and spermicides. These other methods work similarly to condoms in preventing sperm from reaching an egg. Because of this, they are often referred to as barrier methods, although they do not physically block sperm in the same way that condoms do.

What are the different types of birth control you use at the time of sex? — They include:

Condoms – There are 2 types of condoms, external (male) and internal (female):

External condoms are placed over the erect penis before sex. This prevents semen (the fluid that contains sperm) from getting into the partner's body during sex.

Internal condoms work in a similar way, but are worn inside the vagina to keep semen from entering the body (picture 1).

Condoms are the only form of birth control that can also protect against infections you can get through sex. (These are called sexually transmitted infections, or "STIs.") They are a good choice if you don't know your partner's sexual history or if you or a partner already has an STI. Some people use condoms in addition to another type of birth control, such as the pill.

Diaphragm and cervical cap – A diaphragm is a flexible device inserted through the vagina and placed over the cervix before sex (picture 2). It is used along with foam, gel, or cream that contains spermicide, which kills sperm. The diaphragm keeps the spermicide in place around the cervix. If sperm cannot travel through the cervix, they cannot fertilize an egg.

A cervical cap is similar to a diaphragm, but smaller. It is typically not recommended for people who have given birth before. This is because pregnancy and childbirth change the size of the cervix, which makes a cervical cap fit less well.

Sponge – The birth control sponge is a soft, disk-shaped device that contains spermicide. It is inserted through the vagina before sex. It works by preventing sperm from getting into the uterus.

Spermicides – Spermicides are chemicals that kill sperm. They come in different forms, including foams, gels, creams, films, and tablets. Spermicide can be used by itself, but works better if used with another method such as a condom or diaphragm.

Vaginal "pH regulator" gel – This gel is inserted into the vagina like spermicide, but works in a different way. Instead of killing sperm, it changes the level of acid in the vagina, which makes sperm unable to move. It is less likely than spermicide to irritate the vagina or the partner's penis.

Vaginal pH regular gel can be used with another method such as a condom or diaphragm. It should not be used with a type of birth control called the "vaginal ring," which contains hormones.

How well do these methods of birth control work? — It depends on which type you use. The table shows the average chances of pregnancy for people who use each type (table 1). In general, barrier methods do not prevent pregnancy as well as some of the other available methods. Other methods include hormonal methods, such as birth control pills, and long-term methods such as an intrauterine device ("IUD").

Barrier methods of birth control work best if they are used correctly. This means using your method of birth control every time you have sex. Follow the instructions about how and when to use the barrier method.

Combining more than 1 type of birth control will further lower the risk of pregnancy. For example, using spermicide along with a condom is more effective than using spermicide alone.

What are the benefits of these methods of birth control? — In general, these methods have the following benefits:

They are safe to use.

They do not contain hormones.

They will not affect your monthly period.

Many can be bought without a prescription, and some (like condoms) might be free at some health centers.

They do not affect fertility after you stop using them, so if you or your partner want to get pregnant, you can start trying right away.

Condoms also protect against STIs.

What are the downsides of these methods? — Possible downsides include:

They do not work as well as other birth control methods to prevent pregnancy.

You must remember to use them every time you have sex.

Some methods, like spermicide, can cause irritation of the vagina or penis.

Some people do not like how sex feels with a condom.

How do I choose the right birth control method for me? — This is a personal decision. When choosing birth control, think about what is most important to you. You should also think about how likely you are to use each method the right way. For example, can you remember to use your birth control every time you have sex? Do you also want protection from STIs? Are you planning to try to get pregnant in the near future?

Your doctor or nurse can also talk to you about the different options and help you make the best decision for you.

What if I forget to use my birth control? — If you have sex and forgot to use your birth control, you can take emergency contraception to reduce your risk of pregnancy. Some forms of emergency contraception require a prescription, but you can buy others in a pharmacy. If you need to use emergency contraception, do it as soon as possible after sex.

If you are worried that you could have an STI, talk to your doctor or nurse. They can tell you about your risk and your options for testing or treatment.

More on this topic

Patient education: Choosing birth control (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Emergency contraception (The Basics)
Patient education: Sexually transmitted infections (The Basics)

Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Barrier and pericoital methods of birth control (Beyond the Basics)
Patient education: Hormonal methods of birth control (Beyond the Basics)
Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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