Male Condom

Male condoms are usually made from latex rubber, and less commonly, from polyurethane. They provide effective contraception, and their failure rate with strongly motivated couples has been low. When used properly, condoms provide considerable but not absolute protection against a broad range of STIs, including chlamydia, herpes, HIV, gonorrhea, syphilis, and trichomoniasis. They may also prevent and ameliorate premalignant cervical changes, probably by blocking transmission of human papillomavirus (HPV).

Female Condom (vaginal pouch)

This device is a soft, loose-fitting pouch that prevents pregnancy and STIs. Compared to male condoms, the pregnancy rate with the female condom is lower. The female condom contains a flexible ring at each end, where the open ring remains outside of the vagina. The closed internal ring of the condom remains inside of the vagina. To aid in placement, the internal inner ring is pushed up as far as it can go, near the pubic bone. Side effects include mild discomfort of the inner ring bumping against the cervix if it is not properly inserted.

Diaphragm

The diaphragm is a reusable rubber or silicone cup that covers the cervix, and it is inserted into the vagina with a spermicidal agent. It can be inserted hours before intercourse, but if more than 2 hours elapse, additional spermicide should be placed in the upper vagina for maximum protection and be reapplied before each coital episode. The diaphragm should not be removed for at least 6 hours after intercourse. It should not be left in place, however, for longer than 24 hours, as there is a risk for toxic shock syndrome (a potentially fatal condition due to bacteria). Diaphragms are generally associated with higher failure rates due to inconsistent user methods.

Cervical Cap

This is a flexible, cup-like device, made of natural rubber that is fitted around the base of the cervix. It can be self-inserted and allowed to remain in place for up to 48 hours. It should be used with a spermicide applied once at insertion. If properly fitted and used correctly, the cap is comparable in effectiveness to the diaphragm. Incorrect fitting or improper placement makes it less effective overall than the diaphragm and spermicide.

Contraceptive Sponge

The contraceptive sponge is sold over the counter and is a disc, which can be inserted up to 24 hours prior to intercourse. After moistening, it is placed directly against the cervix. While in place, it provides contraception regardless of the frequency of intercourse. It should remain in place for 6 hours after intercourse. Although perhaps more convenient, it is less effective than the diaphragm and condom.

Spermicide or vaginal gel

These can be in various forms: creams, gel/jelly, suppositories, film, and foam in aerosol containers. They are used widely, especially by women who find other methods unacceptable. They are useful especially for women who need temporary protection, for example during the first week after starting OCPs or while nursing.

Spermicides work by providing a physical barrier to sperm penetration as well as a chemical spermicidal action. They must be deposited high in the vagina in contact with the cervix shortly before intercourse. The duration of maximal effectiveness is usually no more than 1 hour. Thereafter, they must be reinserted before repeat intercourse.

Vaginal spermicides, when used alone, are much less effective in preventing pregnancy than OCPs, an IUD, or spermicides used with another form of birth control, such as cervical caps, condoms, or diaphragms. The number of pregnancies is especially reduced when spermicides are used with a condom. Spermicides do not protect against STIs.