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 Overview/Lessons Learned | Contraceptive Methods | Key Issues
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Female Barrier Methods

Female barrier methods are contraceptives that a woman places in her vagina before sex to prevent pregnancy. These include the diaphragm, the cervical cap, and the female condom. The diaphragm is a latex device that covers the cervix and part of the vaginal wall, and is held in place by a flexible rim. The cervical cap is a smaller rubber device that fits snugly around the cervix. Since the cap is not widely available, information presented is focused primarily on the diaphragm, unless otherwise noted. The female condom is a sheath made of thin, transparent, soft plastic that a woman inserts in her vagina before sex. It has two rings: a flexible removable ring at the closed end to aid with insertion, and a larger flexible ring that stays outside the vagina at the open end to help protect the external genitalia.

Barrier methods are best suited for a woman who finds using a method near or at the time of intercourse acceptable, can learn the insertion technique, and has sufficient privacy for insertion and removal. In addition, women who use the diaphragm and cap must be able to care for and store the device. The methods can be very effective when used correctly and consistently with each intercourse. Typically, however, accidental pregnancy rates are high compared to many other methods; women for whom an accidental pregnancy would present a serious health concern should use a more effective method. Barriers can provide important protection from sexually transmitted diseases (STDs) and can be used even if a partner refuses to use condoms. Clients at risk for STDs could be counseled to use dual methods: a barrier method for STD protection and a second, more effective method for pregnancy prevention. Key characteristics of mechanical barrier methods are highlighted below.

Effectiveness

First year failure rates for typical use: diaphragm, 20%; cervical cap, 20% for women who have not had children and 26% for women who have had children; female condom, 21%. Effectiveness depends on whether a woman uses a vaginal method correctly every time she has sex and on which method she uses

Age limitations         

No restrictions on age

Parity limitations

No restrictions on use for nulliparous or parous women although parous women may experience higher rates of pregnancy with the diaphragm and cap

Mode of action

Creates a physical barrier to block passage of sperm into the uterus and fallopian tubes; diaphragm and cervical cap effectiveness is increased by use of spermicide

Effect on STD risk

Diaphragm and cervical cap are somewhat protective against agents that attack the cervix; the female condom offers significant protection for all STDs

Drug interaction

None

Duration of use

Used near or at the time of intercourse. The diaphragm and cap must be left in place for at least six hours after intercourse. Appropriate for both short-term and long-term use. Women can use barrier contraceptives throughout their reproductive years

Return to fertility

Immediately upon discontinuation

Return to Contraceptive Method List


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