What are barrier methods of contraception?

Barrier methods work by preventing the man's sperm from reaching the woman's egg. There are several types, including spermicide, condoms, cervical caps, diaphragms, and the sponge.

Spermicides are chemical barriers that come in the form of vaginal creams, gels, foams, films, and suppositories. They work by being applied in a woman's vagina where they can then kill or inactivate sperm that are deposited by the man. Among other benefits, spermicides are inexpensive and are readily available over the counter.

It's important for a woman to read the directions of the particular type of spermicide that she decides upon. Some need to be inserted into the vagina just prior to the act of intercourse, while others require insertion 10 to 30 minutes before intercourse so that they have time to dissolve in the vagina and become activated. (This usually holds true for the film and tablet forms of spermicides.)

You may recall that manufacturers used to advertise the supposed protective effect of Nonoxynol 9 (N9), a chemical found in many spermicides. Specifically, it was claimed that N9 would protect against the transmission of HIV and other STDs. However, in 2003, the FDA warned the public that the results of a large study showed that N9 did not protect women from these diseases. In fact, it was disclosed that the use of N9 products could cause vaginal and rectal irritation, which, in turn, could actually increase the risk of contracting HIV and other STDs. In 2007, the FDA finally required all products that contain N9 to carry a warning about these risks. Accordingly, I think it would be wise to steer clear of these products.

How do condoms protect against STDs and pregnancy?

Condoms, of course, are thin sheaths that are placed over a man's penis in order to capture the sperm-filled semen and thereby prevent it from fertilizing the woman's egg.

There's a difference between semen and sperm. Semen is the fluid that a man ejaculates as he reaches orgasm. Sperm are the little swimmers within the semen that actually swim up the woman's fallopian tubes and fertilize the egg.

Latex condoms should be used only with water-based lubricants because oil-based lubricants such as creams, vegetable oils, and petroleum jelly can damage them.

Condoms are usually made of latex, and they are inexpensive and easy to obtain over the counter. (Non-latex condoms are made of animal tissue and provide less protection against STDs than the latex ones. Accordingly, you and your daughter should avoid them.) Latex condoms should be used only with water-based lubricants because oil-based lubricants such as creams, vegetable oils, and petroleum jelly can damage them.

To use it correctly, the man should take a new, rolled-up condom, place it over the end of his erect penis, hold the tip of the condom to allow some extra space for the semen to go when he ejaculates, and then unroll the rest of the condom down over the shaft of his penis. Right after he ejaculates, the man should grasp the condom at the base of his shaft and then withdraw his penis from the woman's vagina. This procedure prevents the man's semen from spilling into the woman's vagina once he becomes flaccid after ejaculation.

Condoms should be used only one time. They provide important protection against many STDs, but many people, both women and men, are surprised to find that the failure rate of condoms is approximately 15%.

What is a female condom?

A female condom may sound like an oxymoron to some people, but it's not. It consists of a plastic pouch that has a closed inner ring that is placed in the vagina next to the cervix. The open, outer ring then extends past the vaginal opening. Any lubricant can be used with a female condom and it, too, is available over the counter.

When using a female condom, after the man ejaculates, the woman should squeeze and twist the outer rings of the pouch to close it. She then should pull the entire condom out of her vagina and discard it. Because, among other issues, semen sometimes spills out of the female condom when the woman is trying to twist it closed, the failure rate is an unimpressive 21%.

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