Fast Five Quiz: Contraception

Michel E. Rivlin, MD; Bradley Schwartz, DO


November 21, 2019

All barrier methods require the user to closely follow directions for use if the method is to be successful. The condom is a thin sheath placed over the glans and shaft of the penis; it is applied before any vaginal insertion. It is one of the most popular mechanical barriers. Among all mechanical barrier methods, the condom provides the most effective protection of the genital tract from STDs.

The Reality female condom is a polyurethane sheath intended for one-time use, similar to the male condom. It contains two flexible rings and measures 7.8 cm in diameter and 17 cm long. The ring at the closed end of the sheath serves as an insertion mechanism and internal anchor that is placed inside the vaginal canal. The other ring forms the external patent edge of the device and remains outside of the canal after insertion. Simultaneous use of the female and male condom is not recommended because they may adhere to each other, leading to slippage or displacement of either device.

Diaphragms are used together with a spermicide. Use of a diaphragm during multiple acts of intercourse may increase the risk for urinary tract infections. Use for longer than 24 hours is not recommended because of the possible risk for toxic shock syndrome. A diaphragm requires professional fitting. Poorly fitted diaphragms may cause vaginal erosions. Diaphragms have a high failure rate. Use of a diaphragm requires brief, formal training. The diaphragm may develop an odor if not properly cleaned.

The cervical cap is a cup-shaped latex device that fits over the base of the cervix. A groove along the inner circumference of the rim improves the seal between the inner rim of the cap and the base of the cervix. The cap must be filled one third full with spermicide prior to insertion. It is inserted as long as 8 hours before coitus and can be left in place for as long as 48 hours. It provides continuous contraceptive protection for its duration of use regardless of the number of intercourse acts. Unlike with the diaphragm, additional spermicide is not necessary for repeated intercourse. The cervical cap does not involve ongoing use of hormones.

Read more about mechanical barrier methods.


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