Barrier methods

Question 1

How many days can sperm survive in the female genital tract?

Answer 1

• Sperm can survive 7 days in the female genital tract
• ovum is fertile (able to be fertilised by the sperm) for up to 24 hours after the release
• so if sperm can survive 7 days → fertile period is 7 days before ovulation and one day after

Question 2

What’s the Pearl Index?

Answer 2

The number (%) of unintended pregnancies in the first year of use of contraception

Question 3

Which method of barrier contraception provides the greatest protection against STIs?

Answer 3

Male condom

Question 4

What is the only condition that may contraindicate use of a male condom?

Answer 4

Latex allergy

May use polyurethane condoms instead!

Question 5

Name (4) types of barrier contraception

Answer 5

• male condoms
• female condoms
• diaphragm
• cervical cap

Question 6

How to use a female condom (Femidom)?

Answer 6

• It has two rings either end
• the end with the small ring should be inserted into the vagina before sexual intercourse
• the large ring at the other end should cover the area around the vagina and the penis should be inserted into it
• Femidoms also protect both partners against STIs

Question 7

Advantages of male condom use

Answer 7

• Not contraindicated by any condition (exception latex allergy → other materials (such as polyurethane) used instead
• it is the only contraceptive method mentioned that is controlled by the male, which may be desirable by the couple
• widely available and simple to use
• are protective against many STIs

Question 8

Disadvantages of male condom use

Answer 8

• can be seen as an interruption to sex
• Sperm can still enter the vagina even with the use of a condom in situations:
• The condom splits
• The wrong size is used
• Too much or too little lubricant is used
• If the penis touches the vagina before a condom is used (pre-ejaculation fluid can contain sperm)

Question 9

Advantages of female condom use

Answer 9

• No contraindications
• Less likely to tear than the male condom.
• May protect against some STIs
• Can be inserted up to 8 hours before intercourse

Question 10

Disadvantages of female condom use

Answer 10

• Perfect use is rarely achieved – may become dislodged
• couple may lack motivation to use them every time
• Penis may be inserted between condom and vaginal wall
• Can be noisy and/or uncomfortable for the woman during intercourse

Question 11

How to use a diaphragm?

Answer 11

• The cervical cap fits over the cervix and the latex dome of the diaphragm holds it between the pubic bone and the sacral curve, covering the cervix
• must be inserted into the vagina before sexual intercourse and must remain in situ for at least 6 hours afterwards (no longer than 24 hours)

Question 12

What could be used in combination with a diaphragm?

Answer 12

• a spermicide containing nonoxynol-9 which attacks the acrosomal membranes of the sperm, immobilising them
• it is now not recommended as nonoxynol can damage the vaginal epithelium

Question 13

How is cervical cap used?

Answer 13

• sit directly over the cervix
• held in place by suction and vaginal tone
• often combined with spermicide to increase their efficiency

Question 14

Cervical cap vs diaphragm

Answer 14

Caps and diaphragms have both the same advantages and disadvantages

Question 15

Advantages of diaphragm/cap

Answer 15

• 92-96% effective with perfect use
• Only has to be used during sex
• No serious health risks

Question 16

When can we insert diaphragm/ cap?

Answer 16

3 hours before intercourse

Question 17

Disadvantages of cap/diaphragm use

Answer 17

• Perfect use is rarely achieved – may tear
• couple may lack motivation to use them every time
• require prior planning and careful insertion
• require measuring and fitting to find the correct size – any weight gain or pregnancy mandates a refitting
• associated with a higher risk of UTIs
  
  • Most likely due to the position of the diaphragm/cap putting pressure on the urethra
• STI transmission is not reduced