Vaginal spermicides (foams, jellies, creams, film)
These substances kill sperms on their way to meet an egg and must be put into the vagina before intercourse. They are unsafe as a sole method of contraception and should be used along with a sheath or a diaphragm. Follow the instructions for the brand you intend to use. Most are active for only 1-3 hours.
Advantages
• Easy to use.
• Can be bought without a prescription.
• Work well if used together with a barrier method.
Disadvantages
• Not reliable except when combined with a barrier method.
• Can be messy as they melt and run out of the vagina.
• Put some men off oral sex. If this is a problem insert the spermicide just before intercourse.
• May have medical side-effects.
Research shows that liver function is altered and blood pressure lowered in some women using spermicides. They are absorbed from the vagina, especially if left in place for long periods.
• You can’t bath or have a wash on a bidet for six hours after sex.
The cap (diaphragm)
This is a dome-shaped barrier made of latex rather like a sheath. It has to be used with a spermicide to be safe. It is a good method for many women but it has to be supplied by a doctor, who will measure the woman for the correct size. For best results it must be used properly.
Advantages
• It is cheap and easy to use.
• It is nearly as safe as the Pill.
• There are no medical or health side-effects.
• It can be used to hold back menstrual flow to make for more pleasant love-making during a period.
Disadvantages
• It is not suitable for the woman who dislikes handling her genitals.
• It interferes with sensation in some women, especially those who enjoy the front wall of their vagina (around the G-spot) being stimulated during intercourse.
• It has to be put in well before sex and this removes the spontaneity for many women who find such ‘premeditated’ preparation un-sexy.
• It is easy to forget that it is in place for a day or two.
• It has to be supplied by a trained person in the first place.
• It should ideally be checked every six months by a trained person to see that the fit has not changed. This is especially important soon after a baby.
• It is easy for small holes, invisible to the naked eye, to develop which render the barrier ineffective.
• It interferes with sensation in those men who like to feel their partner’s cervix hitting against the tip of the penis.
How to use it
Place 3 or 4 inches of spermicidal jelly on the inside of the cap and spread some around the rim too. Insert the cap in the way that you have been taught and do so well in advance of intercourse. If you don’t have sex within 3 hours use more spermicide in the vagina. Don’t remove the cap for at least six hours after intercourse. If you have sex more than once during this six hours use more spermicide without removing the cap.
Look after the cap well. Remove it gently after intercourse ensuring that you don’t damage the dome with your nails. Wash it with plain, warm water and leave it out to dry. Never use perfumed soap or detergent to wash it. Never use Vaseline or disinfectant or you will spoil it. Hold it up to a good light every month and look for obvious holes. If there is any sign of damage, get a new one. Never wear a cap for more than twenty-four hours without removing and washing it.
The sponge
This is a disc of spermicide-impregnated sponge that the woman places in the vagina before intercourse.
Advantages
• Fairly easy to use.
• A good, non-permanent, barrier method.
Disadvantages
• All the disadvantages of absorbing spermicides into the bloodstream.
• Must be left in place for six hours after intercourse.
• It has to be thrown away after a single use and so is expensive.
• It can be felt in the vagina by the man’s penis or fingers.
• It is rather unreliable (75-85 per cent effective only) and so is really only suitable for couples who want to space their children rather than those who want to be absolutely sure about fertility control.
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