What Are the Barrier Methods of Contraception and How Do They Prevent Pregnancy?

Here’s an unwelcome statistic for India: Only around 10% of men use condoms. This highlights a massive gap in reproductive health practices as per National Family Health Survey 5 (NFHS) data. While the percentage is relatively higher in urban India, the burden of choosing contraceptive methods is mainly left to the women in the relationship.

This low adoption rate highlights the need for more awareness and accessibility of various contraceptive methods. Currently, when it comes to contraception, there are more options than ever before. But for those seeking non-hormonal, user-controlled methods, a specific category stands out: Barrier methods.

At their core, barrier methods are devices that physically block sperm from reaching and fertilising an egg. A key characteristic of most contraceptive barriers is their non-hormonal nature, making them a suitable choice for individuals who cannot or prefer not to use hormonal contraception due to health concerns or personal preferences. Their primary function is to physically stop sperm.

The fundamental principle behind barrier methods is that they prevent fertilisation by blocking the path of sperm into the cervix. So, the sperm don’t reach the egg.

Think of them as a "gatekeeper" or a "roadblock on the path to the egg." In addition to this physical block, some barrier methods are used in conjunction with spermicide.

Spermicide kills or immobilises sperm, adding a second, chemical layer of protection against pregnancy. This dual sword improves the effectiveness of these contraceptive barrier methods.

Understanding the various barrier methods to prevent pregnancy is crucial for informed choice.

Male Condoms

Male condoms are thin sheaths typically made of latex, polyurethane, or polyisoprene, and are worn over the penis during sexual intercourse.

They are highly effective when used correctly and regularly. To use them, unroll the condom onto an erect penis before any genital contact. After ejaculation, withdraw the penis while still erect, and hold the base of the condom.

PS: Male condoms are the primary contraceptive method that also provides significant protection against sexually transmitted infections (STIs). This makes them a crucial tool for both pregnancy and disease prevention.

Internal Condoms (Female Condoms)

Internal condoms, often referred to as female condoms, are nitrile pouches with flexible rings at each end. One ring is inserted deep into the vagina, while the other remains outside.

They offer an alternative for wearer-controlled protection and can be inserted up to eight hours before sex. Like male condoms, internal condoms also offer good protection against STIs.

Diaphragm

A diaphragm is a shallow, dome-shaped silicone cup that is inserted into the vagina before sex to cover the cervix.

It must be fitted by a healthcare professional to ensure a proper fit and must always be used with spermicide. The diaphragm is inserted before intercourse and must remain in place for at least six hours after sex, but no longer than 24 hours.

Cervical Cap

The cervical cap is a smaller, thimble-shaped silicone cup that fits snugly over the cervix. Similar to the diaphragm, it requires a prescription and must be fitted by a doctor to ensure an effective seal. It is also used with spermicide and can be inserted several hours before intercourse. It must remain in place for at least six hours after, but generally no more than 48 hours.

Contraceptive Sponge

The contraceptive sponge is a soft, disposable foam sponge containing spermicide. It is designed to be moistened with water and inserted into the vagina before sex, where it covers the cervix.

The sponge works in two ways: it physically blocks the cervix and continuously releases spermicide to kill sperm. It can be inserted up to 24 hours before sex and must remain in place for at least six hours after, but not more than 30 hours in total.

Only condoms, both male and internal (female) condoms, provide effective protection against sexually transmitted diseases (STDs). These include HIV, chlamydia, gonorrhoea, and syphilis.

This is a vital distinction to make, as other barrier methods like diaphragms, sponges, and cervical caps do not protect against STDs. It is paramount to understand this difference to safeguard one's health.

The concept of "dual protection" is highly recommended: Using a condom for STD prevention alongside another highly effective method (such as an IUD or the birth control pill) for pregnancy prevention.

By design, most contraceptive methods are intended for use by individuals with a uterus. Among the barrier methods, the following are specifically not meant for males:

• Internal Condoms (Female Condoms)
• Diaphragm
• Cervical Cap
• Contraceptive Sponge

For context, among barrier methods, only the male condom is designed for males. A vasectomy is a permanent, male, non-barrier, surgical contraceptive method.

While this article focuses specifically on barrier contraception methods, it's important to understand that they represent just one category within the broader spectrum of reproductive choices. How many contraceptive methods are there in total? Over a dozen. The main categories include:

• Barrier Methods (e.g., Condoms, Diaphragms, Cervical Caps, Contraceptive Sponges)

• Hormonal Methods (e.g., Birth Control Pills, Patches, Vaginal Rings, Injections, Hormonal IUDs)

• Intrauterine Devices (IUDs – including non-hormonal copper IUDs) Permanent Sterilisation (e.g., Vasectomy for males, Tubal Ligation for females)

• Natural Rhythm Methods (e.g., Fertility Awareness-Based Methods)

This diversity highlights the importance of choosing the right contraceptive method that aligns with individual health needs, lifestyle, and preferences.

Barrier methods are an effective, non-hormonal way to prevent pregnancy, offering individuals significant control over their reproductive health. It is crucial to reiterate that condoms, both male and female, are unique among barrier contraceptive methods in their ability to also prevent the spread of STDs.

While India faces challenges in male condom usage, increased awareness and accessibility of various contraceptives can empower individuals to make informed choices. We strongly encourage readers to discuss their options with a doctor to find the best fit for their body, lifestyle, and health needs.