Consists of thin, nearly
hemispherical dome made of rubber or latex material,
with a circular, covered metal spring at the periphery.
These are available under the names of ortho diaphragm,
Used as means
to retain spermicides in contact with the cervical
os and not as a sperm-proof mechanical barriers.
The instructor (Gynecologist
or specially trained nurse) chooses the appropriate
size after internal examination. The cap should
the sexual act. An applicator full of spermicidal
cream or jelly should be introduced vaginally or
a foam pessary introduced at least 15 minutes earlier
as it takes time to dissolve.
- Female oriented
and entirely harmless.
- No gross medical
- Doesn’t interfere
with sexual pleasure.
- Like condoms, diaphragms
can prevent spread of sexually transmitted diseases,
although less effectively.
of spermicides with occlusive caps is found to
be messy and unacceptable for some women.
may set in if caps are not removed for a long
is suitable only for a small group of intelligent,
highly motivated women.
caps do not prevent spread of AIDS.
- After intercourse,
the vaginal diaphragm shouldn’t be removed 6 –
8 hours of the last act and shouldn’t be kept
for more than 24 hours.
- After removal, vaginal
diaphragm should be cleaned with soap and water,
dried thoroughly and kept in a good well fitting
be re-used for average 50 times or up to 6 months.
Less than 2%, when used as per manufacturer’s
Cervical caps are small
thimble or dome shaped rubber appliances designed
to cover the cervix i.e.: opening of the mouth of
uterus. They remain in place by suction. The degree
of suction depends on the tightness of the fit.
They are available under the names are Orthocervical
cap, Miler cervical cap, etc.
They are not much used in practice.
are chemical agents capable of destroying sperms.
Spermicides alone are not very effective in preventing
pregnancy and are not recommended alone. Their main
role is to improve the contraceptive effect of other
barrier methods. They are mostly used along with
diaphragms, cervical caps and condoms. The most
commonly used spermicidal agent is Nonoxyonol-9.
suppositories E.g.: Ortho foams. Today vaginal
creams and jellies e.g.: Delfen cream, Volper
- Foam tablets: e.g.:
Durafoam tablets, "Today" in India.
- C-films: which are
5-cm squares of water soluble, semitransparent
plastic impregnated with spermicide agent called
Nonoxynol- 9. It is inserted high up in vagina
just before coitus. They are active for two hours.
- Can be purchased
without any prescription.
- Easily available
and easy to use.
- Relatively cheap.
- They give some protection
against sexually transmitted diseases.
- They can be used
for added lubrication.
- Messy to use so
is not liked by some couples.
rate is high 10 – 30%.
- Spermicides do increase
the risk of urinary tract infection.
failure rate is 10 – 30 %
When used with barrier methods like condoms, diaphragms;
spermicides increases the contraceptive effect.
- Norplant small tiny
tubes containing hormone progesterone is implanted
under the skin by a small surgery under local
- It prevents release
of eggs. No eggs. No pregnancy
- It also causes thickening
of cervical mucus preventing (hindering) the entry
of sperms into the cavity of uterus.
99% (failure rate is less than 1%). More
than 99% (failure rate is less than 1%).
- Highly effective,
relatively cheap over a period of time, reversible.
- Protection starts
within 24 hours of insertion.
- Easy to use, no
after care is needed.
- It is effective
in long run and protection is given for 5 years.
- There is no problem
with sex interference or handling.
- There are no estrogenic
side effects as with
combined oral contraceptive pills. Link to oral
contraceptive pills in preventing pregnancy.
may help in preventing anemia.
is best suitable for mothers who are breast-feeding.
It doesn’t alter the quality or quantity of breast
milk secretion or no adverse
effects in breast fed infant.
- It must be inserted
and removed by trained health care personnel.
- It has side effects
– irregular bleeding, prolonged menstrual bleeding
and amenorrhoea (absence of menses) in more than
60% of users.
- It may cause transient
ovarian cysts in 10% users.
may be difficult at times.
to fac------- tales a few months (unlike pills,
where it is quickee)
Many women cannot take Oral Contraceptives regularly,
leading to a failure rate of 2 – 8 % per year, though
the pills are almost 100% effective. In India, and
many other countries, some women have more faith
in injections than in oral medicines. There are
two types of injectable steroid contraceptives.
only contraceptive injections
DMPA or Depo-Provera.
NET – EN
(once a month injections)
do they act?
- Inhibits the release
of the egg.
- Thickening of mucus
at the mouth of the uterus, which hinders entry
of sperms inside.
the inside lining of uterus less suitable for
implantation of fertilized egg.
- Cancer of the breast
or genital tract,
- Abnormal uterine
- Suitable for women
who have more faith in injections than in oral
- One injection 2
monthly or 3 monthly.
- No regular medication
- Doesn’t interfere
with sex play.
- It reduces menstrual
blood flow and prevents anemia.
- It is most suitable
for lactating women because it doesn’t have any
bad effect on breast milk secretion.
- It causes weight
gain of 1-3 kg in fair percentage of woman, which
is an advantage in thin ladies, but sometimes
the weight gain is much more.
- Best suited for
patients of sickle cell disease (abnormality in
the shape of red blood cells).
- DMPA use protects
against the risk of cancer of the endometrium
(inside lining of the uterus).
- Periods are commonly
affected by contraceptive injections. It is common
for them to become irregular or stop all together.
Some users have reported excessive periods.
- Weight gain of average
1 – 3 kg has been noted.
- The return of fertility
is of longer duration.
- Bone mineral loss