Male and Female Condoms
What it does: Physically blocks contact between the vagina and the
penis, essentially stopping sperm and disease-carrying liquids in
their tracks. Along with IUDs, condoms are one of the oldest
contraceptive devices known to man. Prior to the 20th century, they
were often made from the intestines of sheep or lambs and could be
washed and re-used. Today, most condoms are made from latex and
need to be thrown out after a single use.
The female condom, on the other hand, is quite new and intimidating
to some people. Instead of sliding over the man's penis, the female
condom fits inside of you, almost like a pouch or a pocket. Made of
polyurethane, it's stronger than latex condoms but also transfers
heat better, meaning that both partners can often feel more
sensation with the female condom than with the male. You can insert
the female condom up to a couple of hours before sex as the two
flexible rings, one in the closed end that is held against your
cervix and one in the open end that covers part of your outer
vaginal lips, keep it securely in place.
Both female condoms and male condoms made from latex or
polyurethane protect against STDs, including the smallest viruses
like hepatitis B that can sneak through some barriers. Male condoms
made from natural lambskin, on the other hand, should only be used
for preventing pregnancy. Their pores are too large to block out
viruses.
What it doesn't do: It wont work if you don't use it. Probably the
most common reason for condom failure is couples opting to not use
the barrier every time or waiting to put it on until after they've
already come into contact with each other's fluids. With typical
use, which includes occasional slip-ups like this, the failure rate
for condoms alone is between 12 percent and 15 percent. If you
follow the instructions to the letter and pair condoms with
spermicide, however, that rate can be reduced to as little as 2
percent to 3 percent.
How to get it: Walk down to your local pharmacy, grocery, or big
box store. It's that simple. Condoms are available over the
counter, and in most places you can waltz right in and pick up a
box from the shelf without needing a clerks assistance.
Is it reversible? Very much so. The second you take a condom off,
you can get pregnant again.
Side effects: None, unless you happen to have a latex allergy. In
addition, some people say they don't like the condom because it
decreases sensation. If it's not lubricated well enough, the female
condom can also make a lot of distracting noise during sex.
Who might benefit most: Anyone who wants to prevent the
transmission of STDs. Remember, other birth control methods won't
do this. So if you're not absolutely sure about your health and
that of your partner (and by this we mean, if you've not both been
tested for the full gamut of STDs), using a condomeven if you're
already using a different method of birth controlis only common
sense.
Who should consider a different method: People with latex allergies
used to have few options when it came to condom use. Today, though,
polyurethane condoms are widely available. They're every bit as
effective as latex, though they are a bit more expensive.
Fertility Awareness
What it does: Turns out, the name is pretty descriptive of what's
going on. Women who practice fertility awareness use one (or more)
methods of tracking their menstrual cycles, in order to figure out
which days they are most likely to be fertile. There are several
ways to do this. One of the most famous is the calendar rhythm
method: A woman tracks the beginning and end of her period for at
least eight months and then uses that information (and a little
math) to get an estimate of which days she's most likely ovulating.
Other methods may track basal body temperature, which changes
minutely in the days before and after ovulation, and cervical
mucus, which changes type and thickness with the onset of
fertility. Women who combine several of these methods are more
likely to be successful at remaining childless.
Once you know which days you're likely to be infertile, you simply
save vaginal sex for those days, substituting abstinence, sex with
a condom, or your preferred non-vaginal sex act during the rest of
the month.
What it doesn't do: Protect you against sexually transmitted
diseases. If you decide to use the fertility awareness method it is
incredibly important that you and your partner be monogamous.
Besides the lack of protection against disease, it seems that
committed, monogamous couples are most likely to practice fertility
awareness accurately and consistently.
It's also important to note that, unlike most other contraception
methods, fertility awareness is quite cheap and can be practiced
without buying any specialized tools or paying a monthly fee.
How to get it: Unlike most methods of contraception, fertility
awareness requires some serious training if you're going to do it
right. You can get the information from a book, but it's often
helpful to have a trained counselor who you can contact if you have
questions or if you're confused about something that's going on
with your body.
Ask your medical professional where you can go to get training in
fertility awareness locally. One good source for this is the Roman
Catholic Church. Officially, fertility awareness is the church's
only approved form of birth control, so Catholic family counselors
tend to be pretty well-versed in the methods and potential problems
that may arise. They're also likely to offer classes, which you
usually can take no matter what religion (or lack thereof) you
happen to practice.
Getting training is extremely important as it can mean the
difference between a perfect-use failure rate of about 8 percent
and a typical or imperfect-use failure rate of anywhere from 20
percent to 40 percent. Bottom line, if you want fertility awareness
to work, you'll need to know what you're doing.
Is it reversible? Very much so. In fact, it might even help you get
pregnant as, by the time you're ready for that step, you'll have
pretty much figured out what your fertile days are and can simply
flip your unprotected sex days to fit your new goal.
Side effects: None
Who might benefit most: Couples who have ruled out hormonal and
barrier methods for religious, health, or other personal
reasons.
Who should consider a different method: Couples who don't want to
follow a regimen that requires organizational skills, careful
planning, reliable documentation of menstrual patterns, and
adherence to strict rules about when sex is OK and when it must be
avoided.
Diaphragm & Cervical Cap
What it does: Both diaphragms and cervical caps function as
physical barriers, which block sperm from entering the uterus. They
also serve as a handy way to hold spermicidal cream or foam against
the cervix, providing further protection against sperm. Prior to
the 1960s, diaphragms were one of the most popular of all
contraceptive devices. Over the years, they've been eclipsed by
oral contraceptives and, to a lesser extent, IUDs.
Although it's pretty simple to understand how diaphragms and
cervical caps work, using them can be a bit more difficult.
Diaphragms are held in place by springs and cervical caps by
suction. To get them into position, you need to carefully maneuver
them onto your own vagina and set them against your cervix. That
takes training. And it takes a diaphragm or cervical cap that has
been fitted to your biological proportions. Once you know how to
use it, the barriers can be inserted several hours before sex and
must be left in for at least six hours afterwards--but should be
left in for no longer than 24 hours total.
What it doesn't do: Protect you against all STDs. There is,
however, some evidence that it may protect you against some minor
STDs, including bacterial vaginosis.
How to get it: You'll definitely need a medical practitioner for
this one. Your provider will be able to help you pick the type of
diaphragm or cervical cap that is right for you, aid you in finding
a size that fits your unique cervical proportions, and show you how
to find your cervix with your fingers and put the barrier in place
and remove it properly. This training is vital. With perfect use
(and particularly in conjunction with condoms) diaphragms and
cervical caps have a failure rate of less than 9 percent. Without
perfect use, though, that number climbs. Typical use failure rates
can range as high as 30 percent.
Is it reversible? Yes, simply have sex without it and fertility
returns.
Side effects: Very few. The most concerning issue is a small risk
of toxic shock syndrome if the barrier is left in place for longer
than 24 hours.
Who might benefit most: Women who aren't comfortable with hormonal
methods and who don't mind using a birth control method that
requires them to plan ahead each time they intend to have
sex.
Who should consider a different method: Women who aren't
comfortable being intimately familiar with their insides and with
spermicide; one of the complaints about these methods is that they
are messy. Another problem is that many women consider the process
involved in using a diaphragm or cervical cap to be a huge
inconvenience. That tends to lead to non-perfect use and higher
failure rates.
