Study conference 8  Barrier Contraceptive Methods

Introduction

Barrier contraceptive methods are another form of contraceptive an approach used for avoiding pregnancy and certain sexually transmitted infections. Various male and female obstacle methods the contraception have remained in use for centuries, and they are one of the oldest techniques in use. They are designed to prevent the passage of sperm into the uterus during the sex-related act. The success of such techniques depends ~ above the quality of the barriers, and the an ideas and willingness the the couple to usage the method. The male condom is the just male barrier known, while a variety of different female barriers exist, such together the diaphragm, female condom and also cervical cap, every one of which space widely available. Spermicides are regularly used in conjunction with obstacle methods. They are chemical barriers which can also be supplied on your own.

You are watching: Which of the following statements about barrier methods of contraception is false?

In this research session, you will certainly learn around the various barrier methods, their varieties and mechanism of actions, their efficiency of use, and also the advantages and disadvantages of each.


Learning Outcomes for study Session 8

When you have actually studied this session, you must be maybe to:

8.1 Define and use correctly every one of the key words printed in bold. (SAQs 8.1 and 8.6)

8.2 explain the species of obstacle contraceptives. (SAQs 8.2 and also 8.6)

8.3 describe the mechanism of action, use, effectiveness, advantages and defect of the masculine condom. (SAQs 8.2, 8.3, 8.4 and 8.6)

8.4 explain the use, advantages and flaw of the mrs condom. (SAQs 8.5 and 8.6)

8.5 talk about the use, advantages and disadvantages of making use of diaphragms. (SAQ 8.6)

8.6 describe the mechanism of action, efficiency and advantages of spermicides. (SAQ 8.6)


8.1  Types the barriers

Barrier contraceptives are broadly classified into two main types: mechanically barriers and also chemical barriers.


8.1.1  Mechanical barriers

Mechanical barriers are tools that administer a physical obstacle between the sperm and also the egg. Examples of mechanical barriers include the masculine condom, woman condom, diaphragm, cervical cap, and also sponge. The condom is the just contraceptive technique that helps avoid sexuallytransfer infections (STIs).


8.1.2  Chemical barriers

Chemical barriers or spermicides room sperm-killing substances, available as foams, creams, gels, movies or suppositories, which are frequently used in female contraception in conjunction through mechanical barriers and other devices. Spermicides space usually easily accessible without a prescription or clinical examination.


8.2  The masculine condom

The masculine condom is just one of the many widely used obstacle methods in the world. In Ethiopia, it has perhaps to be the only barrier technique ever known and used. Thus, in this study session, much more emphasis will certainly be given to the masculine condom 보다 to any other barrier technique and you will learn about it in detail.


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8.2.1  Mechanism of action

A male condom is a extending made to fit over a male erect penis. The can likewise be dubbed a rubber, sheath or skin, and is known by countless different brand names. It works by providing a barrier between partners throughout sexual intercourse, so that bodily fluids, such together semen and also blood, room not shared. As a result, pregnancy and also reproductive street infections (RTIs), including human immunodeficiency virus (HIV), and acquired immunodeficiency syndrome (AIDS), can be prevented. Most condoms are make of slim latex rubber. Some prophylactics are coated with a dried lubricant or with spermicide. Different sizes, shapes, colours and textures room common.


8.2.2  Effectiveness

Condoms deserve to be really effective in staying clear of pregnancy when used consistently and correctly. The pregnancy rate for couples who use condoms every time they have intercourse is approximated to be 3% per very first year the use.

Condoms also aid prevent sexually transmitted illness (STDs or STIs). Throughout sexual intercourse, prophylactics can avoid the sex-related transmission of many diseases, consisting of gonorrhoea, syphilis, chlamydia, HIV/AIDS and trichomoniasis (refer to her Communicable illness Module).


8.2.3  How to use a masculine condom

In this section, you will learn just how a masculine condom is used. Table 8.1 reflects you the an easy steps. You deserve to learn just how to show it using wooden models or toys. You need to practise it on her own, or aided by your mentor, so that you can demonstrate it come any customer in her community. Eventually, girlfriend will have to ask your client to demonstrate it ago to inspect that the procedure has to be understood.


Table 8.1 Five basic steps as soon as using a male condom. (Source: family Planning: A worldwide Handbook because that Providers, WHO, 2007, p.203)
StepsDescriptionIllustration
1 usage a new condom because that each sex act. Check the condom package. Execute not use the condom if the is torn or damaged. Prevent using one expired condom. Carry out so only if a more recent condom is not available. Tear and also inter-base.net the package carefully. Perform not usage fingernails, teeth, or anything that can damage the condom.
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2 Before any physical contact, place the condom on the reminder of the erect cock with the rolled side out.For the finest protection, put the condom on prior to the cock makes any kind of genital contact.
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3 Unroll the condom all the means to the base of the erect penis.The condom must unroll easily. Forcing it on could reason it to break throughout use. If the condom does not unroll easily, it may be ~ above backwards, it is in damaged, or be as well old. Litter it away and also use a new condom. If the condom is top top backwards and also another one is no available, rotate it over and also unroll that onto the penis.
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4 immediately after ejaculation, hold the rim of the condom in place and also withdraw the prick while that is tho erect.Withdraw the penis. Slide the condom off, preventing spilling semen. If having sex again, use a brand-new condom.
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5 Dispose that the used condom safely.Wrap the condom in that is packaging and also put it in the rubbish or latrine. Store it far from the with of children.
Condom failure

Condoms room used about the human being by unmarried and also married couples. Every users space not equally expert in handling condoms. Therefore, do not assume the the customer knows how to properly use a condom, nevertheless of previous experience. There is constantly a possibility that male condoms could rest or slip during sex. The many common causes of condom failure room breakage and also slipping. To protect against a condom from breaking because of dryness, the user needs to make certain there is enough lubrication from natural secretions, or use a water-based lubricant. A water-based lubricant is a jelly-like lubricant make of water, e.g. KY jelly. Oil-based lubricants can cause condoms come break.

To store a condom from slipping off, the user should be particular that the rim stays close to the base of the prick during intercourse. This is especially important at the finish of intercourse together the penis is withdrawn. Watch Box 8.1 for mistakes frequently made through condom users, and also what essential messages to tell your clients around handling condoms.


The 5 most common mistakes are:

Not having actually a condom once needed. Beginning intercourse without a condom on the penis, climate interrupting intercourse to placed on the condom (or deciding not to use the condom at all).Tearing the condom with a fingernail.Not hold the pickled in salt of the condom once withdrawing the dick from the vagina, bring about condom slippage and leakage.Forgetting to use the condom altogether.

IMPORTANT

Clients have to be informed that:

They have to not use two condoms at once. Placing 2 male condoms on a prick can advanced the chance of tearing. Used prophylactics should it is in thrown away after every sex act. Masculine condoms and female prophylactics should not be supplied at the exact same time.The condom have to be used from ‘start to finish’ through every action of intercourse.
Advantages

When supplied consistently and correctly with every act of sexual intercourse, male prophylactics can stop pregnancy and also STDs, including HIV/ AIDS. They space safe, and have no hormonal side-effects. They can be stopped at any time, and fertility returns soon after every use. They are an extremely easy come find and also use without seeing a medical care provider first. Moreover, men of any age can use them, and using a condom permits a man to take obligation for avoiding pregnancy and also sexually transmitted infections.


Disadvantages and side-effects

Condoms do have actually some disadvantages. The typical ones space as follows:

Women need to rely top top the man’s collaboration to protect themselves indigenous pregnancy and disease. Some people attach condoms with immoral sex, sex exterior marriage, or sex v prostitutes, and do not desire to usage them. Some civilization are too embarrassed come buy, asking a partner to use, placed on, take off, or litter away condoms.Latex prophylactics may cause itching for a couple of people who room allergic to latex and/or lubricants. Over there is a little possibility that a condom will slip off throughout sex. Condoms can weaken and also may break throughout use if stored for too lengthy or in too lot heat, sunshine or humidity, or if offered with oil-based lubricants, such together vaseline or edible oils.

8.3  The female condom

8.3.1  Mechanism of action

A female condom is a thin, loose-fitting and flexible plastic tube worn inside the vagina. It has inner and also outer rings (Figure 8.2). A soft ring in ~ the closed finish of the pipe covers the cervix throughout intercourse and holds it within the vagina. Another ring in ~ the inter-base.net end of the tube stays outside the vagina and partly consists the lip area. The female condom helps defend partners from pregnancy and STIs, consisting of HIV/AIDS. The is the only female-controlled machine offering this protection. Like the masculine condom, the mrs condom gives a obstacle between partners throughout sexual intercourse, to protect against the sharing of bodily fluids, choose semen and also blood. This ensures that pregnant does not occur, and STIs space not sent .


Figure 8.2 female condom. (Source: family members Planning: A global Handbook because that Providers, WHO, 2007, p.212)

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Male and female prophylactics should not be supplied at the very same time, as the result friction may lead to slipping or tearing.


Female prophylactics can be placed up to 8 hours before intercourse, and also are only reliable when put prior come intercourse. At first, female prophylactics can it is in uncomfortable come use, however they come to be easier with practice. Note that a woman condom and also a male condom need to not be provided at the very same time, because this can cause friction that may cause slipping or tearing that the condoms.

To insert the condom (Figure 8.3), the woman has to squeeze the ring in ~ the closed end of the tube. She deserve to use her other hand to spread out the outer lips, and also insert the squeezed condom into the vaginal canal. The within ring must be pushed simply past the pubic bone and also over the cervix.

After insertion, she needs to make sure the condom is not twisted. About one customs of the inter-base.net end will stay outside the body. The external ring that the woman condom requirements to be hosted in place throughout intercourse. After intercourse, she has to squeeze and twist the outer ring to save all fluids, consisting of sperm, inside the condom, and also gently pull it out and also throw the away.


Figure 8.3 how to insert a mrs condom. (Source: household Planning: A global Handbook for Providers, WHO, 2007, p.214)
Advantages

Female and also male condoms have many advantages in common. However, the following benefits are details to woman condoms:

Unlike the masculine condom, erection is not vital to store the condom in place. Female condoms do not alleviate a male partner’s stimulation. Female condoms can be offered by people who are known to be sensitive to latex because, while many male condoms are make of latex, female prophylactics are made of plastic, i m sorry rarely reasons an allergic reaction.
Disadvantages

These room the most usual disadvantages that the female condom:

Female condoms make a remarkable sound during sexual intercourse. That is sometimes difficult to insert or use, and also some women can have an obstacle on the an initial attempt at self-insertion. It have the right to break or leak. It is much more expensive 보다 a male condom.

8.4  The diaphragm

8.4.1  Mechanism that use

Although this barrier an approach is not typical in Ethiopia, the is useful for you to learn around some the the basics of the diaphragm. The diaphragm is a small dome-shaped latex cup with a versatile ring that fits over the cervix. The cup acts together a physics barrier against the entrance of sperm right into the uterus. A diaphragm is commonly used in addition to spermicide.


8.4.2  Effectiveness

The diaphragm has a reasonably high fail rate, about 16% end the an initial year of use. However, the is thought about a an excellent choice by females whose health and wellness or lifestyle stays clear of them from using an ext effective hormonal contraceptives.


8.4.3  How to insert a diaphragm

During the installation process, a fitting ring is inserted into the vagina. The biggest ring that fits comfortable is generally the size chosen. Diaphragms have the right to be placed up to two hours before sex, due to the fact that spermicide is only reliable for 2 hours. If the mrs inserts her diaphragm more than two hours before intercourse, she will need to insert much more spermicide right into her vagina later on (see box 8.2 for guidelines). As a basic rule, diaphragms have to be replaced every one to 2 years.


Before or after each use, the woman should hold the diaphragm as much as the light, or fill it through water, to inspect for holes, tears or leaks.A small amount that spermicide (about one tablespoon) is usually inserted inside the cup, and some is smeared around the lip the the cup.The device is climate folded in fifty percent and put into the vagina by hand, or v the aid of a plastic inserter.The diaphragm have to fit over the cervix, blocking entry to the uterus.If much more than six hrs pass before repeat intercourse occurs, the diaphragm have the right to be left in place, and extra spermicide put into the vagina using an applicator.The diaphragm have to remain in the vagina for 6 to eight hrs after the final act that intercourse, and can safely stay there approximately 24 hours after insertion.The diaphragm should be washed through soap and also warm water after each use, and then dried and stored in its initial container, which need to be kept in a cool dried place.
Advantages

The diaphragm deserve to be brought in a purse, have the right to be inserted up to two hours before intercourse begins, and also usually can not be feel by either partner. It likewise does not interfere with a woman’s hormones.


Disadvantages and also complications

Common complications when using a diaphragm space that some females dislike having actually to insert the machine every time they have actually intercourse, or have actually trouble mastering the insertion and also removal process. The diaphragm can also be dislodged throughout sex and the failure rate is high, around 16%. Additionally, the diaphragm does not protect against STIs. Constant urinary tract infections and also vaginal infections have the right to be a problem for some women as soon as using a diaphragm.


8.5  Spermicides

8.5.1  Mechanism that use

Spermicides are sperm-killing chemicals placed deep right into the vagina, close to the cervix, before sex. Castle are easily accessible in foaming tablets, melt or foaming suppositories, melt film, jelly and cream. Jellies, creams and foam from cans have the right to be provided on their own, with a diaphragm, or through condoms. Films, suppositories, foaming tablets or foaming suppositories have the right to be supplied on their own or through condoms.


8.5.2  Effectiveness that spermicides

They work by causing the membrane of the sperm cell to break, death them or slowing your movement. This keeps the sperm from meeting the egg.


Spermicides are among the least effective family to plan methods, v a 29% possibility of pregnancy, and also as with various other methods performance depends on the user. Risk of pregnant is greatest when spermicides room not supplied with every action of sex. In general, spermicides may be an appropriate choice for women who require back-up protection versus pregnancy (for instance, if castle forget to take your birth regulate pills). Spermicides should not be used alone together the primary technique of birth control.


8.5.3  Advantages and disadvantages of spermicides

Spermicides space safe to use. They are a female-controlled technique that virtually every woman can use without the need to consult a health care provider first. They deserve to increase vaginal lubrication, so that vaginal dryness and also friction will be minimised. They room much less complicated to use with a small practice and can be quit at any time. They have actually no hormone side effects. Regrettably they are among the least effective methods on their own.


Summary of study Session 8

In study Session 8, you have actually learned that:

Barrier contraceptives are extensively classified right into two types: mechanical barriers and chemical barriers. Mechanical obstacles are devices that provide a physical barrier between the sperm and the egg while chemical barriers are recognized as sperm-killing substances or spermicides.The male condom is the key barrier technique for men. That is a sheath that fits end the penis. It functions by producing a barrier between partner so that bodily fluids, such as semen and blood, space not shared.Condoms have the right to be an extremely effective in avoiding pregnancy and also STDs when provided consistently and also correctly.The most essential message to tell your client is that the condom should be offered from ‘start to finish’ v every action of intercourse to efficiently prevent pregnancy and also STIs.One of the advantages of male prophylactics is that guys of any kind of age have the right to use them, and also using condoms allows a male to take duty for avoiding pregnancy and also diseases.The disadvantage of utilizing male condoms is the a man’s cooperation is needed for a mrs to protect herself from pregnancy.A female condom offers a barrier between partner to prevent sharing bodily fluids prefer semen and also blood. This ensures the STIs space not pass on, and also that pregnancy does no occur. That is likewise the just female-controlled an equipment offering this protection.The female condom is beneficial because, unlike the male condom, erection is not necessary to keep the condom in place.The diaphragm is a little dome-shaped latex cup v a flexible ring the fits end the cervix. The cup acts as a physics barrier against the entry of sperm right into the uterus. A diaphragm is usually used along with a spermicide.Spermicides space sperm-killing building material which job-related by bring about the membrane of sperm cells to break, killing them or slowing their movement. This keeps the sperm from meeting an egg.

Self-Assessment inquiries (SAQs) for examine Session 8

Now the you have actually completed this study session, you have the right to assess exactly how well you have achieved its learning Outcomes by answering these questions. Write your answers in your examine Diary and also discuss them v your tutor at the next Study assistance Meeting. Girlfriend can check your answers through the notes on the Self-Assessment questions at the end of this Module.


What is the significant difference between mechanical barriers and chemical barriers? In what circumstances is each many effective?


Answer

The major difference in between mechanical barriers and also chemical obstacles is that mechanical obstacles are tools that administer a physical obstacle between the sperm and the egg, if chemical barriers act as sperm-killing substances. Obstacle methods can be an ext effective when used together with other contraceptive methods, such as dental contraceptives. Spermicides can also be used together with other mechanically barriers.


You have currently learnt that prophylactics have a number of advantages. Talk about the unique advantage that they have actually over other contraceptive methods.


Answer

The unique advantage of prophylactics is the they have the right to be provided for bear control and also at the same time prevent STIs, consisting of HIV/AIDS.


Counselling on the use of contraceptives is just one of the solutions that you need to provide. During counselling, a customer asks even if it is a masculine condom have the right to be used much more than once. She additionally asks if it deserve to be used with the mrs condom, and also if using 2 male condoms (one of peak of the other) gives much better protection. What space the key messages you must pass on?


Answer

The vital messages to pass on as soon as counselling client who desire to usage male condoms are:

Used prophylactics should be thrown far after each sex act. Male and female prophylactics should not be supplied at the very same time. Placing 2 male prophylactics on a cock increases the possibility of tearing.
Answer

The most common reason for a masculine condom break is lack of enough lubrication from natural secretions, which outcomes in boosted friction. Boosted friction in turn reasons breakage. To conquer this, users are advised to usage a water-based lubricant, such together KY jelly.


Sometimes, making use of a mrs condom is more advantageous for the woman than relying top top a male partner to wear a condom. Why? give your reasons.


Answer

Using a female condom is an ext advantageous because that the woman than relying top top a male partner since it is the only female-controlled machine offering protection against pregnancy, STIs and HIV/AIDS.


Which of the following statements is false? In each case explain why that is incorrect.

A using male and also female condoms at the very same time gives an ext protection against pregnancy and STIs.

B attract two prophylactics at a time can’t stop breakage.

C In stimulate to prevent dryness and friction throughout sexual intercourse, you need to put on edible oil and vaseline.

D The diaphragm is just one of the least effective birth control methods. Besides, it can not protect against STIs.

E Spermicides deserve to be used alone together a major protection versus pregnancy.

F The instrument of action of both male and also female prophylactics are the same, in the both provide a physical barrier between partners so the body fluids, such together semen and blood, space not shared.

G guys should wait for the cock to come to be erect before they deserve to safely stay a condom. This is not crucial for women, however.


Answer

A is false due to the fact that wearing both male and also female condoms at the very same time have the right to increase the likelihood that breakage, as a an outcome of increased friction.

B is true. Put on two prophylactics at a time cannot prevent breakage.

C is false due to the fact that to stop dryness during sexual intercourse, you should not use edible oil or Vaseline, yet rather only water-based lubricants, such as KY jelly.

D is true. The diaphragm is one of the least effective birth regulate methods.

E is false because spermicides have the right to only be really effective when used with other contraceptive methods, together as oral contraceptives, condoms and also diaphragms.

F is true. Both male and female condoms act together physical barriers so semen and blood are not shared.

G is true. Males should wait because that the penis to come to be erect before wearing a condom.


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