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Diaphragm, cervical cap, and sponge

Author
Kristen Eckler, MD, FACOG
Section Editor
Robert L Barbieri, MD
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

Barrier contraception prevents pregnancy by blocking sperm from entering the female reproductive tract. Female-controlled barrier methods include the diaphragm, cervical cap, sponge, and the female condom. These methods are often used with a spermicide to create a chemical barrier to sperm and thus increase efficacy.

This topic will review the diaphragm, cervical cap, sponge, and spermicide. Information on female condoms, male condoms, and choosing a contraceptive method is presented separately. (See "Female condoms" and "Male condoms" and "Contraceptive counseling and selection".)

MECHANISM OF ACTION

Barrier contraceptives provide a physical barrier to migration of sperm from the vagina to the upper reproductive tract, where fertilization occurs. Concomitant use of spermicides enhances contraceptive efficacy by immobilizing sperm, thus creating a chemical "barrier." (See 'Spermicide' below.)

CHOOSING A BARRIER METHOD

In choosing a method of contraception, the advantages and disadvantages of the method need to be assessed and compared with advantages and disadvantages of alternative methods. Selection of a contraceptive method balances many patient preferences and is reviewed in detail separately. (See "Contraceptive counseling and selection".)

Selection of barrier method — In selecting a barrier contraceptive, we discuss the method failure rates, protection from sexually transmitted infections, cost, and product availability with the woman (table 1). For women who desire a barrier contraceptive, we suggest the wide-seal diaphragm with spermicide because it has the lowest typical-use pregnancy rate compared with the other barrier contraceptives (figure 1). However, as contraceptive selection includes many patient preferences, we defer to the patient's wishes for the final choice.

                                               

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Literature review current through: Nov 2016. | This topic last updated: Wed Apr 27 00:00:00 GMT 2016.
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