Non-Hormonal Contraceptives

Non-hormonal contraceptive alternatives include the condom, diaphragm, intrauterine device (IUD), cervical cap, female condom, and vaginal spermicides.

The condom is a sheath placed over the erect penis, preventing pregnancy by blocking the passage of sperm. Most condoms are made of latex rubber, which is impermeable to viruses. A small number are made from lamb intestine, which is not. When used correctly and in conjunction with spermicides, condoms are highly effective contraceptives. Latex condoms are the most effective method for reducing the risk of infection from sexually transmitted diseases (STDs).

Diaphragms and cervical caps are soft rubber barriers that cover the cervix to decrease access of sperm to the ovum. The diaphragm is a shallow, dome-shaped cup with a flexible rim while the cervical cap is smaller and thimble-shaped. Both require fitting by a trained clinician. The effectiveness of these methods depends on their fit and insertion and on the spermicidal agent placed in the barrier before insertion.

The diaphragm may be inserted as long as six hours before intercourse and must be left in place for at least six hours afterwards but not for longer than 24 hours because of the risk of toxic shock syndrome (TSS). The cervical cap protects for 48 hours and for multiple acts of intercourse within this time. Wearing it for more than 48 hours is not recommended because of the risk of TSS. The diaphragm and cervical cap offer no protection against HIV transmission, but do offer some protection against other STDs.

The IUD is a mechanical device inserted into the uterus by a health-care professional. It is believed that the IUD has a primarily spermicidal effect, with interference of implantation being a backup mechanism. The IUD is a very effective method of contraception. Rare side effects include pelvic inflammatory disease and ectopic pregnancy. Occasionally, heavy bleeding and cramps occur during or shortly after insertion of the IUD. IUD's do not provide any protection against sexually transmitted diseases.

The female condom is a newer barrier method consisting of a lubricated polyurethane sheath shaped similarly to the male condom. The closed end, which has a flexible ring, is inserted into the vagina, while the open end remains outside, partially covering the labia. It should not be used together with a male condom because they may slip out of place. Effectiveness of the female condom is similar to other barrier methods. Female condoms provide protection against STDs and can be used safely in people with latex allergies.

Vaginal spermicides (nonoxynol-9 or octoxynol) are available in foams, creams, jellies or suppositories. They are most effective when used in combination with diaphragms, cervical caps and condoms.

Despite the availability of many contraceptive methods, thousands of unplanned pregnancies and STDs occur each year. When choosing a form of contraception, individuals should assess their lifestyle needs and have an awareness of correct and optimal use of the contraceptive of choice and its impact on STD transmission.