Effectiveness
The effectiveness of barrier methods varies and depends mainly on consistent correct use every time you have sex, regardless of the time of the month, including when you have your period. Failure due to a flaw in the contraceptive itself is rare. If in doubt, you can take the morning-after contraception (pill or sterilet). We recommend adding a spermicide with the female condom and always using a spermicide with the diaphragm and cervical cap.
Who are they for ?
These methods are mainly designed for women whose fertility rate is naturally low, i.e., women over 40 years and for women for whom pregnancy would be acceptable. These contraceptives, which have the advantage of being controlled by the woman, may also be used at mid-cycle to increase the efficacy of another method of contraception. Lastly, any person at risk for STDs should use condoms (see the Male Condom brochure).
The male condom
See the male condom brochure.
Spermicides
Spermicids are not very efficient when used exclusively. TheyNonoxynol-9 spermicides are not available in Canada anymore because of their toxicity risk depending of the different vaginal mucosa. They are not very effective if you use it by itself, but are recommended with the cervical cap and the diaphragm.
The only available spermicide in Canada is cellulose and lactic acid based: the CayaGel. The gel is from Trimedic and are disposed in 60g tubes. Apply 4 mL in the diaphragm cupola.
You can also buy online the green Contragel selled by Anares national Health in United States, http://www.anareshealth.ca/node/519. It is also made of cellulose and lactic acid. You can also commanded with the French company Bivea.
- Effectiveness: 72%-82%
- Cost: 25$-30$
The female condom (REALITYTM )
The female condom should always be worn before the sexual relation. Hit lubrication helps the insertion. The female condom is formed by a flexible ring at each end. The intern ring may be uncomfortable, so can be took off. The biggest one must stay outside and must overlay the vagina lips. Be careful to make sure it doesn’t move during the sexual relation. It may also be noisy during sex. The female condom adapts to the shape of the vagina and therefore does not compress or squeeze the penis. Make sure it is well-closed (turning the opening of the condom before the penis is tapped out) to prevent sperms to fill in. Don’t use it with a male condom, because the friction can rip the female condo and you can only use it once. It offers an excellent STDs protection. Female condoms are not commercialized in Canada anymore. You can purchase the two brands on Internet (Reall FC1 and FC2™). Female Health Company produce FC2. Those two brands produce female condoms made of synthetic nitrile robber, not latex.
- Cost: $2,00-2,50 each
- Effectiveness: 79%-95%
The diaphragm
The diaphragm is a dome of thin rubber mounted on a flexible ring that adapts to the size of the vagina. It must be used with spermicidal jelly (4 mL) placed in and around the diaphragm. There are 2 brands of diaphragms easily purchasable in Canada: Milex and Caya.
Traditional diaphragm (Milex brand)
Women who choose this method must be seen by a doctor who will determine the right size (60 to 90 mm in diameter) and teach the woman how to insert it. A variation in weight or childbirth may change the size of the vagina making it necessary to be refitted for a diaphragm. The size should also be checked once a year. To prevent toxic shock syndrome and unpleasant odours, keep the diaphragm in place only for as long as necessary, while respecting the minimum time of 6 hours after sex, and do not use it during your period. If you have successive sexual relations, keep the diaphragm in place and add 4 mL of spermicide in the vagina. Care for your diaphragm by washing it, dusting it with bicarbonate of soda (baking soda) and storing it in a cool, dark place. There are 2 models: the Omniflex and the Arcing. The most chosen by women is the ARCING. You can buy a Milex diaphragm dialing 1-800-404-2398.
- Effectiveness: 88%-94% (with spermicide)
- Cost: 100$-120$ + cost of spermicide (25$-30$) CayaGel or Contragel
Caya Diaphragm (Trimedic)
Since January 2014, Trimedic sells the CAYA diaphragm. That diaphragm is only available in one size, which ease it use (no measure to take, so no medical visit requested). It covers the complete cervix and is placed between the bottom of the vagina and the pubic symphysis. It can be inserted like a tampon and is easy to take off. You must make sure your cervix is well covered by the diaphragm. It is comfortable for both of the sexual partners and must be placed for at least 6 hours after sex.
It must be used with a spermicide (4 g : 1/2 teaspoon) on and around the diaphragm. In case of successive sexual relations, add 4 g of spermicide in the vagina. The Caya diaphragm fits to most of women (any weight and number of childbirths). It is made of silicon and may last 2 years when nicely cared. Trimedic branding sells their own cellulose and lactic acid spermicide; the CayaGel.
- Effectiveness: 83%-90% (with the CayaGel)
- Cost: 100$ + cost of the spermicide (25$-30$)
The cervical cap
There is one type of cervical cap on the market: the FemCap. It is dome-shaped and made of thick rubber. It is placed on the cervix and must be used with spermicidal jelly. It comes in 3 sizes: small, medium and large (small for women who never had child, medium for women that had an abortion, a miscarriage or that labored by Caesarean operation and large size for women that gave birth). Approximately 75% of women find a size that fits. Using a cervical cap requires instruction that may be provided by a doctor or some women’s health centres.
You must use it with a spermicide gel. We recommend that you not use the cervical cap for 6 weeks after childbirth, during vaginal bleeding or during your period. Some positions may cause the cap to move and destroy its effectiveness. To avoid unpleasant odours, you must wash and dry your cervical cap after each use and leave it in place only for as long as is necessary; however, leave it in place for a minimum of 6 hours after sex. It must not stay in place for more than 40 hours and is available in Canada. It can be ordered in pharmacy or by the internet at: www.medisafecanada.com
- Cost: $100-$125+ cost of spermicide ($25-$30)
- Effectiveness: 80% to 91% (with spermicide gel) It is more effective with women that never had a child
Contraceptive sponge
The sponge TODAY is the only one available in Canada.
It is manufactured with a gentle, flexible foam. The sponge comes with a small loop to make it easier to remove. It is impregnated with a spermicidal gel that disperses very well, is not irritating, and is well tolerated. It only offers protection for one time. These sponges can be left in place for a maximum of 30 hours and must be left in place in the vagina for at least 6 hours after sex. The sponge must not be used during your period. The sponge is more effective for women that never had childbirth. Right now, we that we can only purchase them in Shppers Drugmart in the Pharmaprix drugstores of Québec.
- Cost: approximately $20/box of 3
- Effectiveness: 76% to 90% (if you never had a child) and 88%-91% (if you had a childbirth)
VCF
VCF™ (vaginal contraceptive film) is available in Canada. It is a thin film measuring 5 x 5 cm that resembles waxed paper and contains spermicide. It is easy to use: fold the film in 4 and insert it at the end of the vagina 15 minutes before sex. It is eliminated naturally.
- Cost: 9 for approximately $16
- Efficacy: 70% to 91%
Last update : July 2016