Contraception is used to prevent
unplanned conception and unwanted pregnancy. Last week, we discussed
barrier contraceptives where we learnt that condom use started from
ancient civilisation, during which all sorts of crude materials like
tortoise shell, animal horn, etc., were used in ancient China and Japan,
among others.
The discussion also examined modern day
male and female condoms in detail. Modern male condom is the most
commonly practised barrier method of contraception.
Continue reading after the cut....
Today, we will continue our discussion
on barrier contraceptives, and we shall examine cervical cap (including
Lea Shield), diaphragm and contraceptive sponge.
As we have seen from series of our
discussions on barrier methods of contraception, generally, barrier
contraception does not affect the man or the woman’s future reproductive
life, especially fertility. The use only comes up during sexual
intercourse; hence, it is safe all the time, including when a woman is
breast-feeding.
Even certain health conditions are not
affected by the use of contraceptives, except where the doctor advises
against it. For example, it is not important if the man or the woman is
hypertensive or diabetic. Better still, contraceptives are very cheap
and easily available. For instance, condoms can be purchased and used
without doctor’s prescription.
Apart from serving as birth control,
some of these barrier methods, especially condoms and diaphragms, may
also reduce the risk of cervical cancer (cancer of the mouth of the
womb) by preventing the infection of a group of virus that can be
sexually transmitted from the sperm to the lower part of the womb during
sexual intercourse.
They also prevent other sexually transmitted infections, such as Human Immunodeficiency Virus (HIV).
Cervical cap is a form of barrier
contraception. It fits over the mouth of the womb (cervix) and prevents
the sperm from entering the womb by blocking the cervix. The idea of
blocking the entrance of the womb (cervical os) started thousands of
years ago in ancient civilisation to prevent pregnancy. These include
oiled paper cones and lemon halves. Also, sticky mixtures like honey or
cedar rosin were used to block the cervical os. The ancient methods were
associated with infections to the female reproductive system and also
led to future or long-term complications.
But in modern civilisation, cervical
caps are of various types and of diverse modifications. Examples include
Prentif, Vimule, Femcap and Dumas. Prentif was very popular in the
United States for many years; later, Femcap became very popular.
Cervical caps are made of plastic or
silicon cup. They are of different sizes, and are re-usable. The
cervical cap is held in place by suction and has a strap to help with
the removal. It is effective in preventing pregnancy if used with
spermicides.
Lea’s Shield is a form of vaginal
barrier contraceptive. It is made of silicon, and fits one size for all.
Unlike cervical caps that come in different sizes, Lea’s Shield can be
washed and reused. It must be inserted before sexual intercourse and
must be left for about eight hours after intercourse and up to maximum
of 48 hours, just like cervical caps. It is also recommended to be used
with spermicides.
Lea’s Shield is not held in place by the
cervix as does the cervical cap; nor is it held in place by pubic bone
as do the diaphragms. Rather, it is held in place by the vaginal wall.
As a result, the length of the vagina or the size of the cervix does not
play any role.
Diaphragm is made of soft rubber or
latex cup that comes in various sizes. It covers the cervix when fitted
into the vagina and is held securely in place behind the pubic bone and
rear vagina wall. The health care provider examines the woman and
decides the best size, just like cervical cap.
Spermicides is also applied to improve
the efficacy. It must be fixed before sexual intercourse and left in
place for six hours after intercourse and maxim of 24 hours. Oil- based
lubricant must not be used, just as you don’t use oil-based lubricant
for the latex male condom.
Cervical sponge is a small disposable
foam sponge that already contains nonoxynol-9, a spermicidal. It
prevents pregnancy by acting as cervical barrier and kills sperm cells
before they enter into the womb.
It must be inserted before sexual
intercourse so that it will form a foam barrier on the cervical os. Most
studies show that cervical sponge is as effective as diaphragm or
cervical cap, but some women have allergic reactions to spermicides or
they can have increased risk of vaginal infection because of the
associated irritation.
In rare cases, cervical sponge may cause
toxic shock syndrome (a severe blood infection that usually presents
suddenly) and can be very dangerous if not treated immediately. It is
due to bacterial infection. Toxic shock syndrome is associated with the
use of tampons. It is also associated with inappropriate use of barrier
contraceptive method, such as when diaphragm is left in the vagina for
more than 24 hours.
The use of barrier methods like cervical
caps, diaphragms, contraceptive sponge, etc., are becoming less popular
because of the device itself or because the spermicides used with it
may cause vagina irritation by damaging the vagina lining and lead to
increased chance of HIV infection.
But male condom stands out as the most reliable form of preventing sexually transmitted infections, including HIV.
To be concluded
- Samuel Adebayo(dayspringsk05@yahoo.com)
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