Now it’s time to move on to the non-hormonal methods. Namely, the IUD, the sponge, Lea Contraceptive, the cervical cap, diaphragm, and spermicide. Tubal ligation and vasectomy also fit into the “non-hormonal” category, but as they’re permanent, I’ll be talking about them separately.
Notice what’s missing? Condoms! I’ll also be covering the male and female condoms in their own post, because condoms are essential to safer sex and they deserve a full shout out! Let’s get started ...
The Intra-Uterine Device (IUD):
[caption id="attachment_1355" align="alignright" width="236" caption="Copper IUD"]
[/caption]If you’ve read the previous post, you’ve got a bit of an understanding about how the IUS works. The IUD is similar, but instead of a cylinder containing hormones, it has a thin copper wire wrapped around it.
As with the IUS, the IUD is inserted by a doctor into a woman’s uterus. Once inserted, it can stay in place for up to five (5) years. Your doctor will trim the strings of the IUD so that they hang down into the top of the vagina (they're generally not noticeable by male partners). The copper wire changes the chemistry in the uterus, killing sperm and preventing implantation. The IUD is extremely effective - 99% - and has no impact on later fertility once it’s removed.
The IUD may be a good option for women who are looking for long-term, worry-free birth control at a low cost (approx $85 in Ontario). Like most birth control, the IUD does NOT protect against STIs, and it may even make it easier for a woman to contract an STI, so it’s essential to USE WITH CONDOMS.
The Contraceptive Sponge:
[caption id="attachment_1356" align="alignright" width="205" caption="Contraceptive Sponge"]
[/caption]Personally, I think that the sponge is pretty cool. It’s a small, round, disposible sponge soaked in spermicide, which a woman inserts and places at her cervix. The idea is to kill sperm before they can enter the cervix on their way to the uterus (and egg!). Once inserted, the sponge protects for 12 hours, even if you have sex multiple times in this period.
That said, the sponge is NOT very effective on its own, so it needs to be used with condoms. When both condoms and the sponge are used together properly, they are 98% effective.
As with other spermicidal methods, it’s important to know that some people are allergic to spermicide. Also, some women find that using the sponge leaves them prone to yeast infections. If you’re not sure if the sponge is a good choice for you, talk to your doctor about other birth control options. If you want to check it out, the sponge comes in packs of 4 at most drugstores.
And don’t forget, the sponge itself does NOT protect against STIs, so make sure you’re using condoms too!
Lea Contraceptive:
[caption id="attachment_1363" align="alignright" width="190" caption="Lea Contraceptive"]
[/caption]I have to admit, I’ve never actually seen one of these in person. That said, they are out there and people are using them, so I’ve done some research to be able to educate you!
The Lea Contraceptive is a small device made of soft silicone. A woman inserts it into the vagina, in front of the cervix, to prevent sperm from getting in. On it’s own, it’s not all that effective -- about 87%. With spermicide, it jumps up to 91.3% effectiveness, but that’s still a pretty high failure rate when you consider other contraceptive options. On the plus side, the Lea Contraceptive is reusable, and can be left in place for up to 8 hours.
As with most birth control options, the Lea Contraceptive does NOT protect against STIs. To improve your protection, always use condoms as well.
Cervical Cap:
[caption id="attachment_1359" align="alignright" width="190" caption="Cervical Cap"]
[/caption]I have one of these in my sex ed kit, and they’re pretty neat. The cervical cap is just that - a small, flexible cap. Made of silicone, the cervical cap fits against (thereby covering) the cervix, preventing sperm from entering the cervix. To increase effectiveness, the cap needs to be filled with spermicide before it is inserted.
Some women like the cap because it offers them privacy and control. Because the cervical cap needs to fit properly, a doctor needs to determine what size of cap you need before you purchase it.
Because of the variation in fit, effectiveness can also vary quite a bit. It’s also much more effective in women who have not given birth. Statistically speaking:
In women who have NOT given birth before: If the cap fits you well and you insert it properly every time you have sex, the failure rate of the cervical cap is about 9% (meaning that if 100 women use the cap perfectly for a year, 9 of them are likely to get pregnant). That said, nobody is perfect, and “typical use” (meaning how most people will use the cap) failure is 20% (so 20 of those 100 women will become pregnant over the course of a year).
In women who HAVE given birth: the failure rate is much higher. Perfect use still has a failure rate of 26%, and typical use fails 40% of the time. Yikes!
It’s crucial to use condoms with the cap, both because of the high failure rate and because it does NOT protect against STIs.
Diaphragm
[caption id="attachment_1357" align="alignright" width="214" caption="Diaphragm"]
[/caption]Even if you’ve never seen one, you may have heard of the Diaphragm before now. In fact, a relative of the modern diaphragm has been around since at least the mid-1800s, although they’ve certainly made a few improvements along the way!
The diaphragm is a thin, dome-shaped latex cap used to cover the entrance to the cervix. In order to be effective, the diaphragm must be filled with cream or foam spermicide before it is inserted. The diaphragm offers privacy and control to women, who insert it prior to having intercourse. That said, the failure rate is higher than some other methods of contraception (but lower than the cervical cap) -- at about 4-8%.
Women who choose the diaphragm may find it difficult to insert at first or discover that it doesn’t fit them properly. It’s essential to use condoms with the diaphragm, as it DOES NOT protect against STIs. As well, some women may develop urinary tract infections (UTIs) while using it.
Spermicide
[caption id="attachment_1358" align="alignright" width="240" caption="Spermicidal Film"]
[/caption]While spermicide used to be frequently recommended, it's taken more of a back seat in recent years as researchers have learned more about it. That said, some individuals and couples still choose it as a contraceptive option and it’s certainly worth discussing.
Spermicide is composed of a chemical called nonoxynol-9 and is available in the form of cream (for diaphragms), gels, foam, film or suppository. Once inserted into the vagina (in front of the cervix), spermicide destroys sperm on contact. Alone, their effectiveness is quite limited (6-21% failure rate) and spermicide should always be used in conjunction with another method of contraception (ideally a condom).
Although spermicide offers some protection from bacterial infections, it does NOT offer protection from STIs overall. In fact, spermicide alone may increase the risk of HIV infection, so it’s essential to use it with a condom for protection from STIs. The reason for this potential risk increase is that spermicide may irritate the vagina, penis and anus, leaving those areas more vulnerable to infection. Spermicide can also be messy, and must be inserted shortly before sex, as it’s only effective for an hour.
Now that we've covered the hormonal methods of birth control and most of the non-hormonal methods, it's time to get ready for Birth Control Options - Part 3 -- CONDOMS!
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