American Medical Association Family Medical Guide - American Medical Association [243]
Female condom
The female condom is a thin rubber sheath that fits inside the vagina. The condom has soft, flexible rings at both ends. A small ring at the closed end of the condom holds the condom in place against the cervix. A larger ring at the other, open end of the condom remains outside the vagina. To insert the condom, you squeeze the smaller inner ring on the closed end and insert it into your vagina. Using your index finger, push the condom up as far as you can until it reaches the cervix. About 1 inch of the open end stays outside the vagina and rests against the external genitals.
Spermicides
Spermicides are chemicals that kill sperm. They are available over the counter as cream, jelly, or foam and are inserted into the vagina shortly before intercourse. Follow the package directions and reinsert more spermicide before each time you have intercourse. Always use a spermicide with a condom, a diaphragm, or a cervical cap. Very rarely, spermicides can cause mild allergic reactions, producing itching and redness in either partner’s genital area.
Diaphragm
The diaphragm is a rubber cup fitted over a flexible wire frame that blocks sperm from entering the uterus. A trained health care professional fits a diaphragm to a woman’s vagina to cover the cervix (the opening to the uterus) and shows her how to use it. A diaphragm must be inserted correctly and no more than 6 hours before intercourse. You must put a ring of spermicidal cream or jelly around the edge of the diaphragm and about half a teaspoon in its center before you insert it. To insert it, you squeeze it together into a half circle. Check immediately after insertion to make sure that the rubber of the diaphragm covers your cervix and that the edge of the diaphragm is behind your pubic bone. If the diaphragm does not cover your cervix, it will not block sperm from the uterus and you can become pregnant.
Using a diaphragm
Before using your diaphragm, place some spermicide around the rim and in the center of the cup (top). When inserted properly, the diaphragm completely covers the cervix, and the rim of the diaphragm lies behind your pubic bone (bottom).
After intercourse, you must leave the diaphragm in place for at least 6 hours to allow the spermicide to kill any sperm. If you have intercourse again within 6 hours, put more spermicidal cream or jelly in your vagina, using the plastic applicator that comes with the spermicide. For intercourse after 6 hours, remove the diaphragm, wash it, put spermicidal cream or jelly on it again, and reposition it in your vagina. The diaphragm can be a highly effective method of birth control if you use it carefully and consistently.
Cervical Cap
The cervical cap, like the diaphragm, blocks sperm from the uterus. The cap is much smaller than the diaphragm and fits tightly over the cervix (the opening to the uterus) rather than extending to the walls of the vagina. A trained health care professional fits the cervical cap to each woman and instructs her in how to insert it. The cervical cap should be used in the same way as a diaphragm, with spermicidal cream or jelly, following the same precautions. Used in this way, a cervical cap is about as effective as a diaphragm in preventing pregnancy. However, the smaller size of the cap can make it trickier to place correctly, especially for women who have short fingers.
Cervical cap
The cervical cap is a barrier method of birth control. Like a diaphragm but smaller, the cap completely covers the cervix, blocking sperm from entering the uterus.
IUD
The intrauterine device (IUD) is a tiny contraceptive device made of copper or a hormone-containing plastic that your doctor inserts into your uterus. An IUD prevents pregnancy by blocking sperm from the fallopian tubes, where fertilization normally takes place. An IUD is usually inserted during a woman’s menstrual period, when