Intrauterine System or IUS (Mirena) – The IUS is a small T-shaped device like the IUD and is placed inside the uterus by a doctor. Each day, it releases a small amount of a hormone similar to progesterone called levonorgestrel that causes the cervical mucus to thicken so sperm cannot reach the egg. The IUS stays in your uterus for up to five years. It does not protect against STDs or HIV. The IUS is 99% effective. The Food and Drug Administration approved this method in December 2000. You will need to visit your doctor to have it inserted and to make sure you are not having any problems. Not all doctors insert the IUS so check first before making your appointment
The Female Condom – Worn by the woman, this barrier method keeps sperm from getting into her body. It is made of polyurethane, is packaged with a lubricant, and may protect against STDs, including HIV. It can be inserted up to 24 hours prior to sexual intercourse. Female condoms are 79 to 95% effective at preventing pregnancy. There is only one kind of female condom, called Reality, and it can be purchased at a drug store.
Diaphragm, Cervical Cap or Shield – These are barrier methods of birth control, where the sperm are blocked from entering the cervix and reaching the egg. The diaphragm is shaped like a shallow latex cup. The cervical cap is a thimble-shaped latex cup. The cervical shield is a silicone cup that has a one-way valve that creates suction and helps it fit against the cervix. The diaphragm and cervical cap come in different sizes and you need a doctor to “fit” you for one. The cervical shield comes in one size and you will not need a fitting. Before sexual intercourse, you use them with spermicide (to block or kill sperm) and place them up inside your vagina to cover your cervix (the opening to your womb). You can buy spermicide gel or foam at a drug store. Some women can be sensitive to an ingredient called nonoxynol-9 and need to use spermicides that do not contain it. The diaphragm is 84 to 94% effective at preventing pregnancy. The cervical cap is 84 to 91% effective at preventing pregnancy for women who have not had a child and 68 to 74% for women who have had a child. The cervical shield is 85% effective at preventing pregnancy. Barrier methods must be left in place for 6 to 8 hours after intercourse to prevent pregnancy and removed by 24 hours for the diaphragm and 48 for cap and shield. You will need to visit your doctor for a proper fitting for the diaphragm or cervical cap and a prescription for the cervical shield.
Contraceptive Sponge - This is a barrier method of birth control that was re-approved by the Food and Drug Administration in 2005. It is a soft, disk shaped device, with a loop for removal. It is made out of polyurethane foam and contains the spermicide nonoxynol-9. Before intercourse, you wet the sponge and place it, loop side down, up inside your vagina to cover the cervix. The sponge is 84 to 91% effective at preventing pregnancy in women who have not had a child and 68 to 80% for women who have had a child. The sponge is effective for more than one act of intercourse for up 24 hours. It needs to be left in for at least six hours after intercourse to prevent pregnancy and must be removed within 30 hours after it is inserted. There is a risk of getting Toxic Shock syndrome or TSS if the sponge is left in for more than 30 hours. The sponge does not protect against STDs or HIV. There is only one kind of contraceptive sponge for sale in the United States, called the Today Sponge, and it can be purchased at a drug store. Women who are sensitive to the spermicide nonoxynol-9 should not use this birth control method.
You can purchase what are called spermicides in drug stores. They work by killing sperm and come in several forms – foam, gel, cream, film, suppository, or tablet. They are inserted or placed in the vagina no more than one hour before intercourse. If you use a film, suppository, or tablet wait at least 15 minutes before having intercourse so the spermicide can dissolve. Do not douche or rinse out your vagina for at least six to eight hours after intercourse. You will need to use more spermicide before each act of intercourse. You may protect yourself more against getting pregnant if you use a spermicide with a male condom, diaphragm, or cervical cap. There are spermicidal products made specifically for use with the diaphragm and cervical cap. Check the package to make sure you are buying what you want.
All spermicides have sperm-killing chemicals in them. Some spermicides also have an ingredient called nonoxynol-9 that may increase the risk of HIV infection when used frequently because it irritates the tissue in the vagina and anus which can cause the virus to enter the body more freely. Some women are sensitive to nonoxynol-9 and need to use spermicides without it. Spermicides alone are about 74% effective at preventing pregnancy. Medications for vaginal yeast infections may decrease effectiveness of spermicides.