Contraception: Condoms and diaphragms
Condoms and diaphragms are barrier contraceptive methods that work by stopping a man’s sperm from reaching a woman’s eggs. Condoms (also called sheaths), are used by a man, and diaphragms (also called caps), are used by a woman.
Condoms
Condoms are used to avoid unwanted pregnancies and to reduce the risk of contracting a sexually transmitted infection (STI), such as chlamydia, genital herpes, hepatitis, gonorrhoea, syphilis and HIV. Condoms are put on over a man’s erect penis before sex.
Most condoms are made from latex rubber, although latex-free condoms are available. Latex condoms perish easily, especially if exposed to heat and sunlight, and should always be used before their expiry date.
Spermicides are no longer recommended for use with condoms as they can cause irritation in some people and can actually increase the risk of getting an STI.
A woman taking an oral contraceptive pill is only protected against pregnancy, not sexually transmitted infections. For safer sex, a condom should be used as well.
The chance of becoming pregnant while using a condom is 2–10%, depending on how carefully it is used.
Diaphragms
Diaphragms are inserted high into the woman’s vagina to cover the cervix (the opening of the womb) and stop the man’s sperm from entering the womb. To work properly they need to be used with either a spermicide, which kills sperm, or a spermicide-alternative which provides a low pH barrier to sperm. They should be left in the vagina for at least six hours after sex, and it is best not to swim, take a bath, or use a vaginal douche during this time.
Diaphragms available in NZ are made from silicone. Silicone diaphragms are less likely to perish and have replaced latex diaphragms. Diaphragms need to be washed and dried after use and inspected regularly for damage.
Diaphragms give only limited protection against sexually transmitted infections. The chance of becoming pregnant while using a diaphragm is 4–20%, even if it is used correctly with a spermicide.
Diaphragms come in different sizes and must be fitted by an experienced doctor or nurse. The fit must be checked at least once a year and after pregnancy, vaginal surgery or if you lose more than 3kg in weight.
Spermicides
Spermicides are foams or gels which contain an ingredient (nonoxynol-9) which kills sperm. They should ONLY be used with diaphragms since they are not effective enough to be used alone. They are not very effective as lubricants and can cause irritation in some people. There have been problems with the supply of spermicides in New Zealand.
See Your Pharmacist or Medical Professional
What to do if your condom breaks, your diaphragm becomes dislodged, or you have not used any method of contraception
If your condom or diaphragm was not used correctly, is damaged, has dislodged during sex, or you did not use one, you may become pregnant or contract a sexually transmitted infection.
You may want to think about using emergency contraception. The Emergency Contraceptive Pill (ECP) can prevent an unwanted pregnancy if the woman takes it within 72 hours of unprotected sex, although the sooner the better. The ECP can be sold by specially trained pharmacists – you don’t need a prescription. It is also available from your doctor, Family Planning or Sexual Health Clinic.
An intrauterine contraceptive device (IUD) can also protect against pregnancy if a woman has it fitted within five days of unprotected sex. See your doctor, Family Planning or Sexual Health Clinic for information.
If you are worried you may have been exposed to a sexually transmitted infection, talk to your doctor, Family Planning or Sexual Health Clinic. They can also help you decide what contraceptive method would be best for you.
Treatment Tips
Pointers for condom use
If you haven’t used a condom before, read the instructions so you use it correctly
Always check the expiry date and store condoms away from heat and sunlight to prevent damage
Remove condoms from their packet carefully to avoid tearing
Condoms are more likely to tear during use if the vagina is too dry, so use a water-based lubricant
Don’t use oil-based lubricants, such as baby or cooking oils, Vaseline or butter – they quickly damage the condom
Some products used for vaginal thrush can also damage condoms – if the woman is using vaginal thrush treatments, ask your pharmacist for advice
Spermicides are no longer recommended for use with condoms as they have been linked to an increased risk of sexually transmitted infections
Some people are allergic to latex rubber – latex-free condoms are available
Condoms are also available on prescription for less cost – see your doctor, Family Planning clinic or Sexual Health Clinic.
Pointers for using diaphragms or caps:
A diaphragm or cap must always be used in combination with a spermicide or spermicide-alternative
The device (diaphragm or cap) should be inserted before sex and left in place for six to eight hours afterwards - do not go swimming, take a bath or use a douche during this time
If sexual intercourse occurs more than two hours after the device has been inserted, an extra applicator of spermicide or spermicide-alternative should be put in the vagina before intercourse
After removal, the device should be washed and dried
The device should be inspected regularly for damage.
Treatment Options
Diaphragms or caps
e.g., Ortho All-Flex
See your doctor or Family Planning Clinic to discuss having a diaphragm or cap fitted.
Condoms – latex
[GENERAL SALE]
Without spermicide
(e.g., Durex range, Marquis Condoms, Shield Blue, Gold Knight)
Suitable lubricants include Ansell Personal Lubricant, Durex Play, and KY Jelly
Condoms – latex-free
[GENERAL SALE]
Without spermicide (e.g., Durex Deluxe)
Non-latex condoms are suitable for people with latex allergies
Durex Avanti condoms are safe to use with water and oil-based lubricants.
Spermicides
There are currently no spermicidal creams or gels available for purchase in NZ
This is due to the widespread problems with irritation due to the nonoxynol-9 component of previously available spermicides
A natural alternative to spermicide, ContraGel Green is available on-line.
More Information
For more information on sexually transmitted infections (STIs), such as chlamydia, genital herpes, genital warts, hepatitis, gonorrhoea, syphilis and HIV, visit the 'everybody' Sexual Health Centre.
