Non-hormonal Birth Control Options

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Without the use of any hormones, these options can involve creating a barrier between sperm and egg, changing the chemistry of the reproductive tract, or a combination of both.

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Male condom

Male condoms are easy to find at most pharmacies, convenience, and grocery stores. No prescription is needed, and they’re only used during sexual activity. 

Condoms come in a variety of sizes, thicknesses, textures, colours and even flavours. Most are made of latex, but non-latex options include polyurethane and polyisoprene options.

How it works

  • The condom acts as a physical barrier preventing direct contact between the penis and the vagina
  • It prevents the exchange of body fluids and also traps the sperm in the condom so it cannot fertilize the egg

How it's used

  • Condom should be put on before sexual intercourse or oral sex and be worn over the penis during sexual activity
  • Disposed after use
  • A new condom should be used for each repeated sexual act

Effectiveness

82% with typical use, 98% with perfect use
(failure rate for women during first year of use)

Pros

  • Widely available without a prescription
  • Helps protect against most sexually transmitted infections (STIs)
  • Non-latex options exist for those with latex allergies or sensitivities
  • May decrease the risk of cervical cancer
  • May help the wearer avoid premature ejaculation
  • Can be used with other contraceptives (e.g. spermicide) to help increase their effectiveness

Cons

  • Must be available at a time of sexual activity
  • Must be used, handled, and stored properly
  • Expires
  • May reduce sexual spontaneity
  • May slip or break during intercourse
  • May reduce sensitivity for either partner
  • May interfere with the maintenance of an erection
  • Requires participation of both partners

Female condom

Resembling a very large male condom, the female condom is a soft, loose-fitting, seamless sheath with two flexible rings, one at each end.

How it works

This barrier method prevents the sperm from entering  the vagina

How it's used

  • Can be placed in the vagina up to 8 hours before sexual intercourse
  • Inserted by the woman herself, the external ring at the open end of the condom sits outside the vagina. The internal ring at the closed end of the condom is inserted into the vagina and helps to keep it in place
  • Disposed after use
  • A new female condom should be used for each repeated act of sexual intercourse

Effectiveness

79% with typical use, 95% with perfect use
(failure rate for women during first year of use)

Pros

  • Helps protect against both pregnancy and sexually transmitted infections (STIs)
  • Can be used by people with latex allergies
  • Can be used with oil-based lubricants
  • Male partner may find it more comfortable and less constricting than male condoms
  • Available at pharmacies without a prescription

Cons

  • May be difficult to insert correctly
  • More expensive than male condoms
  • Potential challenges include slippage and breakage
  • The rings on the female condom may cause discomfort during sex
  • May be noisier than male condoms during sex

The sponge

A small, disposable, polyurethane foam device that is placed in the vagina. It fits over the cervix to provide a physical barrier to help prevent sperm from entering. The sponge also contains a spermicide,

which helps to absorb and trap sperm.

How it works

  • Slowly releases spermicide over 24 hours which helps to absorb and trap, the sperm, destroying its membrane
  • The sponge itself also helps to provide a physical barrier to prevent sperm from entering the cervix
  • Protection begins immediately when inserted and lasts for 24 hours even with repeated acts of intercourse

How it's used

  • Can be inserted into the vagina up to 24 hours before intercourse
  • One side has a concave dimple that fits over the cervix. The other side has a loop to facilitate removal
  • Should be left in the vagina for at least 6 hours after the last act of intercourse but should not remain in the vagina for more than 30 hours total

Effectiveness

Variable depending on use and birth history.

  • In women who haven’t given birth: 88% typical use, 90% perfect use
  • In women who have given birth: 76% typical use, 80% perfect use
    (failure rate for women during first year of use)

Pros

  • Offers a barrier method and spermicide all-in-one
  • Provides 24-hour protection, and doesn’t need to be replaced for repeated sex during this time
  • Enhances the effectiveness of other forms of contraception such as condoms
  • Available at pharmacies without a prescription

Cons

  • Increases the risk of vaginal and cervical irritation or abrasions, which increases the risk of transmission of HIV
  • Can be difficult to insert correctly
  • Does not protect against (sexually transmitted infections) STIs

Cervical cap

A deep silicone cap that fits against the cervix and prevents sperm and bacteria from entering.

How it works

Provides a physical barrier between sperm and the cervix.

How it's used

  • Should always be used with a gel that immobilizes or kills sperm
  • Can be inserted into the vagina up to 2 hours before sex
  • The gel should be reapplied with an applicator for each repeated act of intercourse, or after 2 hours has passed
  • It should be left in the vagina for at least 6 hours after intercourse and should not remain in the vagina for more than 48 hours
  • Should be replaced every year

Effectiveness

Unknown. 

Pros

  • Reusable
  • Can be used by women who are breastfeeding
  • Available in three different sizes

Cons

  • May increase the risk of recurrent urinary tract infections (UTIs)
  • May increase the risk of toxic shock syndrome (TSS)
  • Can be difficult to insert correctly
  • Gel must be reapplied after each act of intercourse
  • A poor fit or silicone allergy may prevent some women from using the cap
  • Does not protect against sexually transmitted infections (STIs)

Diaphragm

Made of latex or silicone and nylon, the diaphragm is a cap that covers the cervix and prevents sperm from entering. It’s used with a gel that also forms a physical barrier in front of the cervix and inhibits sperm movement.

How it works

Acts as a physical barrier between sperm and the cervix.

How it's used

  • Should always be used with a gel, which is placed inside the diaphragm to immobilize or kill sperm
  • Can be inserted into the vagina up to 2 hours before sex
  • It should be left in the vagina for at least 6 hours after intercourse but should not remain in the vagina for more than 48 hours
  • If there is repeated intercourse within the first 6 hours, more gel should be inserted with an applicator (the diaphragm should not be removed)

Effectiveness

Unknown. 

Pros

  • Can be used by women who are breastfeeding
  • One size fits most
  • Available at pharmacies without a prescription

Cons

  • May increase the risk of recurrent urinary tract infections (UTIs)
  • May increase the risk of toxic shock syndrome (TSS)
  • Can be difficult to insert correctly
  • Water-based gel must be reapplied after each act of intercourse
  • Latex or silicone allergy will prevent some women from using it
  • Does not protect against sexually transmitted infections (STIs)

Spermicides

Spermicides should be used along with another barrier method of contraception, like a condom because they’re not highly effective alone. They contain a chemical called nonoxynol-9, and come in the form of a cream (only for use with diaphragms), gel, foam, film, or suppository.

How it works

By inserting spermicide in front of the cervix in the vagina, it helps destroy sperm on contact.

How it's used

  • Spermicidal film must be inserted into the vagina at least 15 minutes before intercourse. It will melt and disperse. If more than 3 hours have passed before intercourse, another film must be inserted
  • Spermicidal foam is inserted into the vagina using an applicator. It is effective immediately and for up to one hour after insertion. It must be applied again for each act of intercourse

Effectiveness

82% with perfect use, 72% with typical use
(failure rates in the first year)

Pros

  • When used with another barrier method, effectiveness increases
  • May also protect against bacterial infections and pelvic inflammatory disease

Cons

  • Potentially messy
  • Must be inserted right before sex, because it’s only effective for 1-3 hours (depending on the format)
  • May irritate the entrance of the vagina or the tip of the penis
  • May increase the risk of HIV transmission
  • Does not protect against sexually transmitted infections (STIs)

Copper intrauterine device (Copper IUD)

It’s a small T-shaped device that’s inserted into the uterus by a healthcare professional.

How it works

  • Prevents fertilization. This is based on the inhibition of sperm and egg transport and/or the capacity of the sperm to fertilize eggs.
  • Possibly prevents attachment (implantation).

How it's used

  • The device is inserted into the uterus by a health professional. The procedure is fairly simple and only takes a few minutes.
  • Depending on the device, the IUD can remain inserted for 3-10 years before needing to be replaced.

Effectiveness

Highly effective 

Pros

  • Reversible
  • Long term
  • Cost-effective
  • May be suitable for women who cannot take hormones
  • May be used as an emergency contraception within 5 days of unprotected sex

Cons

  • Irregular bleeding, spotting or heavy menstruations and longer periods may occur
  • Some pain or discomfort during and after insertion
  • Rare risks with the insertion could include infection, perforation of the uterus, or expulsion of the IUD
  • Does not protect against sexually transmitted infections (STIs), including HIV/AIDs. 
  • Risk of ectopic pregnancy.

Disclaimer: The contents of this article are for informational purposes only and may not be complete, and are not intended, nor should they be used, as a substitute for professional medical advice. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding contraception.
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