THE MALE CONDOM

The male condom is a birth control method used by a man. He puts it on his penis before having sex. It catches the sperm when he “comes” (ejaculates) so the sperm does not go into the woman's body. Latex and polyurethane condoms not only prevent pregnancy, they also are the best protection against STDs, including AIDS.

Condoms are not very expensive. You can buy them at a drugstore or large discount store without anyone asking questions. You do not need to be a certain age or have a prescription.

You should remember not to touch a latex condom with anything greasy because oil weakens the rubber and the condom might break. You can buy special creams or, even better, use a spermicidal foam or gel with a condom. Condoms do not break often but for extra protection, in case one does, the woman can also put spermicide (a sperm-killing product) into her vagina before having sex.

To protect yourself and your partner, you must use a latex or polyurethane condom every time you have sex.

WHO SHOULD NOT DEPEND ON CONDOMS?

• Condoms may not be the best birth control method for you if (1) you tend to forget to keep a supply on hand, (2) you are inclined to skip using protection just this once; or (3) you or your partner are still embarrassed or uncomfortable using condoms after you have tried them several times. (It is worth making an extra effort to learn to use and become comfortable with this method, however, because a condom is the best disease protection available.)

THE FEMALE CONDOM

The female condom is larger and looser than the male condom. The closed end fits over the cervix, inside the vagina. The open end hangs slightly outside and protects the lips of the vagina. Because it is made of polyurethane, it becomes very soft and flexible when it is in place. It is very effective in protecting both partners against pregnancy and diseases, including AIDS.

Like a male condom, the female condom can be bought by anyone. You do not need a prescription. It is sold in drugstores under the name Reality Female Condom. The cost is higher than a male condom.

You will want to practiceputting it in place before you use it. It does not interrupt lovemaking because you can insert it ahead of time.

Although the female condom looks a little strange, many women and men find they like it. A man likes it because it's more comfortable than a male condom and he doesn't have to pull out as soon as he has come (ejaculated). Women like it because it gives them control over their own safety.

WHO LIKES THE FEMALE CONDOM?

• Women who are concerned about STD transmission and cannot get a man to use a condom
• Women who prefer to have control over risks in their lives
• Women who have sexual relationships with more than one partner or have one monogamous relationship after another
• Women who use oral contraceptives, Depo-Provera, Norplant, or an IUD but also want protection against STDs
• Women interested in trying different barrier methods

THE DIAPHRAGM

The diaphragm is a method of birth control used by a woman. It looks like a rubber cap with a flexible rim. It is always used with a spermicide (sperm-killing) gel. It is designed to fit over the cervix (at the upper end of the vagina) to prevent sperm from getting into it. You put it in place before you have sex. It prevents pregnancy and protects against some STDs, but not all. It has not been shown to protect against AIDS.

Because diaphragms must fit well to be effective, they come in several sizes. A diaphragm should fit so it stays in place but you do not feel it. A nurse or doctor must examine you and write a prescription for the correct size. With the prescription, you can buy a diaphragm at a pharmacy or a clinic. You do not need a prescription for a spermicide, which you can buy at the clinic, pharmacy, or supermarket.

You can put in the diaphragm up to 6 hours before you have sex and you must leave it in for at least 6 hours afterward.

ARE YOU A GOOD CANDIDATE FOR A DIAPHRAGM?

• If touching your genitals is distasteful to you, you may prefer another method of birth control.
• If spontaneous, uninterrupted sex is important to you or your partner, and stopping at any point to insert the diaphragm is a nuisance that would discourage your use of it, you may want to consider another method of birth control.
• Using this contraceptive effectively also requires a certain amount of planning ahead so that you have both the diaphragm and a supply of spermicide handy. To protect it from damage, the diaphragm should be carried in its case, which is roughly 5.8 inches and fits into a large purse. The case often has room for a tube of spermicide. To be safe, you need to take it with you whenever you might need it. If this is not easy, another method may be a better choice.
• On the other hand, the diaphragm is a good method of birth control for the woman who should not use hormonal methods because of health reasons — such as a heart problem or smoking habit.

THE CERVICAL CAP

The cervical cap is a small, deep rubber cap that fits tightly over the cervix to prevent sperm from entering. It is used with a spermicide. You push the cap up your vagina and over the cervix anytime before you have sex. It must be left in place for at least 6 hours afterward, but you can wear it for as long as 48 hours.

A cervical cap protects you against pregnancy and some STDs. It does not protect against AIDS and the other STDs that are caused by viruses.

Cervical caps come in four sizes. Your clinic nurse or doctor will examine you to see if you can use the cap. With a prescription for the correct size you can buy a cap from the clinic. You also can buy the spermicide you will need at a pharmacy or the clinic.

NOT EVERY WOMAN CAN WEAR A CERVICAL CAP

• Not all women can wear it. Caps come in four sizes and do not fit all women, largely because of ordinary variations in the anatomy of the individual cervix.
• If the cervix has uneven sides, is exceptionally long or short, or is irregularly shaped, it usually is impossible to achieve the snug fit necessary for effective birth control. If the uterus is extremely anteflexed — bent so the cervix points back toward the spine - the cap could easily be dislodged.
• A woman may not be able to use a cervical cap because she has a very long vagina and cannot reach her cervix to place a cap on it. An experienced cervical cap fitter can usually identify these problems.