Friday 22 November 2013

Barrier contraceptives - Spermicides

D. Spermicides
Spermicides are chemical barriers that consists of two components: a spermicidal chemical, most commonly nonoxynol-9 and a delivery base.
Spermicides can be delivered through foam, cream, jelly, film, suppositories or tablets.
They can be used either alone or with another contraceptive method.

Mechanism of action:
They will inactivate or kill sperm, making fertilization unlikely and also act as mechanical barriers. Should be introduced ½ hour before the sexual act, including 10 minutes time to allow the tablet to melt.
No douching is permitted with in 8 hrs.
Can be used by:
Women who cannot or do not want to use hormonal methods.
Couples who have sexual intercourse infrequently.
Women wanting a method that they control.
Breast feeding women who need contraception.

Should not be used by:
Women having cervical cancer (awaiting treatment)
High risk of HIV.

Advantages:
Spermicides are effective at preventing pregnancy when used consistently and correctly.
They are safe, with no systemic side effects.
Easy to initiate and discontinue with immediate return to fertility. Do not require clinical visit while starting or partner co-operation while using.

Disadvantages:
Spermicides are not effective as other methods in typical use.
Side effects like local irritation can occur, especially if used several times a day.
May interrupt sexual activity. Usage can be messy.
Can make yeast infection or urinary tract infections more common because of repeated use and local aberrations.
Formally thought to reduce the risk of STDs but research found no protection against them.

Effectiveness:
The failure rate of spermicides when commonly used is 21%.
That can be decreased to 6% when used correctly and consistently. 

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