Condoms are soft, one-time-use, disposable tubes or sheaths that fit over an erect penis. They come in various sizes, shapes and thicknesses, and some come pre-lubricated while others come without lubrication. Most condoms are made of latex which is a type of rubber, but non-latex polyurethane options exist, which is useful for people with latex allergies or sensitivities. The condom is placed on an erect (hard) penis and gently unrolled, and it works by preventing sperm from entering the other person’s body during penetrative sex or oral sex. Condoms can be used for anal sex, vaginal sex or oral sex on a penis (many prefer the non-lubricated condoms for oral sex, as the lubrication has a texture and taste). Condoms are only form of birth control that also protects against many STIs, like chlamydia, gonorrhea, and HIV. Condoms can be bought from most pharmacies and convenience stores, and many sexual health centres will give them out for free.
Pro-tips: It’s important to store condoms in cool and dry places like backpacks, purses, or bedside drawers (as opposed to your wallet, glove box, or the pockets of your skinny jeans) to make sure the heat doesn’t break them down. Using water or silicone-based lubricants on the inside (just a few drops) and outside of the condom can enhance sexual enjoyment for both partners and reduces friction that can cause tears. Do not use oil based lubricants such as petroleum jelly, massage oil or hand lotion because they will break down the latex, causing a risk of the condom tearing. Only use one condom at a time – for example, don’t double up two condoms together as the friction can cause the condom to tear.
Pros: Condoms are your number one prevention strategy against STBBIs if you are sexually active. They are also easily accessible. Most latex condoms are fairly inexpensive and can be purchased at pharmacies, corner stores and vending machines. Many sexual health clinics, medical clinics, and youth drop-in centres have free condoms available.
Cons: Condoms can tear, slip off, and may reduce sensation for some people. If you have vaginal sex and the condom breaks, you can get emergency contraception (it is most effective the earlier it is taken, up to 5 days after sex). Latex condoms can cause an allergic reaction if you are allergic to rubber. Polyurethane condoms are available but are a bit more expensive. Condoms also expire over time, so it’s important to check the expiry date on the back of the condom wrapper. A person’s penis has to be erect in order to put a condom on. One condom is only good for one ejaculation.
Effectiveness: Condoms are 85% effective with typical use and 98% effective with perfect use.
The internal condom (the reality condom or the “female condom”)
The internal condom is a lubricated sheath or tube made of polyurethane that is inserted into the vagina or the anus before sex. The internal condom can help prevent pregnancy, STIs, or both. When used vaginally, one end of the condom covers the cervix and the other end covers the external genitals and sits at the opening of the vagina. The internal condom stops sperm from entering the person’s body. When used for anal sex, the inner ring of the condom is inserted into the rectum and the outside ring rests on the anus. The internal condom can also be used like an external condom if you take the inner ring out and put the condom directly onto the penis.
Pro-tips: The internal condom is usually available in drugstores but may be a bit harder to find than other condoms Some sexual health centers may carry them and offer them for free. One condom can only be used for one act of sex. Never use two condoms together – like . an internal condom paired with a regular condom— because the friction can tear both condoms.
Pros: It protects against both STIs and pregnancy. It can increase pleasure for some people because the outer ring may rub against the clitoris. Many people like the internal condom because it fits loosely around their penis. Polyurethane transmits heat better than latex, which may also enhance pleasure. It can be used if you have an allergy to latex. The penis doesn’t need to be erect in order to use it.
Cons: It can be messy, tear or slip out of place, and some people may have a hard time putting it in. You have to make sure the condom stays in place or the penis could slip out and enter the vagina or rectum outside the condom. (If your partner’s penis slips out of the condom and enters your vagina, you can take emergency contraception up to 5 days after having sex). The condom can also make funny noises during intercourse because it’s made of plastic. Adding extra water-based lubricant can help reduce the noise. These condoms are more expensive than most others.
Effectiveness: The internal condom is 79% effective with typical use and 95% effective with perfect use.
The Cervical Cap
The cervical cap is a small, thimble-shaped flexible cap that is inserted into the vagina before vaginal sex. It covers the cervix and prevents sperm from getting inside during penetrative sex with a penis. The cervical cap is used with a spermicidal jelly to help prevent pregnancy, and spermicide should be reapplied each time you have sex It’s important not to use any kind of oil based lubricants such as petroleum jelly, massage oil, or hand cream during sex, as this can break down the latex in the cervical cap.
You should know: In Canada, the only cervical cap available is called FemCap. The FemCap distributer also stocks a contraceptive gel called Contragel that they recommend as the accompanying spermicidal jelly. As of August 2009, apart from Contragel, it’s difficult to purchase the necessary spermicidal jelly. Ask your health care provider for more information.
Pros: Can be inserted ahead of time so sex play is not interrupted. The cap may be a good choice for people who do not want to use hormonal birth control. It can be used multiple times and does not have to be discarded after one use, but spermicide does need to be reapplied each time. The cervical cap is small & discreet and can be easily carried around in a purse or bag.
Cons: Some find the cervical cap hard to insert. Some people may be allergic to the latex or develop an irritation from the spermicide. The cervical cap does not protect against STIs. It has to be fitted by a doctor since they come in different sizes. It may be very hard to find a doctor who knows how to fit a cervical cap, or to find the spermicidal jelly to pair with the cap as it is no longer made in Canada. Some people also simply find that it doesn’t fit them, particularly if you have given birth via vaginal delivery.
Effectiveness: The cervical cap is 40-60% effective with typical use and 74-94% effective with perfect use. It is less effective for those who have given birth via vaginal delivery.
The Contraceptive Sponge
The sponge is a soft round sponge made of polyurethane that is soaked in spermicide. You can buy it at the pharmacy and insert it into your vagina before intercourse. The sponge covers the cervix and traps and blocks sperm from getting into the uterus, while the spermicide kills the sperm. The sponge has to be in the vagina for 6-8 hours after ejaculation to ensure that all sperm are killed, and it can be left in for up to 24 hours. It should be removed no later than 24 hours after sex to avoid a possible infection.
Pros: The sponge can be inserted several hours before having sex. You do not require a prescription to get the sponge. It can be purchased at pharmacies. It’s good for multiple ejaculations (as long as it’s left in 6-8 hours after the last ejaculation). The package is discreet, making it easy to carry in a purse or bag. It does not contain hormones, making it an option for those who are sensitive to hormones.
Cons: It’s possible to develop an irritation from the spermicides. If the sponge is left in too long there is a risk of developing Toxic Shock Syndrome (TSS), which can be very harmful if not treated. The sponge will not protect against STIs. The active ingredient in the spermicide can also be irritating to the vaginal wall, making you more susceptible an STI.
Effectiveness: The sponge is 68% effective with typical use and 80% effective with perfect use. The sponge can be less effective for people who have given birth vaginally.
A diaphragm is a soft, dome-shaped cup made of latex or silicone, with a flexible steel ring around the edge. You insert it into the vagina before penetrative vaginal sex to prevent pregnancy. The diaphragm needs to be filled with spermicide, about 1 teaspoon full in the cup or dome, spread around the rim of the diaphragm. It then covers your cervix to block sperm from entering. It can sometimes be a bit difficult to find the necessary spermicidal jelly to use with the diaphragm, as it is no longer made in Canada. Diaphragms are not one size fits all – they come in different sizes, so at first, a health care provider will fit you for your diaphragm and show you how to insert and remove it. If you give birth via vaginal delivery, it’s important that you are refitted for you diaphragm as you may need a different size.
Pros: You can insert the diaphragm ahead of time, so sex is not interrupted. It’s reusable, so you don’t have to use a new one every time you have sex. However, you do need to apply more spermicide each time to ensure optimal effectiveness. The case that holds the diaphragm is fairly discrete and can easily be carried in a purse or bag. The diaphragm does not contain hormones, making it an option for those who are sensitive to hormones.
Cons: Some people find the diaphragm to be messy or hard to insert and remove. Some people develop an irritation from the spermicide, which can make it more possible to get an STI. Some people develop urinary tract infections from using a diaphragm. The diaphragm doesn’t protect against STIs. Diaphragms have to be fitted by a doctor or a health worker because they come in different sizes. It may be hard to find a doctor who knows how to fit a diaphragm.
Effectiveness: The diaphragm is 84% effective with typical use and 94% effective with typical use.
Spermicides are contraceptive foams, jellies, tablets, suppositories, or films that you insert into your vagina before having vaginal sex to help prevent pregnancy. Spermicides work by slowing down the mobility of sperm and/or killing sperm. Typically, spermicides are combined with other birth control methods, such a condom, cervical cap, or diaphragm.
Pros: Contraceptive film is very small and discrete and can be easily carried in a purse or bag. Spermicides may be a good choice for people who do not want to use hormonal contraception. When used with a condom, spermicides are approximately 99% effective in preventing pregnancy. Spermicides do not require a doctor’s prescription and can be purchased at pharmacies.
Cons: If you or your partner(s) has an allergy to nonoxynol–9 (the main ingredient in the spermicide) it may cause irritation inside the vagina or on the penis. This irritation can make it more possible to get an STI. Some people find spermicides messy. Spermicides do not taste good, so if you are planning to have oral sex, you may want to consider another option. Spermicides do not protect against STIs.
A dental dam is a soft, disposable sheet of latex or polyisoprene that is held over the vulva or anus to prevent the exchange of fluids and avoid skin-to-skin contact. The dental dam is thrown away after sex. They are used to prevent STIs, but do not prevent pregnancy.
Pros: It prevents fluids from being exchanged, as well as skin-to-skin contact, which reduces the risk of STIs. The polyisoprene option is suitable for people with a latex allergy, and dental dams contain no hormones.
Cons: It is possible for dental dams to slip or break during sex, especially during oral sex if teeth are used. Some may find that they reduce sexual spontaneity or sensitivity. They can be a bit difficult to use at first but become easier with time.
Gloves are latex or non-latex gloves used to either cover the hands during sexual activity (fisting, fingering, etc) or cut open sideway to serve as a dental dam. Gloves are thrown away after sex. Like dental dams, they are used to prevent STIs but not prevent pregnancy.
Pros: Gloves can be used to cover things on your hands (like small cuts, hangnails, eczema, or fresh tattoos) where it might be possible to transmit or receive STIs that are transitable through blood or other bodily fluids. They are relatively easy to find, and non-latex options exist for those with a latex allergy. They contain no hormones.
Cons: A new glove must be used each time or for each body part. They may reduce sexual spontaneity or sensitivity.