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  1. 1
    029804

    Barrier methods of contraception.

    Kleinman RL

    London, England, International Planned Parenthood Federation, 1985. 48 p. (IPPF Medical Publications.)

    This booklet, published by the International Planned Parenthood Federation (IPPF), discusses the mode of action of barrier methods of contraception--their advantages, disadvantages, and effectiveness. Each method is dealt with in detail under the headings of 'application,' 'instruction to users,' 'advantages,' 'disadvantages and side-effects' and 'effectiveness.' Areas of research and safety issues are also discussed. The various types of barrier contraceptives are: 1) spermicides--creams, jellies, melting suppositories, foaming suppositories or tablets, and aerosol foams; 2) unmedicated mechanical barriers--vagnial diaphrams and cervical caps, including cavity-rim, Vimule and vault caps; 3) medicated mechanical barriers--vaginal sponges; and 4) condoms. When used properly and conscientiously, the contraceptive agents are both safe and effective, although their mode of action may be more complex than has been assumed in the past. The function of barrier contraceptives is to block the passage of sperm into the cervical mucus; the condom prevents sperm from being deposited in the vagina, whereas the vaginal barriers interfere with sperm transport after semen has entered the vagina. In addition to blocking the intial wave of sperm form entering the cervix, the spermicidal preparations also kill the sperm within the vagina; most products now in use contain a nonionic surface active agent as a spermicide. Favorable attributes of barrier methods are: 1) few local side effects, 2) no highly skilled medical intervention is needed, 3) they are applied locally in the vagina, 4) they may inhibit sexually transmitted diseases, 5) there are few medical contraindications to their use, and 6) most are available without prescription. Disadvantages are: 1) they are generally less effective than most hormonal contraceptive and IUDs, 2) strong motivation is required for successful use, 3) they require manipulation of the genitalia, 4) some types are inconvenient or messy, and 5) most must be applied at or near the time of sexual intercourse. New spermicides, custom fitted cervical caps, and enzyme inhibitors are some of the new methods being researched and developed. The appendix includes the IPPF policy statement on barrier methods of contraception.
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  2. 2
    791681

    Jost intra-vaginal-device: a spermicidal sponge.

    TYRER LB; BRADSHAW LE

    [Unpublished] 1979. Presented at the Program for Applied Research on Fertility Regulation and Asociacion Pro-bienestar de la Familia de Guatemala International Workshop on New Devleopments in vaginal Contraception. Guatemala City, Guatemala, April 25-27, 1979. 9 p.

    The Jost intravaginal device (IVD) incorporates nonoxynol into a resilient, open-and-closed-cell polyurethane plug and is designed primarily as a spermicidal contraceptive with secondary action as a barrier to the cervical os. The IVD is applied via an applicator high into the vaginal canal where it expands and conforms to the shape of the vaginal vault. The spermicide is released during coital thrusts as a foam. In vivo spermicidal screening tests in macaque monkeys showed that in a group of 6 monkeys mated 24 hours after IVD insertion 5 aspirated vaginal specimens were free of motile sperm; however, 6 monkeys mated after 10 minutes of IVD insertion showed 17% motile sperm in aspirates. Phase 1 use-effectiveness studies are underway in Sweden; preliminary data on 200 women using the device for 7 months indicate high acceptability. Phase 2 will be carried out in planned parenthood clinics in the United States, using 200 volunteers who were previously sterilized. Retention times will vary from 24-72 hours. Another study must be designed to determine in vivo spermicidal efficacy.
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