State-of-the-art of non-hormonal methods of contraception: I. Mechanical barrier contraception

Abstract

Mechanical barriers, specifically male condoms, command renewed interest and are used today by more people. The worldwide prevalence rate of male condoms was about 6% in 2007 corresponding to 65 million cohabiting couples. The prevalence of female barrier methods, including diaphragms, cervical caps and female condoms has declined to less than 1% of women in North America and in north-west Europe. Even smaller percentages use female barriers elsewhere. First-year life table pregnancy probabilities of mechanical barrier methods range from 4 to 19 per hundred in clinical trials. The male condom is the only proved preventive tool against several sexually transmitted infections (STIs), especially HIV. The effectiveness of the diaphragm and cervical caps in this regard appears limited. Further research is needed to measure the efficacy of female condoms in disease prevention. Sponges are not known to protect against STIs. Because of their ease of use and availability, low short-term costs, relative freedom from side effects, and usefulness in combating STIs, mechanical barrier methods, especially condoms, will continue to be used on a large scale. For our literature search we used personal files, search engines such as Popline, Medline, PubMed and Google, and data bases of WHO, FHI and Cochrane Library.

KEY WORDS:

• Mechanical barrier contraception
• Male condoms
• Female condoms
• Diaphragm
• Cervical cap
• Contraceptive sponges

Acknowledgement

The paper was prepared at the request of the Internal Scientific Committee of the European Society of Contraception and Reproductive Health (ESC).

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and the writing of the paper.