|
|
|
Barrier methods
Barrier methods provide not only contraception but also offer protection against sexually transmitted infections (STIs). In NZ, sexually active women who are not in a stable relationship are more likely to use condoms than those in a stable relationship. However we obviously still have some way to go in STI protection as yearly Durex studies continue to show that a significant number of New Zealanders had had sex with a new partner in the previous year without using a condom. The numbers are higher than for many other European countries and Australia.
We are talking here about condoms for men and diaphragms and the female condom for women. There are different types and size of condoms some of which are subsidized. This means that they cost $5 for 144. Check the Pharmac schedule to familiarise yourself with the brands that are fully subsidized now, though be aware that this list is updated monthly - https://www.pharmac.govt.nz/tools-resources/pharmaceutical-schedule/
For men there are latex condoms which come in different sizes and also a polyurethane condom for those with rubber allergies. Latex condoms are available with or without spermicide. However some studies have shown that the irritant effect of the spermicide on the vaginal mucosa can actually increase the risk of acquiring a STI and non-spermicidal condoms are now recommended.
Barrier methods for women consist of the female condom and diaphragms. The female condom is available online. The female condom is made of polyurethane and is one size. Diaphragms are available in different sizes (65-90 mm) and should be fitted by trained personnel. Cervical caps are no longer being manufactured.
If you have a copy, John Guillebaud's book will give you further information on barrier methods.
Activity: Condom usage
One of the most overlooked problems with condom use is the fact that some men have never been taught correct use. Women also need to know these details .You must therefore as a practitioner not assume that potential or even regular users have this information and when giving a script, go over this with them.
- On a piece of paper, list the steps you consider essential for correct condom use.
- Now compare your own list with this pictorial one.
- How does the sequence you have chosen compare with the pictorial one shown?
Note: Condoms need to be unrolled in the correct direction - if you try to do this with the condom inside out it will not roll out correctly. Squeezing the air out of the tip and using lubricating jelly helps prevent condom breakages. Discuss extra lubrication with condom users - you will need to know the names of some commonly available brands.
Click here for a detailed view of the correct usage of condoms.
