Barrier methods of contraception

She will need to consider barrier methods of contraception as she can still conceive for up to 2 years after her periods stop. 

If more than 12 hours have elapsed, the above procedure should be followed but an additional barrier method of contraception should be used for 7 days (or abstinence). Whereas the protective effect of cervical mucus returns within 48h, this 7-day period is needed to ensure effective suppression of an ovulation that may have been initiated by the missed piU. s... 

If using a barrier method of contraception (e.g. latex diaphragm, cap or condoms), it may be damaged and become ineffective with... 

Hormone therapy Ethinylestradlol, norethindrone Women of reproductive potential on oral contraceptives should be advised to add a barrier method of contraception when taking a rifamycin. 

Gilliam ML, Derman RJ. Barrier methods of contraception. Obstet Gynecol Clin North Am 2000 27 841-858. 

The male barrier contraceptive device is known as the condom, or mbber, and is widely available in most countries. The condom is a mbber or latex sheath, sometimes packaged with a lubricant and spermicide, which serves as a cover for the penis and a receptacle for semen. The method is very effective if the condom is of good quaUty, remains on, and is replaced for each subsequent intercourse. It was reported that 6 biUion condoms were used in 1990 (101). Usage appears to be increasing as adjunctive use with other methods of contraception for prevention of HIV or other sexually transmitted diseases. By rough estimate, condoms may have been used in more than 13 biUion acts of sexual intercourse that risked unwanted pregnancy, HIV, and/or other sexually transmitted diseases (101). 

Note that whatever other methods of contraception are being used, barrier methods are also advisable to reduce the risk of HIV transmission. 

It is likely that nevirapine induces the metabolism of the components of the oral contraceptive by cytochrome P450 isoenzymes. Although it is not known whether these modest reductions in levels would reduce the anti-ovulatory efficacy of the combined oral contraceptive, it would be prudent to assume they could. The manufacturers recommend that combined oral contraceptives and other hormonal methods of birth control should not be used as the sole method of contraception in women taking nevirapine. They suggest that a barrier method (e.g. condoms) should also be used, and note that this is also advisable to reduce the risk of HTV transmission. The Faculty of Family Planning and Reproductive Health Care (FFPRHC) Clinical Effectiveness Unit notes that nevirapine can induce liver enzymes and may reduce the levels of ethinylestradiol and progestogens. They therefore recommend that their guidance on hormonal contraceptives and liver enzyme inducers is followed, see Hormonal contraceptives + Antiepileptics Barbiturates or Phenytoin , p.985 for fiir-ther detail. 

Various physical barrier devices are available for contraceptive use by men and women. Modem barrier methods such as diaphragms, condoms, and cervical caps were made possible by the discovery of the vulcanisation of mbber. 

Sexual behavior of the female must be determined to understand the risk for STDs. Women who are not in a monogamous relationship must consider their risk of STDs as a factor in their contraceptive decision. Some barrier methods protect against STDs, but agents such as hormonal contraceptives are not capable of preventing STDs if used alone. 

It is obvious that these commonalties can be tailored to achieve successful contraceptive formulations with varying degrees of efficacy, user friendliness, and aesthetics. U.S. marketed contraceptive products all contain N9 as the spermicide at various concentrations. These products rely only on the mechanism of sperm destruction by the nondiscriminating surfactant effects of the spermicide, as effects of the carrier system on sperm motility are generally minimal. No claim of activity against STDs and HIV are made by current contraceptive products, with the exception of full barrier methods such as condoms. 

Spermicides kill sperm. They are not completely effective as contraceptives when used alone but they improve the effectiveness of barrier methods. For centuries, women have used a variety of substances in conjunction with pads or sponges to prevent conception. Acids, such as vinegar, lemon juice and even Coca-Cola, restrict the motility of sperm, so that movement through the vagina is significantly restricted. 

The preferred choice of contraception for any woman with liver disease would be a barrier method, thereby avoiding any interaction with the... 

Condoms should be recommended to infectious patients to prevent the spread of viral hepatitis [31]. In all other liver diseases the barrier method provides an ideal non-hormonal option for contraception. 

NEVIRAPINE OESTROGENS -ETHINYLESTRADIOL Marked si contraceptive effect with nevirapine Induction of metabolism of oestrogens Avoid co-administration, recommend alternative non-hormonal contraceptives - barrier methods are necessary to prevent transmission of infection... 

PROTEASE INHIBITORS OESTROGENS Marked 1 contraceptive effect with nelfinavir and ritonavir Induction of metabolism of oestrogens Advise patients to use additional contraception for the period of intake and for 1 month after stopping co-administration with nelfinavir and ritonavir. Barrier methods are necessaiy to prevent transmission of infection from patients with HIV... 

St John s wort 2. Red clover 3. Saw palmetto 1. Oral contraceptives Failure of contraception. Theoretically, saw palmetto could interfere with oral contraception and hormone replacement therapy St John s wort preparations induce metabolizing CYP3A4 enzymes and glycoprotein drug transporters of these medications Avoid concomitant use. Use an alternative contraceptive methods (barrier methods) if the herb is introduced... 

Use of spermicides in the vagina (They are used in combination with barrier methods. This is strictly chemical rather than hormonal contraception as also are intrauterine devices that contain copper, which is gametocidal). 

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