Birth Control Options – Barrier Methods

How do I choose a birth control or contraception option?

Many factors go into choosing a birth control option, ranging from personal comfort, life goals, health conditions, and the thoughts and opinions of your sexual partner(s). Thinking about your lifestyle and speaking with a health care provider may help provide you with more information so you can make a more informed decision. 

Some questions to consider before choosing a birth control option may include: 

• What are your goals with starting birth control? Is it to prevent pregnancy, STIs, both, or maybe something else entirely? 
• Do you have health conditions that may be affected by any of the birth control options? 
• What are the potential side effects of each option? 
• How much effort is involved in using specific options? How much effort are you willing to put in to prevent pregnancy or STIs? 
• What is the effectiveness of the birth control option in preventing pregnancy? In preventing STIs? 
• If it’s pregnancy you’re trying to prevent, how often do you engage in penile-vaginal sex? 
• If you would like to become pregnant now or in the future, how soon would you like that to occur? 
• What are you most comfortable with? 
• How many sex partners do you have? What are your sex partners comfortable with? 

The various birth control methods have their benefits and disadvantages, and often these depend on peoples’ different perspectives and lifestyles. What works for someone else may not work for you and vice versa. That said, some trial and error may be involved in finding the best fit for you.

How do the barrier methods work?

These methods attempt to block sperm from fertilizing an egg, either with a physical barrier or a substance that lowers the ability for sperm to swim and meet an egg. Some options can also reduce the chance of contracting or spreading STIs.

What are the barrier options?

The following sections describe the barrier methods from most to least effective in preventing pregnancy.

External condoms 

• Three types: latex, plastic (latex-free), and lambskin (animal skin) 
• Recommended to use condoms with lube for lubrication and to reduce the chances of tearing or breaking 
  • Water-based and silicone lubes can be used with all types of condoms, but oil-based lube can damage latex condoms which increases their risk of breaking 
• Latex or plastic condoms prevent the risk of STIs 
  • However, you can still get an STI with an animal skin condom 
• Use every time you have sex 
• Some potential side effects: irritation from sensitivity to latex, discomfort  
• Effectiveness rate: 88 percent 

Contraceptive gel (“Phexxi”) 

• Gel is applied inside the vagina before sex to prevent sperm from swimming to the egg 
• Gel is made of lactic acid, citric acid, and potassium bitartrate 
• Gel keeps the vagina at its normal acidity level of 3.5 to 4.5 pH, which reduces the viability of sperm 
• Recommended to be used with other barrier methods like diaphragm or cervical cap 
• Apply one dose inside the vagina before sex, every time you have sexual intercourse 
• Phexxi is effective for one hour, after which a new dose should be applied if you’re still having sexual intercourse within the same sexual encounter 
• Some potential side effects: irritation in vulvovaginal area, genital discomfort 
• Effectiveness rate (when used alone): 86 percent 

Diaphragm or cervical cap 

• Small dish or cup placed in the vagina by the individual to cover the cervix 
• Wash hands with soap and water thoroughly before inserting and removing to prevent infection 
• Recommended to be used with spermicide (read on for more information) 
• Use every time you have sex 
• Some potential side effects: discomfort, increased risk of toxic shock syndrome, irritation from sensitivity to spermicide, increased risk of urinary tract infections 
• Effectiveness rate: 71 to 88 percent 

Internal condom 

• Made of nitrile, a type of soft plastic that is hypoallergenic 
• Placed inside the vagina by the individual before sex (can also be placed in the anus) 
• Wash hands with soap and water thoroughly before inserting and removing to prevent infection 
• Use every time you have sex 
• Can also protect against STIs 
• Can be used with lube, and some are made with lubrication, but more can be added 
• Some potential side effects: discomfort or irritation 
• Effectiveness rate: 75 to 79 percent 

Sponge 

• Squishy plastic device placed inside the vagina by the individual to cover the cervix 
• Wash hands with soap and water thoroughly before inserting or removing to prevent infection 
• Can be inserted up to 24 hours before sex 
• Leave in place for at least six hours after sex, and then discard upon removal 
• Contains spermicide (read on for more information) 
• Use every time you have sex 
• More effective in people who have not given birth before 
• While no longer available for purchase in the United States, it’s still recognized as a barrier method by many health organizations 
• Some potential side effects: discomfort, irritation from sensitivity to spermicide, increased risk of toxic shock syndrome 
• Effectiveness rate: 73 to 86 percent 

Spermicide 

• Substance applied to another barrier method or applied directly into the vagina to cover the cervix and prevent sperm from swimming to the egg 
  • Can come in the form of gel, cream, film, foam, or a suppository (melts into a cream) 
• Recommended to be used with other barrier methods like diaphragm or cervical cap 
• Apply one dose every time you have sexual intercourse 
• If using in the vagina, apply 10 to 15 minutes before sex, otherwise apply to the barrier method before sex 
• Most spermicides last about one hour, after which a new dose should be applied if you’re still having sexual intercourse within the same sexual encounter 
• Some potential side effects: irritation from sensitivity, increased risk of STIs 
• Effectiveness rate: 79 percent 

Last reviewed/updated: February 14, 2024