Occlusive caps are used as means to retain spermicides in contact with cervical os.
Spermicides must be used along with devices.
Women need to be instructed to use of the device by a doctor.
Usually manufactured from latex rubber and have got a storage and usage life.
They are of four types:
1.Vaginal diaphragm
2.Cervical cap or check pessary
3.Vault cap
4.Vinule cap
1.VaginalDiaphragms:
These are the most common form of occlusive caps.
Easiest to fit & use.
The diaphragm is a soft latex rubber cup that should be used with spermicidal jelly or cream. Available in sizes from 45 mm diameter to 105 mm.
Most commonly used are 60, 65, 70, 75, 80 mm sizes, height varies from maker to maker.
The length from posterior vaginal fornix to symphysis pubis in cms minus one cm is the size of diaphragm generally suitable.
The women inserts a diaphragm into her vagina, fitting it over the cervix, shortly before the sexual intercourse and leaves it in place for at least 6 to 8 hrs after intercourse.
If sexual act vaginally is delayed more than two hours or intercourse is repeated after a few hours, an applicator full of spermicidal by cream or jelly should be introduced earlier as it takes time to dissolve.
Mechanism of action:
Diaphragm blocks sperm from entering the uterine cavity. Spermicides provide additional protection by damaging the sperms. Can be used by women of any reproductive age group and parity who want to use this method of contraception.
Contraindications:
It can't be used within 6 wks after delivery because of chances of infection and as there will be laxity of tissues it will not stay in place. Also in those people who are having allergy to latex it can't be used.
In women with history of toxic shock syndrome, better to avoid using diaphragm because if it retained in vagina precipitation of syndrome can occur.
And in certain anatomical abnormalities of cervix and vagina, where diaphragm cannot be retained in position it can't be used.
Advantages:
Diaphragm is a woman controlled method and possible to use without male partner's co-operation.
Offers contraception only when needed.
So useful for irregular and unplanned sexual intercourse. Effective if used correctly with every act of sexual intercourse.
It is having no systemic side effects. And has no impact on lactation.
Can be stopped at any time and can be inserted before sex to avoid interrupting of sex.
Provides some protection from STDs.
And also reduces the risk of neoplasia.
Contains menstrual flow when used during menses.
Disadvantages:
Initially the diaphragm requires fitting by a family planning provider, involving a pelvic examination.
A woman may need a different size diaphragm after the child birth. Requires having the method on hand and taking correct action before each act of sexual intercourse.
Less effective contraceptive method than IUDs(intra uterine contraceptive devices) or systemic methods.
Interrupts sex if not inserted before hand.
And may be messy to use. The possible side effects usually are local irritation or allergic reaction to latex.
It should be washed with soap and clean water after every use.
And needs careful storage to avoid developing of holes.
Requires a steady supply of spermicide, without it the diaphragm is not very much useful. AIDS and other sexually transmitted diseases are not effectively prevented by this method.
Repeated usage and pressure on urethra while using increases the risk of urinary tract infections.
Effectiveness:
The failure rates of the diaphragm are 18 to 28% as commonly used and 6% when used consistently and properly with spermicide. Diaphragms should be replaced anytime between 6 months to 2 yrs depending on its use.
Spermicides
Spermicides must be used along with devices.
Women need to be instructed to use of the device by a doctor.
Usually manufactured from latex rubber and have got a storage and usage life.
They are of four types:
1.Vaginal diaphragm
2.Cervical cap or check pessary
3.Vault cap
4.Vinule cap
1.VaginalDiaphragms:
These are the most common form of occlusive caps.
Easiest to fit & use.
The diaphragm is a soft latex rubber cup that should be used with spermicidal jelly or cream. Available in sizes from 45 mm diameter to 105 mm.
Most commonly used are 60, 65, 70, 75, 80 mm sizes, height varies from maker to maker.
The length from posterior vaginal fornix to symphysis pubis in cms minus one cm is the size of diaphragm generally suitable.
The women inserts a diaphragm into her vagina, fitting it over the cervix, shortly before the sexual intercourse and leaves it in place for at least 6 to 8 hrs after intercourse.
If sexual act vaginally is delayed more than two hours or intercourse is repeated after a few hours, an applicator full of spermicidal by cream or jelly should be introduced earlier as it takes time to dissolve.
Mechanism of action:
Diaphragm blocks sperm from entering the uterine cavity. Spermicides provide additional protection by damaging the sperms. Can be used by women of any reproductive age group and parity who want to use this method of contraception.
Contraindications:
It can't be used within 6 wks after delivery because of chances of infection and as there will be laxity of tissues it will not stay in place. Also in those people who are having allergy to latex it can't be used.
In women with history of toxic shock syndrome, better to avoid using diaphragm because if it retained in vagina precipitation of syndrome can occur.
And in certain anatomical abnormalities of cervix and vagina, where diaphragm cannot be retained in position it can't be used.
Advantages:
Diaphragm is a woman controlled method and possible to use without male partner's co-operation.
Offers contraception only when needed.
So useful for irregular and unplanned sexual intercourse. Effective if used correctly with every act of sexual intercourse.
It is having no systemic side effects. And has no impact on lactation.
Can be stopped at any time and can be inserted before sex to avoid interrupting of sex.
Provides some protection from STDs.
And also reduces the risk of neoplasia.
Contains menstrual flow when used during menses.
Disadvantages:
Initially the diaphragm requires fitting by a family planning provider, involving a pelvic examination.
A woman may need a different size diaphragm after the child birth. Requires having the method on hand and taking correct action before each act of sexual intercourse.
Less effective contraceptive method than IUDs(intra uterine contraceptive devices) or systemic methods.
Interrupts sex if not inserted before hand.
And may be messy to use. The possible side effects usually are local irritation or allergic reaction to latex.
It should be washed with soap and clean water after every use.
And needs careful storage to avoid developing of holes.
Requires a steady supply of spermicide, without it the diaphragm is not very much useful. AIDS and other sexually transmitted diseases are not effectively prevented by this method.
Repeated usage and pressure on urethra while using increases the risk of urinary tract infections.
Effectiveness:
The failure rates of the diaphragm are 18 to 28% as commonly used and 6% when used consistently and properly with spermicide. Diaphragms should be replaced anytime between 6 months to 2 yrs depending on its use.
Spermicides
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