Female-Controlled Vaginal Barrier Methods: Forgotten but Not Gone

When Margaret Sanger coined the term in the early 1900s, “birth control” meant the diaphragm, a soft rubber dome that’s placed in the vagina to block sperm. In 1916, Sanger was arrested and jailed for telling women how to use a diaphragm. In 1936, after years of court battles, physician–prescribed birth control was legalized in the United States. Diaphragm use became widespread until the 1950s, when the Pill, the first hormonal contraceptive, began replacing the diaphragm. Intrauterine devices (IUDs) and various hormonal methods followed, and vaginal barriers slipped out of focus.

During the 1970s and 1980s, however, young people sought a non-hormonal, female-controlled method that allowed them to experience their natural menstrual cycles. They became interested in old-fashioned methods their mothers might have used, and—through word-of-mouth and feminist publications—vaginal barriers became popular again.

Benefits of Vaginal Barrier Methods

Unlike provider-controlled methods like the Pill, vaginal barriers are easy to stop and start. They’re immediately effective, with no waiting period before they prevent pregnancy, as with hormonal methods. Fifteen minutes after placing the barrier in your vagina, you’re protected. So, there’s no need to use the method unless you have sex in a way that could cause pregnancy. For those who don’t have penis in vagina (PIV) sex very often, a barrier method can be an excellent method.

You don’t have to go to a provider to stop using vaginal barriers, unlike IUDs. They have no lingering effects that might make it hard to get pregnant after you stop using the method, which may be true with some hormonal methods (although the data isn’t clear). If you decide you want to get pregnant, you don’t use the barrier. One barrier method user commented, “We talked for months about having a baby. It seemed like there would never be a right time. Then, one night, we just decided not to use the sponge, just go for it.”

Barrier methods’ effects are local to the vagina. They don’t introduce chemicals or objects into your uterus, like an IUD, or your bloodstream, like artificial hormones. For those who avoid unnatural dietary additives, non-hormonal barrier methods can be a logical next step. Barrier methods appeal to women who want to experience, affirm, or celebrate their natural hormonal cycles.

If your vaginal barrier is the right size and is inserted correctly, neither you nor your partner should feel it during PIV sex. Vaginal barriers don’t interfere with spontaneity since they can be inserted one or more hours beforehand.

Barrier methods don’t cause heavy bleeding, mood changes, or any of the other effects that sometimes occur with hormonal contraception and IUDs. And, they don’t have any of hormonal contraception’s extremely rare but very serious side effects, like heart attack and stroke. “I wanted a hormone-free method, so I got the copper IUD. But I had so much pain and bleeding that I had it taken out and changed to the cervical cap,” said one user. “The cap is really convenient [and] without the pain.”

Using a Vaginal Barrier Method

Touching one’s genitals, an integral part of vaginal barrier method use, is one reason people decide against the method. Genital contact can also be an advantage to the method, however, because placing the barrier helps people learn about their bodies and take an active role in contraceptive use. One nurse practitioner suggests that menstrual cups’ popularity has lead to increased demand for vaginal barriers. “Now that menstrual cups are so popular, people are more comfortable with using a vaginal barrier. They are used to putting the menstrual cup in and feeling their cervix, which makes it easier to use a vaginal barrier.”

The first time you insert a vaginal barrier, it may feel strange. But, most people learn quickly and with practice, it becomes easy to push the barrier method towards the back part of your vagina and ensure it’s placed properly. “It was kind of awkward at first, but now I can put it in really easily, even in the dark in a sleeping bag,” said one diaphragm user. “It’s like learning to use a bicycle—once you learn it, you never forget.”

Types of Vaginal Barrier Methods

The table below describes the differences among the different vaginal barriers. You can get complete directions and information from your health care provider and the consumer instruction booklet.

Vaginal barriers don’t prevent pregnancy as reliably as hormonal methods or IUDs. If you use a vaginal barrier method correctly every time you have PIV sex, however, your personal effectiveness rate will increase. If you use the vaginal barrier and another method, effectiveness increases more. For example, some people use withdrawal in addition to their barrier method. Note that there’s very little research comparing different types of birth controls’ effectiveness, and research on vaginal barriers is particularly unsatisfactory.

Multi-use barrier methods work best with the addition of spermicide that slows down and kills sperm. Spermicide, which comes in the forms of cream, gel, foam, film, and suppository, can also be used alone as a barrier method. When using spermicide as a barrier, you can use an applicator to push it to the end of your vagina. Although it’s possible to develop vaginal irritation from the most common spermicide, nonoxynol 9, other less irritating, alternatives include ContraGel (not FDA-approved) and Phexxi.

Number of pregnancies that would occur if 100 women used a vaginal barrier consistently and correctly for 1 year.