Barnard College Student Health Services

Condoms and Spermicides
• Condoms
• Female Condom
• Vaginal spermicides
• How to use spermicidal foam
• How to use Spermicidal Suppositories
• How to use spermicidal gel
CONDOMS are an effective means of birth control, and prevent the transmission of many sexually transmitted infections (STI's) as well. Additional vaginal spermicide increases the efficacy of condoms in preventing pregnancy; however, there is as yet no clinical evidence that it reduces the rate of STI's. Indeed, as discussed inside, in very large, frequent doses, vaginal spermicide may facilitate the transmission of HIV. Many couples appreciate the convenience of condoms, with or without spermicide, and use it as their usual form of contraception. Condoms are also a good "back-up" method, useful to prevent STI's even when using birth control pills, and as an alternative method when your usual method is not recommended or available. Because of the high failure rate of spermicides (gel, foam or suppositories) when used alone, BCSHS does not recommend their use for pregnancy protection without condoms or diapraghms (gel only).
CONDOMS (Also known as prophylactics, rubbers, safes, skins)
The condom is a contraceptive method used by the man. It is a rubber or natural membrane sheath which fits over the shaft of the erect penis. It prevents pregnancy by catching and holding the man's semen that is released during ejaculation so that the sperm are not deposited in the vagina.

The condom alone, if used consistently (every time), and correctly and is estimated to be about 97% effective in preventing pregnancy. There is data that suggests that the addition of a vaginal spermicide (film, foam, etc.) improves this efficacy rate by about 2-2.5%. There is no clear evidence at this time to indicate that a condom lubricated with a spermicide is more effective against pregnancy than one that is not.
Condom breakage and slippage are quite rare (1/2-2% for breakage; 1-2% for complete slippage). Condom slippage during withdrawal is minimized by holding the rim of the condom against the base of the penis during withdrawal. Oil based lubricants and vaginal creams, e.g. Monistat, Vagisil, Femstat, can degrade latex and increase the incidence of condom damage.
There are no medical risks associated with condom use. A very rare side effect may be an allergic reaction to the latex. The important advantage is that condoms help to prevent the spread of sexually transmitted diseases, such as gonorrhea, syphilis, herpes, trichomoniasis, HIV infection, etc. and may also help prevent the development of cancer of the cervix.
Condoms may be purchased without prescription at any drugstore. You may also stop by Health Services and get them free! One size fits all, but experimentation with different brands is the best way to determine if one type is preferred to another.
There are over 100 brands available in the U.S.; they can be plain, flared, narrowed-down, nippled, colored, ribbed, lubricated with or without a spermicide. Most of the better brands are a thin sheath that provide for the better sensitivity that most men prefer. Colored condoms are not recommended as they may promote an allergic reaction, they also cost more.
Some couples feel that condoms interfere with sexual spontaneity or decrease sensation. Although this may be true for some people, it would be best to try condoms before assuming that they are unsatisfactory for you. Remember that most condoms are only about three thousandth of an inch thick. Some men feel that condoms are useful in helping them maintain erections. Instructions for how to use a condom (with pictures) are available in the Health Services office.
FEMALE CONDOM
The Reality Female Condom can be purchased over the counter without a prescription, It consists of 2 flexible rings connected by a polyurethane sheath (resembles a closed sleeve - one ring used for insertion at the closed end and the other remains outside the covering of the labia). The sheath is prelubricated with a silicone based lubricant - not a spermicide, and can be inserted for up to 8 hours prior to intercourse.
The Reality Female Condom is thin, soft, pliable and transfers heat readily which makes it comfortable during intercourse. The sheath is stronger than latex and less likely to tear or break, and is not susceptible to deterioration with oil based lubricants.
"typical" use failure rates may be as high as 25% a year, as compared to the 15% for "typical" male latex condom use failure rates. However, when reality was used properly every time, the failure rate was 5% for perfect use, compared to 3% for male latex condoms. The most important point is that all protection devices must be used properly and consistently to provide protection.
The Reality Female Condom can be used by those women with latex allergies. It is intended for one time use only, and should not be used together with a male condom.
VAGINAL SPERMICIDES
(foam, suppositories, gel)
The active ingredient in all spermicides nonoxynol-9 (N-9) or octoxinol-9 which prevents pregnancy by killing sperm. Early laboratory studies had shown that N-9 also kills or stops growth of the HIV virus, herpes simplex I & II, gonorrhea, chlamydia, trichomoniasis, syphilis, and other STI's in lab cultures. However, a recent study of professional sex workers in Africa found that vaginal N-9 did not prevent HIV infection in this population and, surprisingly, may have increased transmission by about 50%. One hypothesis for these results is that high doses of N-9 inserted directly into the vagina can irritate mucosal tissue, causing microabrasions. Such abrasions might facilitate the introduction of HIV into the blood stream. We cannot assume, however, that the results of the sex worker study can be generalized to a college student population who use smaller amounts, presumably less frequently. At the time there is no firm scientific data to guide your decision about whether to use vaginal spermicide. If you are using condoms plus the pill, we suggest no spermicide. If condoms are your sole protection against pregnancy, you may wish to use vaginal spermicide to gain an extra 2% protection. your best protection is to use your condom correctly every time!
If you are using an N-9 spermicide as your sole source of protection, please remember that this method will not protect you from all Sty's or HIV. We have no present evidence that it ill increase your risk of HIV. BCSHS advises against using vaginal spermicides alone because of the poor efficacy rate for contraception (75-90%).
Do not use spermicide if you suspect you are pregnant and wish to maintain the pregnancy. Spermicides used during pregnancy may increase the risk of birth defects.
Side effects are rare and generally consist of a local allergic reaction to the chemicals in spermicides. To test for sensitivity, place a small amount of spermicide on the skin at the bend of the elbow or on the lips of the vagina overnight and check for a rash in the morning.
Spermicides are available without a prescription at any drugstore. Conceptrol contraceptive inserts and Ortho gel are available for purchase in Health Services.
Contraceptive foam is an aerosol spermicide (sperm killer) with an appearance and texture similar to shaving cream. Foam is marketed under a variety of names: Delfen, Emko, Koromes. It is inserted into the vagina at the opening of the uterus (the cervical os) with an applicator prior to intercourse.
How to use Spermicidal Suppositories
Spermicidal suppositories (Conceptrol) are tablet inserted far back into the vagina (near the cervix) which effervesce in the vagina and then work like foam.
1. At least 10 minutes prior to intercourse insert one suppository with the index finger as far as possible into the vagina near the cervix.
2. Wait at least 10 minutes after insertion into the vagina prior to male penetration to insure proper dispersion.
3. Suppositories provide protection from 10 minutes to 1 hour after product insertion. Use a new insert with each act of intercourse.
4. Do not douche for at least 6 hours after intercourse.
How to use Spermicidal Gel
Do not insert more than 1/2 hour before intercourse. Gel is most effective when used immediately before intercourse.
1. Read the directions accompanying the package since applicators vary.
2. Open the end of the tube with pointed end of cap.
3. Screw onto end of tube and squeeze contents into applicator and then unscrew.
4. To use, spread the lips of the vagina, insert the applicator as far as it will go, and push the plunger. You should feel the applicator gently bump against the cervix.


Home >Publications		Welcome to Barnard College Student Health Services * Location: Lower Level Brooks Hall * 3009 Broadway, New York, NY 10027 * Hours: Monday - Friday 8:30 a.m. - 5:00 p.m. * Tuesday 5:00 - 7:00 p.m. GYN (by appointment only) * Tel: 212-854-2091 * Fax: 212-854-2702 * Closed Thursday 12:30 - 1:30 p.m. (Staff Meeting)
	Condoms and Spermicides • Condoms • Female Condom • Vaginal spermicides • How to use spermicidal foam • How to use Spermicidal Suppositories • How to use spermicidal gel CONDOMS are an effective means of birth control, and prevent the transmission of many sexually transmitted infections (STI's) as well. Additional vaginal spermicide increases the efficacy of condoms in preventing pregnancy; however, there is as yet no clinical evidence that it reduces the rate of STI's. Indeed, as discussed inside, in very large, frequent doses, vaginal spermicide may facilitate the transmission of HIV. Many couples appreciate the convenience of condoms, with or without spermicide, and use it as their usual form of contraception. Condoms are also a good "back-up" method, useful to prevent STI's even when using birth control pills, and as an alternative method when your usual method is not recommended or available. Because of the high failure rate of spermicides (gel, foam or suppositories) when used alone, BCSHS does not recommend their use for pregnancy protection without condoms or diapraghms (gel only). CONDOMS (Also known as prophylactics, rubbers, safes, skins) The condom is a contraceptive method used by the man. It is a rubber or natural membrane sheath which fits over the shaft of the erect penis. It prevents pregnancy by catching and holding the man's semen that is released during ejaculation so that the sperm are not deposited in the vagina. The condom alone, if used consistently (every time), and correctly and is estimated to be about 97% effective in preventing pregnancy. There is data that suggests that the addition of a vaginal spermicide (film, foam, etc.) improves this efficacy rate by about 2-2.5%. There is no clear evidence at this time to indicate that a condom lubricated with a spermicide is more effective against pregnancy than one that is not. Condom breakage and slippage are quite rare (1/2-2% for breakage; 1-2% for complete slippage). Condom slippage during withdrawal is minimized by holding the rim of the condom against the base of the penis during withdrawal. Oil based lubricants and vaginal creams, e.g. Monistat, Vagisil, Femstat, can degrade latex and increase the incidence of condom damage. There are no medical risks associated with condom use. A very rare side effect may be an allergic reaction to the latex. The important advantage is that condoms help to prevent the spread of sexually transmitted diseases, such as gonorrhea, syphilis, herpes, trichomoniasis, HIV infection, etc. and may also help prevent the development of cancer of the cervix. Condoms may be purchased without prescription at any drugstore. You may also stop by Health Services and get them free! One size fits all, but experimentation with different brands is the best way to determine if one type is preferred to another. There are over 100 brands available in the U.S.; they can be plain, flared, narrowed-down, nippled, colored, ribbed, lubricated with or without a spermicide. Most of the better brands are a thin sheath that provide for the better sensitivity that most men prefer. Colored condoms are not recommended as they may promote an allergic reaction, they also cost more. Some couples feel that condoms interfere with sexual spontaneity or decrease sensation. Although this may be true for some people, it would be best to try condoms before assuming that they are unsatisfactory for you. Remember that most condoms are only about three thousandth of an inch thick. Some men feel that condoms are useful in helping them maintain erections. Instructions for how to use a condom (with pictures) are available in the Health Services office. FEMALE CONDOM The Reality Female Condom can be purchased over the counter without a prescription, It consists of 2 flexible rings connected by a polyurethane sheath (resembles a closed sleeve - one ring used for insertion at the closed end and the other remains outside the covering of the labia). The sheath is prelubricated with a silicone based lubricant - not a spermicide, and can be inserted for up to 8 hours prior to intercourse. The Reality Female Condom is thin, soft, pliable and transfers heat readily which makes it comfortable during intercourse. The sheath is stronger than latex and less likely to tear or break, and is not susceptible to deterioration with oil based lubricants. "typical" use failure rates may be as high as 25% a year, as compared to the 15% for "typical" male latex condom use failure rates. However, when reality was used properly every time, the failure rate was 5% for perfect use, compared to 3% for male latex condoms. The most important point is that all protection devices must be used properly and consistently to provide protection. The Reality Female Condom can be used by those women with latex allergies. It is intended for one time use only, and should not be used together with a male condom. VAGINAL SPERMICIDES (foam, suppositories, gel) The active ingredient in all spermicides nonoxynol-9 (N-9) or octoxinol-9 which prevents pregnancy by killing sperm. Early laboratory studies had shown that N-9 also kills or stops growth of the HIV virus, herpes simplex I & II, gonorrhea, chlamydia, trichomoniasis, syphilis, and other STI's in lab cultures. However, a recent study of professional sex workers in Africa found that vaginal N-9 did not prevent HIV infection in this population and, surprisingly, may have increased transmission by about 50%. One hypothesis for these results is that high doses of N-9 inserted directly into the vagina can irritate mucosal tissue, causing microabrasions. Such abrasions might facilitate the introduction of HIV into the blood stream. We cannot assume, however, that the results of the sex worker study can be generalized to a college student population who use smaller amounts, presumably less frequently. At the time there is no firm scientific data to guide your decision about whether to use vaginal spermicide. If you are using condoms plus the pill, we suggest no spermicide. If condoms are your sole protection against pregnancy, you may wish to use vaginal spermicide to gain an extra 2% protection. your best protection is to use your condom correctly every time! If you are using an N-9 spermicide as your sole source of protection, please remember that this method will not protect you from all Sty's or HIV. We have no present evidence that it ill increase your risk of HIV. BCSHS advises against using vaginal spermicides alone because of the poor efficacy rate for contraception (75-90%). Do not use spermicide if you suspect you are pregnant and wish to maintain the pregnancy. Spermicides used during pregnancy may increase the risk of birth defects. Side effects are rare and generally consist of a local allergic reaction to the chemicals in spermicides. To test for sensitivity, place a small amount of spermicide on the skin at the bend of the elbow or on the lips of the vagina overnight and check for a rash in the morning. Spermicides are available without a prescription at any drugstore. Conceptrol contraceptive inserts and Ortho gel are available for purchase in Health Services. Contraceptive foam is an aerosol spermicide (sperm killer) with an appearance and texture similar to shaving cream. Foam is marketed under a variety of names: Delfen, Emko, Koromes. It is inserted into the vagina at the opening of the uterus (the cervical os) with an applicator prior to intercourse. How to use Spermicidal Suppositories Spermicidal suppositories (Conceptrol) are tablet inserted far back into the vagina (near the cervix) which effervesce in the vagina and then work like foam. 1. At least 10 minutes prior to intercourse insert one suppository with the index finger as far as possible into the vagina near the cervix. 2. Wait at least 10 minutes after insertion into the vagina prior to male penetration to insure proper dispersion. 3. Suppositories provide protection from 10 minutes to 1 hour after product insertion. Use a new insert with each act of intercourse. 4. Do not douche for at least 6 hours after intercourse. How to use Spermicidal Gel Do not insert more than 1/2 hour before intercourse. Gel is most effective when used immediately before intercourse. 1. Read the directions accompanying the package since applicators vary. 2. Open the end of the tube with pointed end of cap. 3. Screw onto end of tube and squeeze contents into applicator and then unscrew. 4. To use, spread the lips of the vagina, insert the applicator as far as it will go, and push the plunger. You should feel the applicator gently bump against the cervix.