In these methods, one uses aids that are placed by the gynecologist or oneself either in the vagina or on the penis, thereby preventing sperm from finding their way to the eggs, either once or over a longer period of time. These aids include, for example, condoms or the IUD.
Condom (condom)
A male condom is a protection that is pulled over the stiff member and prevents ejaculate from entering the vagina. Used properly, it is in the medium safety range (Pearl index 2-12).
The female condom (“femidom”) is a tube that is open on one side and is inserted into the vagina with a ring to prevent it from slipping in (Pearl index 5-25). It is currently only available via the Internet or international pharmacies.
Condoms have the advantage of being the only contraceptive that protects against HIV and other infectious diseases.
Pessary, cervical cap, lea contraceptive.
Pessaries (diaphragms) consist of a latex membrane with a flexible wire ring, are inserted into the vagina before sexual intercourse, and close the cervix. Combined with a chemical contraceptive (e.g. spermicide), the Pearl index is 1-4, otherwise 20. Pessaries must be fitted by a gynecologist.
Similar in appearance and effect is the cervical cap; it covers only a smaller part of the cervical area. Handling is more difficult, and the Pearl index is 6. Since 1996, there has been the Lea contraceptive, a further development of the cervical cap that is easier to handle and-also when combined with a spermicide-safer (Pearl index 2-3).
Contraceptive Sponge
It is small, round, made of polyurethane foam and impregnated with a semen-killing substance. It is easy to use and is inserted into the vagina much like a tampon. It can remain there for up to 24 hours, even with repeated intercourse. Its Pearl index is 5-10.
IUD, copper chain
The copper IUD (intrauterine device = IUD) is a t-shaped or horseshoe-shaped plastic structure with copper wire wrapped around the middle part. The copper ions released there are responsible for the contraceptive effect. Sperm have difficulty passing through and eggs – if they are fertilized after all – are unable to implant.
A further development is the hormonal IUD, which has been on the market since 1990 and releases progestins instead of copper. Another, newer alternative is the copper chain, which works similarly to the copper IUD, but is safer and has fewer side effects. Both are inserted into the uterus by a gynecologist and can remain there for 3-5 years. Safety is high, with a Pearl index of 0.05-0.3.
Chemical contraception
In these methods, one uses chemical aids that are inserted into the vagina at least 10 minutes before sexual intercourse. There, body heat causes them to turn into a viscous slime or foam, creating a barrier for sperm. They also contain substances that inhibit sperm motility or kill them.
They are available as suppositories, foam suppositories, ointments, gels, creams or foam sprays. The Pearl index ranges from 3 to 20; it is recommended that they be combined with other contraceptives such as condoms or pessaries. Disadvantage is that chemical contraceptives irritate mucous membranes and thus can more easily lead to infections.