Types of Non-hormonal Contraceptives

There are many options for non-hormonal contraceptives, however not all are available over the counter (OTC). First we will explore OTC options: male and female condoms and spermicides, then we will look at prescription-based options: diaphragms and cervical caps. 

Male condoms are sheaths or coverings that fit over a man's erect penis made of thin latex rubber or other materials such as polyurethane, polyisoprene, lambskin or nitrile.

Active Ingredient: None! Works as a physical barrier between the penis and vagina

Action: Prevents the sperm from entering the vagina, thereby hindering fertilization

Effectiveness: Due to the nature of this barrier, pregnancies may occur due to incorrect use, slips or breaks, therefore it's highly user dependent. Within the first year of use with a partner, 13 pregnancies are expected out of 100 women. With correct use for every act of sex, this drops to only 2 pregnancies per 100 women. 

Protection against STIs: Yes! Male condoms significantly reduce the risk of STI transmittance, preventing about 80%-95% of HIV transmission that would have occurred without condoms. It also protects against STIs spread by discharge (HIV, gonorrhea and chlamydia) and skin-to-skin contact (herpes and human papillomavirus)

Benefits: Couples who use condoms like how there are no hormonal side effects and can be readily acquired and used as regular, temporary or backup methods of contraception. Condoms are also sold without a provider prescription, helping protect against STIs and make sex last longer. Additionally, condoms don't delay return to fertility as a non-hormonal contraceptive. 

Side effects: There are no major side effects from condoms however, users report dulled sensation during intercourse

Female condoms are sheaths or linings, that fit loosely inside a woman's vagina made of thin, transparent film. They have flexible rings to help insertion and removal

Active Ingredient: None! Works as a physical barrier between the penis and vagina

Action: Prevents the sperm from entering the vagina, thereby hindering fertilization

Effectiveness: Due to insertion practices, female condoms are highly user dependent. In the first year of use, 21 pregnancies are expected per 100 women. This decreases to about 5 pregnancies with correct use for every act of sex

Protection against STIs: Yes! Female condoms reduce the risk of infection with STIs, including HIV.

Benefits: Female condoms are controlled by the woman, and can often provide added sensation during sex in comparison to male condoms. Female condoms are also sold without a provider prescription, helping protect against STIs and do not have to be removed immediately after ejaculation. 

Side effects: There are no major side effects from condoms however, users report dulled sensation during intercourse compared to no condoms

Spermicides are available in the form of foaming tablets, melting or foaming suppositories, creams or jellies. These can be used on their own, however effectiveness increases when combined with a diaphragm or condom. This substance is inserted deep into the vagina, near the cervix before having intercourse.

Active Ingredient: The most common spermicide ingredient is Nonoxynol-9, but others include benzalkonium chloride, chloride, chlorhexidine, menfegol, octoxynol-9 and sodium docusate

Action: Breaks down the sperm membrane ultimately killing or slowing their movement. This achieves the goal of preventing sperm from reaching an egg for fertilization

Effectiveness: Because spermicides require proper use for every act of sex, the effectiveness is highly user dependent. As a contraceptive, it is one of the least effective methods with about 21 pregnancies per 100 women using spermicides in the first year and when correctly administered every time, this only drops to 16/100

Protection against STIs: None, and additionally, frequent use may increase the risk of HIV infection

Benefits: Spermicides use is controlled by the woman and may even increase vaginal lubrication during intercourse. This also can be used without seeing a healthcare provider and additionally has no hormonal side effects. As a "backup" contraceptive, this can be used in combination with any other form of birth control to add to its effectiveness. 

Side effects: Users of spermicides report irritation in or around the vagina and commonly on the partners penis. There is a smaller chance of vaginal lesions and increased risk of urinary tract infections when used more than twice per day. 

Diaphragms are soft cups made from late, plastic or silicone that cover the cervix. They're flexible and contain a spring rim to maintain shape in the place. Often these will require special fitting by a professional however "one-size-fits-all" options are becoming available. 

Active Ingredient: None! This is a physical barrier of the cervix, not hormonal or chemical, however, it is commonly used in combination with a spermicide

Action: Prevents the sperm from entering the cervix, thereby preventing fertilization

Effectiveness: About 17 in 100 women became pregnant in the first year of use with spermicides, and when used properly for every act of sex this number reduces to 16 in every 100 women

Protection against STIs: May protect against some STIs but not recommended for primary prevention

Benefits: As an internal barrier, diaphragms do not interrupt sex when pre-inserted for use. There are no hormonal side effects and usage is controlled by the woman, without further consultation from a professional past the initial sizing. Additionally, they do not cause delays to fertility after usage.

Side Effects: Users report possible vaginal lesions, irritation in or around the vagina and on the partners penis and less commonly, urinary tract infections and vaginosis

Cervical caps are soft, latex or plastic rubber cups that fit snugly over the cervix. They, like diaphragms, also require fitting by a professional before use. 

Active Ingredient: None! This is another physical barrier of the cervix, not hormonal or chemical, however, it is commonly used in combination with a spermicide

Action: Prevents sperm from reaching the cervix by making a seal, thereby preventing fertilization

Effectiveness: Cervical cap use is highly user dependent, changing effectiveness with birth, spermicide use and proper insertion. With women who have given birth, about 32 pregnancies per 100 women is expected over the first year of use with a spermicide. With proper use, this chance is reduced to 26 pregnancies in 100 women for every act of sex that may be performed. For women that have not given birth before, they stand a lower risk of becoming pregnant at just around 16 pregnancies in 100 women using a spermicide, and around 9 pregnancies per 100 women with proper use. 

Protection against STIs: None

Benefits: As an internal barrier, cervical caps do not interrupt sex when pre-inserted for use. There are no hormonal side effects and usage is controlled by the woman, without further consultation from a professional past the initial sizing. Additionally, they do not cause delays to fertility after usage

Side effects: Similar to the diaphragm, cervical caps may cause vaginal irritation, lesions, or irritation to both the vagina and partners penis

Let us know what non-hormonal contraceptives have tried, your experience and how you accessed them in the comments below! For more information please visit the link below to the Family Planning Handbook for Providers.

            (1) Huff, M. B. (2009). Family Planning: A Global Handbook for Providers. Journal of Pediatric and Adolescent Gynecology, 22(2), 135–135. Link.