CONTRACEPTION (2) 

MECHANICAL CONTRACEPTION

Dr. Claude Allouche, Gynecologist Contraception mecanique 2 ia engl
Ahuza Clinic, Raanana
058 726 02 64

C) MECHANICAL CONTRACEPTION

1. MALE CONDOM

The condom, if used correctly, protects against both unwanted pregnancies and sexually transmitted infections (STIs). This closed tube, made of latex or polyurethane, is placed over the erect penis before penetration and removed right after ejaculation.

Check the condom for proper condition (expiration date, integrity, quality label) and use a new one for each sexual encounter. Condoms are sold without a prescription and are affordable.

2. FEMALE CONDOM

Less known than the male version, the female condom is a latex or polyurethane tube with internal and external rings to keep it in place inside the vagina. It can be inserted hours before intercourse and removed after the act. It’s available without a prescription but is more expensive and less commonly used.

3. NON-HORMONAL IUD (Copper IUD)

The copper IUD is a hormone-free contraceptive option for women seeking a long-term but reversible solution. Inserted into the uterus, it disrupts sperm activity. It's effective immediately upon insertion and can also serve as emergency contraception. However, it requires two gynecologist visits: one to assess suitability, and one to place it during menstruation. The copper IUD can prevent pregnancy for 3 to 10 years and is suitable for women who haven’t had children. Menstrual cycles continue naturally, but periods may be heavier or more painful.

4. DIAPHRAGM

This small silicone cap is placed over the cervix before intercourse, blocking sperm. It remains in place for 6 to 8 hours afterward before removal. Due to its complexity in use, it's less effective and is recommended to be used with spermicide. A prescription is needed to obtain the correct size.

5. SPERMICIDES

Spermicides destroy sperm by breaking down their cell membranes, preventing fertilization. They come in various forms (gels, creams, foams, suppositories, sponges) and should be applied before intercourse. Their effectiveness ranges from 1 to 24 hours depending on the form, but they are among the least reliable contraceptive methods (71% effectiveness). Spermicides do not protect against STIs and are available over-the-counter, although they can be hard to find in Israel.

D) PERMANENT CONTRACEPTION

1. FEMALE STERILIZATION

Female sterilization involves blocking the egg from passing through the fallopian tubes using one of three methods:

  • Tubal ligation: The fallopian tubes are cut and sealed. This can be reversible, but success rates vary between 40-85%.
  • Bilateral salpingectomy: The removal of both fallopian tubes is irreversible but may reduce ovarian cancer risk.
  • Essure implants: Small coils are placed at the entrance of the fallopian tubes, causing them to become blocked. This method is irreversible.

2. VASECTOMY

A vasectomy is a male contraceptive method that involves cutting the vas deferens, preventing sperm from reaching the penis. It’s a simple procedure done under local anesthesia and doesn’t affect hormonal function or sexual activity. Reversibility is possible, though success rates are only around 50%.

Sterilization is rare in Israel due to religious opposition and limited coverage by health insurance.