PocketGuide: Barriers and Spermicides - Spermicides: Problems Requiring Action

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PocketGuide for Family Planning Service Providers

Barriers and Spermicides

Barriers and Spermicides

Spermicides: Problems Requiring Action

Physical Disability/Unpleasant to Touch Genitals | Genital Anomalies/Other Abnormalities | Allergy | Does Not Want Inconvenience | Pregancy Would Be High Risk | Wants More Effective Protection | Not Willing to Use Consistently | Repeated Intercourse

PROBLEM	Woman with physical disability or who finds it unpleasant to touch her genitals
ACTION	Counsel to explore problem. Ensure that client can apply spermicide. If discomfort is severe or client cannot overcome touching her genitals, help her choose another method.
RATIONALE	Spermicide use requires touching the genitals (vulva and vagina). If spermicide is not placed deep in the vagina, the method will fail.

PROBLEM	Genital anomalies or other abnormalities
ACTION	Ensure that condition does not interfere with use. If it does, help client choose another method.
RATIONALE	Vaginal stenosis (narrowing of vaginal canal) is uncommon and other congenital abnormalities (double vagina) are rare. If present, they may make application of spermicide difficult. If spermicide is not placed deep in the vagina, the method will fail.

PROBLEM	Allergy to spermicidal agents
ACTION	Help clients with allergy choose another method.
RATIONALE	Allergic reactions, although uncommon, can be uncomfortable and possibly dangerous.

PROBLEM	Woman who does not want any inconvenience
ACTION	Help client choose another method.
RATIONALE	Method is both coitus-related and user-dependent. If it is not used with each act of intercourse, the method will fail.

PROBLEM	Woman's age, parity or health problems make pregnancy a high risk
ACTION	Help client choose another method.
RATIONALE	If pregnancy will expose the client to high risks, then a more effective method should be considered or the couple must agree to follow instructions strictly.

PROBLEM	Couple/woman who wants more effective protection against pregnancy
ACTION	Help client choose another method.
RATIONALE	Spermicide, when used alone, is only about 79–97% effective. If not used correctly (i.e., with each act of intercourse), failure rates may be even higher.

PROBLEM	Couple/woman not willing to use consistently
ACTION	Counsel about importance of consistent use. Help client choose another method.
RATIONALE	Method is both coitus-related and user-dependent. If it is not used with each act of intercourse, the method will fail.

PROBLEM	Repeated intercourse over several hours
ACTION	Apply more spermicide with each act of intercourse.
RATIONALE	Each application of spermicide is only effective for 1 to 2 hours. (Check instructions with each spermicide preparation for specific information on the duration of effectiveness and re-application.)

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