16 Subdermal implants can be inserted and removed as an office procedure and provide effective contraception for up to 5 years. Postcoital administration of estrogen and progestin can reduce subsequent pregnancy if initiated within 72 hours after unprotected intercourse. 49 Surveys indicate that knowledge of and use of postcoital contraception remains low among patients and clinicians. 16 Barrier contraceptive methods include the male and female condom and female barriers used with spermicide. Barrier methods have fewer side effects than hormonal contraception, but average effectiveness is more variable due to inconsistent or incorrect use.
Condoms infrequently slip or rupture, but most failure is due to inconsistent or improper use.
Other female barriers include the diaphragm, cervical cap, vaginal sponge, and vaginal film. The only American manufacturer of sponges discontinued production in 1995, however. For many women, especially those at low risk of STDs, IUDs offer excellent alternatives to OCs and other methods. It is often difficult to perform these methods correctly. Sterilization is the most common method of contraception in the U.S. 62 and has no proven long-term risks.