Dear Reader,

Vaginal contraceptive film (VCF) is a soluble film -- a super thin, wafer-like substance filled with spermicide, usually nonoxynol-9 -- that's inserted into the vagina before intercourse and then "melts," delivering spermicide (chemicals that kill sperm) into the vaginal barrel as a form of contraception. Nonoxynol-9 is also available in jelly, cream, foam, suppository, and tablet forms, and is coated on some lubed condoms; however, these condoms have been found to offer no more protection against pregnancy than those without spermicidal lube.

VCF, when used alone, is far less effective against pregnancy than a condom, which, when used consistently and correctly, offers a 97 percent protection rate. VCF seems to be most effective when used as a back up with another form of birth control. As far as sexually transmitted diseases (STDs) are concerned, although VCF may reduce the risk of getting a bacterial STD, such as gonorrhea and chlamydia, by about 25 percent, it does not protect against them. The only form of birth control effective for STD prevention is a condom.

The following ideas can help increase the contraceptive effectiveness of VCF:

• Using dry, clean fingers, insert one VCF sheet into your vagina, making sure it's placed on or near your cervix.
• Wait at least fifteen minutes after insertion to allow the VCF to dissolve in the vagina before having intercourse.
• Use a new VCF for each sex session as a single application is good for up to only one hour after initial insertion.

As for condoms, no one is thrilled with them; few are thrilled with any of the forms of birth control. However, it's important to find a good match. Do some additional research to learn about other contraceptive options. You can read Our Bodies, Ourselves for the New Century by The Boston Women's Health Book Collective and/or check out the Planned Parenthood web site. Trying various kinds of latex condoms may yield a certain favorite. Adding a little dab of lube inside the condom can also help, as can switching off occasionally with another form of contraception, such as a diaphragm or even the female condom (it seems weird at first, but it works nearly as well as a male condom and gets easier to use with practice). Perhaps "skins" (condoms made from lambskin that protect against pregnancy only) or the new polyurethane male condoms would be fun to try. As opposed to latex, polyurethane conducts heat and allows for more sensation. Other options include both non-hormonal (cervical cap, sponge, and IUD) and hormonal (the Pill, Depo-Provera, and Norplant) choices. After some discussion and possibly sampling your options, you and your husband can then make a more informed decision about which one(s) would best meet both of your needs and wants at this time.

Alice

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