Barrier methods of contraception are among the oldest techniques of pregnancy prevention; their use dates back to ancient times. In the early twentieth century, barrier methods provided the only means of contraception for many women. More recently, their use has declined. In the 1995 National Survey of Family Growth, the use of female-controlled methods of barrier contraception was at its lowest rate ever.<sup>29 Piccinino L.J., Mosher W.D. Trends in contraceptive use in the United States: 1982–1995 Fam Plann Perspect 1998 ;  30 : 4-10 46.  [cross-ref]

Cliquez ici pour aller à la section Références</sup> Nevertheless, one can argue that owing to the current high rates of unintended pregnancy and sexually transmitted diseases (STDs), barrier contraceptives with their dual role of pregnancy and STD prevention are exceedingly important.

Barrier methods pose a unique challenge for users as coitus-dependent contraception. These methods include physical barriers, such as the male condom, the female condom, the diaphragm, the cervical cap, and the sponge, and chemical barriers in the form of jelly, foam, or films containing spermicides. Physical and chemical barriers are often used in conjunction to prevent the passage of sperm, in many cases also providing protection from STDs. These forms of contraception are also advantageous because they can be used intermittently and do not have systemic side effects.

The contraceptive efficacy of all barrier methods depends on their consistent and correct use. The literature examining the efficacy of barrier methods of contraception can be confusing. It is marred by the quality of studies and by the inherent difficulties of the individual methods. Many older studies have come under criticism because they do not conform to the rigorous study standards of more recent studies. A number of studies would be level I data according to the US Preventive Services Task Force classification, that is, evidence is obtained from at least one properly designed randomized controlled trial. A few large randomized trials of barrier contraceptive efficacy exist. These trials include studies of diaphragms versus the cervical cap, studies of the vaginal sponge versus the diaphragm, and studies of different forms of spermicides. Because serious sequelae resulting from barrier methods are exceedingly rare, many of the guidelines and recommendations in this area, such as the risk of toxic shock syndrome, are based on level III data, that is, opinions of respected authorities based on clinical experience and descriptive studies.