Diaphragm

What is it?

The diaphragm is a circular rubber dome that is filled with spermicidal jelly and placed over the woman's cervix.

How It Works

When the diaphragm is correctly placed over the cervix, it acts as a physical barrier to prevent sperm from entering the woman's uterus, thereby preventing conception. The spermicide is a chemical barrier that provides added protection.

How to Use

1. Wash your hands thoroughly before inserting the diaphragm.
2. Spermicide should be placed into the diaphragm and should be spread around on the inside of the rim.
3. Squeeze the sides of the diaphragm together with one hand and open the vulva with the other hand (diaphragms can come with applicators or can be inserted manually). Then insert the diaphragm.
4. Check to make sure that you have inserted the diaphragm correctly by feeling it with your finger. It is in the right place if you can feel your cervix through the diaphragm. The cervix feels like the end of your nose.
5. Once the diaphragm has been correctly inserted, it can provide protection for six hours. If more than six hours has elapsed, you should insert more spermicide on the outside of the diaphragm without taking it out.
6. You should apply an additional applicator full of spermicide with each repeated act of intercourse.
7. You must keep the diaphragm in for at least six hours after intercourse. It is okay to leave it in for longer, but it is not recommended to exceed 24 hours because of the possibility of getting Toxic Shock Syndrome (TSS).
8. When taking out your diaphragm, use your finger to carefully hook under your diaphragm and pull it out.

NOTE: Your doctor will show you how to insert your diaphragm when you go in for your fitting. He or she will have you practice inserting it yourself before leaving.

Advantages

• The diaphragm can protect against certain STD’s, such as gonorrhea and chlamydia.
• Your partner can insert it for you as part of foreplay.
• You can insert it yourself beforehand if you know you will be having intercourse, so as not to interrupt the spontaneity.
• When it is in place you can do all the things you usually do, such as go to the bathroom.
• You can still use your diaphragm during your period. The menstrual fluid will gather inside of the diaphragm. You can use a tampon while the diaphragm is in place.

Disadvantages

• You need a prescription for the size that fits you best. This requires you to see a physician.
• Inserting a diaphragm can interrupt the spontaneity of sex.
• It does not protect against all sexually transmitted diseases.
• The spermicide can have an unpleasant taste or smell.
• It can increase your risk of getting a bladder infection.
• You can’t use the diaphragm if you are allergic to rubber.
• It usually needs to be replaced every two years.

Taking Care of your Diaphragm

• Always wash your diaphragm in warm water with unscented soap.
• Never expose it to detergents or oil based substances. After washing it, dry the diaphragm thoroughly.
• Hold the diaphragm up to the light and look for any tears or holes in it.
• Stop using it if you find a hole.
• Be careful when inserting or removing your diaphragm. If you have sharp nails, hang nails, or jewelry; you may accidentally damage the diaphragm.
• You should see your doctor every year to make sure that your diaphragm still fits correctly.

You may need a new diaphragm if you've…

• Gained or lost more than seven pounds. In this case your diaphragm might not fit as well as it used to.
• Had a baby.
• Miscarried.
• Had an abortion.

Cost

The diaphragm alone can cost between $30 and $40. Before you can buy one, though, you have to pay for a doctor’s examination because you need a prescription in order to get one. Keep in mind that diaphragms have to be replaced every two years. The cost of using a diaphragm also includes the price of spermicide.

Effectiveness

The failure rate for a perfect user is 6% and the failure rate for a typical user is 20%.

© - Reproduced with permission of SexInfo, University of California at Santa Barbara, 2007.