Birth Control Method
Barrier
Description
Slightly larger than a cervical cap, the diaphragm is a soft rubber or latex cup that fits over a woman's cervix, providing a physical barrier to semen trying to enter the uterus and killing sperm before they can fertilize an egg.
How It Works
Fill the diaphragm with spermicidal jelly or cream and then insert into your vagina, placing it over your cervix, which is the opening of your uterus or womb. The pubic bone and rear wall of the vagina keep the diaphragm in place, blocking sperm from entering the uterus; the spermicide kills live sperm and prevents them from fertilizing an egg if they should happen to make it past the barrier. You can have intercourse multiple times while wearing the diaphragm, but you'll need to reapply spermicide each time. You can leave the diaphragm in place and insert fresh spermicidal cream or jelly by using a special applicator. The diaphragm is effective for up to 48 hours, and must be left in place for at least six hours after intercourse.
Should You Use It?
Women who have intercourse infrequently, or whose fertility is low because of age, will find the diaphragm a good choice for contraception. Couples who have intercourse frequently (more than three times weekly) may find the diaphragm less effective than those who have sex sporadically, mostly due to inconsistent and incorrect use. The diaphragm is also very effective for women who have not had children, but higher failure rates apply for women who wait to begin using the diaphragm until after they have given birth.
Effectiveness
With consistent and correct use, the diaphragm is 91% effective; however, most couples will find the diaphragm to be, on average, 80% effective at preventing pregnancy.
STI Protection
Barrier methods may provide considerable protection from sexually transmitted infections (STIs) such as gonorrhea, chlamydia and certain pre-cancerous conditions of the cervix; however, the diaphragm does not prevent the transmission of many other STIs, including herpes, HPV or HIV. Women who frequently use spermicides may experience disruption in the vaginal skin, increasing the risk of STIs and abnormal pap results.
Advantages
- Small and portable.
- Can be inserted up to an hour before sex.
- Effective for 48 hours.
- Wearer can have intercourse an unlimited number of times with each wearing.
- Confidential -- your partner doesn't have to know you're using it.
- Reliable form of contraception when used correctly and consistently.
- Can usually be used for up to two years before they need to be replaced.
Disadvantages
- Must be fitted by a clinician.
- Some women cannot be fitted for a diaphragm or cannot easily reach their cervixes.
- Can be difficult to insert properly and can slip out of place during intercourse.
- May increase the risk for yeast infection, allergic reaction to latex or rubber, urinary tract infection, toxic shock syndrome, vaginal infection or inflammation of the cervix.
- Must be left in for at least six to eight hours after intercourse, but no longer than 48 hours.
- Cannot be used with oils, lubricants or gels unless the lubricant packaging specifically states it is safe to use with latex or rubber.
- A new fitting may be necessary after pregnancy, miscarriage, abortion or weight gain of over 15 pounds.
Where to Buy It
A clinician must fit you for a diaphragm; most health departments, family-planning clinics and gynecologists can help you. During your appointment, make sure you fully understand how to insert and remove the diaphragm. If you have any questions, don't be afraid to ask! Once your doctor has fitted you, you can buy the diaphragm and spermicide at most clinics, drugstores or pharmacies.
Follow Up
After each use, wash the diaphragm thoroughly with hot water and mild soap, or as directed by your physician. Because diaphragms can increase your risk for certain types of infections or inflammations in the vaginal area, you'll want to have a Pap test taken within a few months after you begin using this method. Each time you use the diaphragm, check it for cracks or tears and replace it if it shows any signs of deterioration. Have your diaphragm's fit rechecked annually and after a pregnancy.
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