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Out of 100 women using a diaphragm with spermicidal cream or jelly
Typical use: 12 women become pregnant pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1
Perfect use: 6 women become pregnant pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1pregnant_1

What is a diaphragm and how does it work?

A diaphragm is a nonhormonal birth control method that is used to prevent pregnancy. It has a soft latex-free dome with a flexible rim made from silicone. Latex diaphragms are no longer being made however they may be available in certain regions outside of the U.S. A diaphragm works by forming a barrier to stop sperm from reaching the cervix to prevent pregnancy. The diaphragm should always be used with spermicidal cream or gel. The spermicide comes with instructions and tells you how much to apply inside the dome before inserting it. The spermicide is used with the diaphragm to kill any sperm that might leak in around the edges of the dome.

Where can I get the diaphragm?

If you want to use a diaphragm, you need to get fitted for one by your health care provider. The diaphragm is then available by prescription. It costs between $20-$75 USD. The gel or cream spermicide is bought over-the-counter in a pharmacy or retail store. Each application costs (on average) about 25 cents per use, and a tube cost between $7-18 USD.

How do I use the diaphragm?

inserting a diaphragmYou can insert the diaphragm just before sexual intercourse or up to two hours before intercourse.

  1. First, empty your bladder (pee) and then wash your hands.
  2. Before you use the diaphragm for the first time, wash it with mild soap and warm water. Rinse and dry it with a clean dry cloth.
  3. Check the diaphragm for any tears or holes. (Do not use the diaphragm if you notice that is damaged–use a condom instead). Call your health care provider to get a prescription for a new diaphragm.
  4. Cover the inside dome and rim with about a tablespoon of the spermicidal gel or cream.
  5. Insert the diaphragm deep into your vagina, just as your health care provider taught you.
  6. Make sure that it is in the right place. It should completely cover your cervix and the rim should be behind your pubic bone.

Removing your diaphragm: Do not remove the diaphragm until 6 hours after intercourse. If you have intercourse again before it is time to take the diaphragm out, you still shouldn’t remove it. Instead, use a condom as additional protection. You shouldn’t keep the diaphragm in for longer than 24 hours (even better if you remove by 12 hours) after intercourse.

  1. Wash your hands before you remove the diaphragm. It’s also a good idea to check to make sure you don’t have any ragged fingernails that could tear the diaphragm during insertion.
  2. Remove the diaphragm by sticking your index finger under the rim and gently pulling it out.
  3. Wash the diaphragm very well with mild soap and warm water, and then dry it completely with a dry clean cloth.
  4. Put your dry diaphragm back in its original container and keep it there until you use it again. Store it in room temperature (not too hot and not too cold) and keep it away from direct sunlight.

NEVER use a diaphragm during your menstrual period. Use a condom instead.

What if I need more lubrication?

If you need more lubrication, you can use a vaginal lubricant (such as K-Y Jelly). Do not use any oil-based products (such as baby oil, lotion, suntan oil, or vegetable oil) since they can break down the material of the diaphragm and make it less effective.

How effective is the diaphragm against pregnancy?

If women use the diaphragm every time they have sexual intercourse and follow instructions every time, it is 94% effective. This means that if 100 women use the diaphragm all the time and always use it correctly, 6 women will become pregnant in a year.

It’s obvious that the diaphragm is most effective against pregnancy when it is used correctly and every time you have sexual intercourse. The typical woman may not use the diaphragm every time she has sexual intercourse and/or may not always use it correctly. If women use the diaphragm, but not perfectly, it is 88% effective. This means that if 100 women use the diaphragm, at least 12 women will become pregnant in a year.

Does the diaphragm protect against STIs?

No. It is important to use condoms for STI and HIV protection.

What about douching after intercourse?

Douching is not recommended after intercourse. There are no benefits and it’s not safe because it can cause an increased risk in pelvic inflammatory disease, bacterial vaginosis (an infection of the vagina), and ectopic pregnancy (implantation of the fertilized egg outside of the uterus). Your body makes everything it needs to keep it clean. All you should be using to clean the outside of your vagina is water and soap. However, if you decide to douche in spite of this warning, you should wait at least 6 hours after intercourse so that the spermicide doesn’t get washed away.

Do I ever need to get a new diaphragm?

Yes. The diaphragm should be replaced at least every 2 years or sooner if you notice any damage such as a tear or if it has discolored. Also, if you have gained or lost more than 10 pounds, had a baby, or if the diaphragm does not fit well, you will likely need to get fitted for a new one by your health care provider. Talk to your health care provider if you have any concerns.

Get into the habit of carefully looking at your diaphragm in front of a light to check for any tears, cracks or tiny holes before you use it. Be careful not to puncture it with a sharp fingernail. DO NOT use a damaged diaphragm. Call your health care provider to get a prescription for a new one.

Are there any problems with the use of the diaphragm?

Using a diaphragm can get messy. Also, some women may be allergic to the material of the diaphragm or to the spermicide that is used with the diaphragm. Also, women may be more likely to get a urinary tract infection. Frequent use of spermicide may cause irritation of the vagina wall and increase the risk of acquiring HIV.

What if I have problems with the diaphragm?

Young and adult women who are allergic to latex can safely use the silicone diaphragm. If you have any of the problems listed below, call your health care provider.

  • Pain or discomfort while the diaphragm is in place
  • Your partner has pain during intercourse
  • Soreness in your vagina
  • Rash around your vagina
  • Frequent bladder infections
  • Discharge that smells bad or that comes out in larger amounts than normal
Diaphragms are made out of latex or silicone. Women who are allergic to latex can safely use the “latex free” silicone diaphragm.

Can any woman use the diaphragm?

No. If you have a change in the shape or elasticity of your vagina from surgery or congenital problems such as spina bifida, you should not use a diaphragm. If you have frequent urinary tract infections using a diaphragm, your health care provider will likely suggest another birth control method.

Should I use any other type of contraception with the diaphragm?

You should always use the spermicide that is meant to be used with the diaphragm. It’s also a good idea to use a male condom when you are using the diaphragm. This will increase the effectiveness and protect you against STIs.

If you decide to use a diaphragm to prevent pregnancy, you’ll need to use it every time you have sex. Women using a barrier method, such as a diaphragm or sponge, should be aware of the very low risk of getting toxic shock syndrome (TSS). Also, women who are allergic to nonoxyl-9 should not use any vaginal barrier method that contains this spermicide or works with spermicide.