Diaphragm Birth Control

Diaphragm at a glance

• A diaphragm is a reusable birth control device inserted into the vagina to prevent sperm from entering the woman's uterus and making contact with an egg, thus preventing pregnancy.
• Diaphragms are shaped like a dome with a flexible outer ring, and can be made of latex rubber or silicone.
• A health care provider will perform an internal vaginal exam to prescribe the right diaphragm size.
• A prescription is required to buy a diaphragm, which typically lasts one to two years with proper care and maintenance.
• Each year a woman should see her physician to make sure it is the right size.
• Women who have gained weight or given birth should be re-fitted earlier to ensure the diaphragm fits correctly and stays effective.

How to use a diaphragm

A diaphragm may be inserted up to six hours before intercourse. When inserted correctly, neither sexual partner should feel the diaphragm during sex.

• Before inserting the diaphragm, wash your hands and then place spermicide inside the dome and around the outer rim of the birth control device. Additional spermicide must be applied for each act of sexual intercourse.
• Fold the diaphragm in half, keeping the edges together and the spermicide inside the fold.
• With the dome pointing down or backwards, insert the diaphragm all the way into the vagina, so that the diaphragm covers the cervix (the lower, narrow part of the uterus).
• Tuck the forward rim of the diaphragm up behind the pubic bone (the front of the pelvis) and the back rim up behind the cervix.
• If the diaphragm feels uncomfortable, check that it is in the proper position, or consult with a health care provider to be sure that the diaphragm is the correct size.
• After intercourse, the diaphragm should be kept in place for six to eight hours.
• The diaphragm must be removed every 24 hours to reduce the risk of a serious infection.

How to take care of a diaphragm

A diaphragm should be washed with warm water and soap each time it is removed. Dry the diaphragm carefully and store it in the provided container. Products like talcum or baby powder can damage the rubber, so they should not be used. A diaphragm should be checked regularly for holes by holding it up to a bright light and gently stretching the rubber to see if any light passes through. If the diaphragm is damaged, see a health care provider for a new prescription.

Safety and effectiveness of diaphragm contraceptive

When this birth control method is used correctly, the spermicide kills most of the sperm on contact and the diaphragm creates a barrier in front of the cervix to keep the surviving sperm from passing into the uterus. Diaphragms are 82 percent to 94 percent effective at preventing pregnancy if used with spermicide and used correctly.

Benefits of diaphragms

Unlike the birth control pill or birth control shot, diaphragms are only used at the time of sexual intercourse and do not require remembering to take medication.

No hormones are involved in the use of diaphragms, making them safe to use for women with medical conditions that prohibit estrogen and women who are breastfeeding. This also means the diaphragm does not affect the menstrual cycle.

Risks associated with diaphragms

Unlike male or female condoms, diaphragms do not provide protection against sexually transmitted diseases (STDs). Diaphragms are also less effective at preventing pregnancy than intrauterine devices (IUDs) or hormonal birth control (such as the pill, patch, or shot).

The diaphragm birth control device can irritate the urethra, causing urinary tract infections more frequently in some women.

Spermicide must be used along with the diaphragm each time intercourse occurs, and some people may develop an allergic reaction or irritation on their genitals from the spermicide. Irritated skin on the genitals can increase the risk of contracting an STD.