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Diaphragm

All About the Diaphragm and Diaphragm Use

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Updated November 09, 2010

Diaphragm

Diaphragm and Spermicide

Photo Courtesy of Michael Matisse/Photodisc/Getty Images

What is a Diaphragm?

A diaphragm is a flexible, latex, dome-shaped cup with a bendable rim. It is designed to fit securely in the vagina to cover the cervix. Diaphragms have been used since the 1830s and require a prescription to obtain. They are considered to be the first major innovation for women seeking personal control to protect themselves from an unintended pregnancy. Due to improvements in design and effectiveness, diaphragm use still remains a popular birth control choice for many women.

How It Works:

A diaphragm acts as a physical barrier or barrier method. By blocking the opening of uterus, sperm are prevented from joining an egg. The diaphragm is held in place over the cervix by the vaginal muscles. Before being inserted, a diaphragm is coated with spermicidal cream, jelly, or foam; if any sperm manage to get over the rim of the diaphragm, they will be immobilized by the spermicide.

Types of Diaphragms

Diaphragms are available in many sizes and designs, so this increases your chances of finding one that is a good fit. In addition to size, there are two kinds of diaphragms:
  • A flat ring option: This type of diaphragm can be squeezed into a flat oval and is then inserted. The flat ring type also comes with an applicator, so this makes insertion a little easier.

  • An arcing or coil spring option: This type of diaphragm forms a bent circle when squeezed. You can insert an arcing or coil spring diaphragm with your fingers.

Advantages of a Diaphragm:

  • It has no effect on a woman's natural hormones
  • Is reversible, so fertility immediately returns
  • Usually cannot be felt by either partner
  • Very few side effects
  • Breastfeeding mothers can use a diaphragm
  • Is effective immediately
  • Can be easily carried in a pocket or purse
  • It may lower the risk of catching certain sexually transmitted diseases
  • May prevent against some types of precancerous changes in the cervix
  • Can be inserted hours ahead of time, so it does not interrupt sexual activity

Disadvantages:

  • Some women report that this method is messy and inconvenient

  • Requires some planning ahead (must be in place every time you have sex)

  • Some women find diaphragms difficult to insert

  • They may require refitting

  • Diaphragms may be pushed out of place by some sexual positions, penis sizes, and thrusting angles and techniques

  • The spermicide and/or semen may leak out during the 6 hours after intercourse (which some women report as being uncomfortable) - wearing a panty liner may help

Who Can Use:

In general, most women can use a diaphragm. However, this method is not recommended for women who are uncomfortable touching their genitals or for those with allergies to latex or spermicide (some women who have a mild reaction to spermicide find that switching brands can help lessen this issue).

Additional conditions that may rule out diaphragm use include:

Possible Side Effects:

The most concerning side effect is the slight risk of toxic shock syndrome (TSS) if the diaphragm has been left in place for longer than 24 hours. In these rare cases, symptoms of TSS include diarrhea, vomiting, a sunburn-type rash, dizziness, sudden high fever, faintness, weakness, and sore throat, aching muscles and/or joints. If you are experiencing these symptoms, remove your diaphragm and contact your doctor immediately.

Some women who use diaphragms may get repeated urinary tract/bladder infections. This may be alleviated by urinating before inserting the diaphragm. Sometimes, if your diaphragm is too large, the rim can press against the front wall of the vagina thereby irritating the urethra (the tube that carries urine from your bladder), so you may need to have your diaphragm refitted.

Where to Buy and Costs:

If you want to use a diaphragm, you need to get fitted for one by your doctor. A diaphragm is then available by prescription. Your doctor will examine you to make sure you are a good candidate for diaphragm use and will determine your correct diaphragm size. Diaphragms may be purchased at a pharmacy. An examination to be fitted for a diaphragm may cost around $50 to $200. The price for a diaphragm averages from $25 to $45. Spermicidal jelly or cream can also be purchased at a drug store and may cost about $8 to $17 for a kit.

Keep in mind that you may need to be refitted for a new sized diaphragm after:

  • Abdominal or pelvic surgery
  • A full-term pregnancy
  • A miscarriage or abortion (after 14 weeks of pregnancy)
  • Your diaphragm is more than 2 years old
  • A 20-percent change in weight, or if you have gained or lost more than 10 pounds
It is also a good idea to keep up with regular pelvic examinations, and make sure to bring your diaphragm to your examination.

Diaphragm Effectiveness:

Typical use: 84% effective

Perfect use: 94% effective

Of every 100 women who use diaphragms with spermicide, 16 will become pregnant (with typical use) and 6 will become pregnant with perfect use during the first year of use.

Next Page: Increasing diaphragm success, important things to be aware of, caring for diaphragms, and information about STD protection

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