Discovering If a Diaphragm Is the Best Option for You

A diaphragm is a flexible, dome-shaped cup with a bendable rim. It is made of soft silicone or latex. You bend the diaphragm in half and insert it into the vagina. A diaphragm covers the cervix to help prevent pregnancy.

A woman holding a diaphragm
Dorling Kindersley / Getty Images

History

Diaphragms have been used as a birth control method since the 1830s. You need a prescription to get a diaphragm. They are actually considered to be the first major contraceptive innovation for people who wanted the ability to protect themselves from unintended pregnancy.

Over the years, there have been many improvements in the design and effectiveness of diaphragms — so they are still a popular birth control choice for many people. In fact, with typical use, they are 88% effective, and with perfect use, they are 94% effective.

How It Works

A diaphragm acts as a physical barrier. It blocks the opening of the uterus. This way, sperm cannot reach and fertilize an egg.

Before you insert your diaphragm, you need to coat it with a spermicidal cream or jelly — so, if any sperm manage to get over the rim of the diaphragm, they will hopefully be killed by the spermicide. The diaphragm is held in place by your vaginal muscles.

How to Use It

You will find that with a little bit of practice, a diaphragm is very easy to use. Your healthcare provider should show you how to insert and take out your diaphragm. You should keep practicing at home until you feel comfortable using your diaphragm.

Remember:

  • You must keep your diaphragm in place for six hours after the last time you had sex.
  • If you have sex again, make sure to insert more spermicide deep in your vagina.
  • If you have sex more than six hours after you have inserted the diaphragm, you also need to add more spermicide deep in your vagina.
  • Do not leave your diaphragm in place for more than 24 hours.

Types

Diaphragms come in different sizes and designs. This increases your chances of finding one that is a good fit for you. Other than size, there are two kinds of diaphragms:

  • A Flat Ring Option: This type of diaphragm can be squeezed into a flat oval before being inserted. The flat ring type has a thinner rim. It also comes with an applicator, which 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

Why should you consider using a diaphragm? A diaphragm can offer you the following advantages:

  • It is hormone-free, so it has no effect on your natural hormones.
  • It is reversible, so your fertility immediately returns when you take it out.
  • A diaphragm cannot usually be felt by either partner.
  • There are very few side effects (urinary tract infections and vaginal irritation are the most common side effects).
  • People who breastfeed can use a diaphragm.
  • It is effective immediately.
  • A diaphragm can be easily carried in your purse, bag, backpack, or messenger bag.
  • It may lower the risk of catching certain sexually transmitted infections (STIs). However, you should still use another method of protection against STIs (like external condoms, also referred to as "male" condoms).
  • Diaphragms may prevent some types of precancerous changes in the cervix (but more research is needed to know more about this).
  • It can be inserted hours ahead of time, so it does not interrupt sexual activity.

Who Can Use It

Most people can use a diaphragm. But, a diaphragm may not be for you if your uncomfortable touching your vagina or if you have allergies to latex or spermicide (some who have a mild reaction to spermicide find that switching spermicide brands can help).

Additional conditions that may rule out diaphragm use include:

  • Having given birth within the last six weeks.
  • A history of frequent urinary tract infections.
  • Recent cervical surgery.
  • A sagging uterus or vaginal obstructions.
  • A recent abortion (after the first trimester).
  • History of toxic shock syndrome.
  • Poor vaginal muscle tone.

How to Get One

If you want to use a diaphragm, you need to get fitted for one by your healthcare provider. Once this happens, your practitioner can give you a prescription. Diaphragms may be purchased at a pharmacy. The cost of a diaphragm fitting and the actual diaphragm will vary based upon your insurance.

  • Abdominal or pelvic surgery.
  • A full-term pregnancy.
  • A miscarriage or abortion (after 14 weeks of pregnancy).
  • A 20% change in weight — or if you have gained or lost more than 10 pounds. Keep in mind that you may need to be refitted for a new diaphragm if you have.
  • You should also be fitted for a new diaphragm if your present one is two or more years old.

STI Protection

There is some evidence that diaphragm use may protect you against some sexually transmitted infections. Research has shown that people who use a diaphragm have a 65% lower chance of getting gonorrhea and trichomoniasis compared to people using no birth control. The frequency of chlamydia is also reduced in diaphragm users. This may be because the cervix is the site of infection for gonorrhea and chlamydia (and the diaphragm covers the cervix) and because spermicide may destroy the trichomoniasis parasite.

Check to see if the spermicide you use with your diaphragm contains nonoxynol-9. Frequent use of nonoxynol-9 may cause damage to your vaginal tissue. This irritation may put you at a higher risk of getting an STI or infection. It is best not to rely on your diaphragm to protect you against sexually transmitted infections.

Frequently Asked Questions

  • How does the diaphragm prevent pregnancy?

    A diaphragm is a bowl-shaped barrier contraceptive device that sits over the cervix to prevent sperm from entering the uterus. Diaphragms are made of thin, flexible silicone. They should be inserted up to two hours before sexual activity and left in place for at least six hours after sex. 

  • How do you get a diaphragm?

    Diaphragms are sold at the pharmacy with a prescription from a gynecologist or women’s health clinic. Diaphragms come in different sizes. The doctor will perform a pelvic exam to determine the right size for you. Spermicide used with diaphragms is available over the counter. 

    Depending on your insurance coverage, a diaphragm can cost anywhere from $0 to about $250.

  • How effective are diaphragms as birth control?

    Studies show diaphragms are 88% to 94% effective in preventing pregnancy when used with spermicide. Proper fit and placement and consistent use ensure better pregnancy protection.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Knowles J. A history of birth control methods.

  2. Neumours Foundation: Teens's Health. The diaphragm.

  3. Planned Parenthood. How do I get a diaphragm?

  4. Planned Parenthood. How effective are diaphragms?

Additional Reading

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.