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A diaphragm is a small, dome-shaped silicone shield that sits over the female cervix. The diaphragm is a barrier method of birth control that works by preventing sperm from traveling through the cervix and entering into the uterus to join with an egg. When used properly with a spermicide, a diaphragm is 84 to 94 percent effective at preventing pregnancy, according to the Centers for Disease Control and Prevention.
SPERMICIDE
Spermicidal jelly, cream or gel must be used with a diaphragm to reduce the chance of any sperm reaching the uterus. Spermicide is put inside the bowl of the diaphragm and around the edges; a good tablespoon is enough. Spread it all over the diaphragm and around the rim. Spermicides kill sperm cells, providing a second mechanism of protection to prevent pregnancy.
PLACEMENT
After applying the spermicide, the diaphragm is folded in half and inserted into the vagina, high enough so it is covering your cervix. Always check with your finger to be sure the diaphragm is covering your cervix; the cervix fells like the tip of your nose. The edge of the diaphragm should be tucked beneath the pubic bone. Your health care provider will teach you how to use your diaphragm and answer any questions you may have.
TIMING
The diaphragm must be placed into your vagina before sexual intercourse and left in place for 6 to 8 hours after sex. It can be inserted right before or up to four hours before sex, although it is preferable to insert the diaphragm as close as possible to when you have sex so that the spermicide is fresh. More spermicide must be used if you have sex again before it is time to remove the diaphragm. Use the applicator to insert more spermicide; do not remove the diaphragm to insert more spermicide. You should not leave a diaphragm in place for longer than 24 hours. The diaphragm is removed by placing a finger into the vagina and hooking the rim to pull it out. The diaphragm must be washed with mild soap, rinsed, dried and stored in its case after use. It should never touch petroleum jelly or baby oil, since these substances can cause the material to break down.
STDs
A diaphragm does not protect you against sexually transmitted diseases, such as HIV, gonorrhea, syphilis and chlamydia. Having your partner wear a condom reduces the risk of STDs and provides added protection against pregnancy.
POTENTIAL CONCERNS
You must be properly fitted for a diaphragm by a health care professional, which some women find embarrassing or inconvenient. A prescription is required to buy one, although some clinics will have them for sale after you have been fitted. A diaphragm needs to be replaced about every two years. If you gain or lose 15 to 20 pounds, you need to be checked to determine if you need a different size diaphragm. A diaphragm is probably not the best contraceptive choice for women who are uncomfortable touching their genitalia. Additionally, some women get frequent urinary tract infections when using a diaphragm. If this happens, discuss prevention and other birth control options with your health care provider. Sensitivity to spermicides is another potential problem with diaphragm use; try switching to another brand. Occasionally, a diaphragm may slip out of place with certain sexual positions or deep, forceful thrusting. If this occurs, the spermicide provides backup protection. This is why you should never use a diaphragm without spermicide.
