What Is It?
The diaphragm is a dome-shaped bowl made of thin, flexible
rubber that sits over the cervix.
How Does It Work?
The diaphragm keeps sperm from entering the uterus by blocking
the cervix. For added protection,
spermicide
is put into the bowl of the diaphragm and along its edges before
inserting the diaphragm high into the vagina so it covers the
cervix.
The diaphragm is inserted up to 6 hours before having sex. More
spermicide must be used each time you have sex while wearing the
diaphragm. After sex, the diaphragm must be left in for at least 6
hours, but no longer than 24 hours. The diaphragm can be removed by
placing a finger into the vagina to pull it out.
Each time the diaphragm is removed, it must be washed, rinsed,
and dried, then stored in its case. It should not be dusted with
baby powder and should never be used with oil-based lubricants such
as mineral oil, petroleum jelly, or baby oil. These substances can
cause the rubber to become brittle and crack. Other vaginal creams,
such as yeast medicines, can also damage the rubber.
A diaphragm should be replaced at least every 2 years. It should
be examined regularly for holes or weak spots, and replaced as
needed.
How Well Does It Work?
Over the course of 1 year, 16 out of 100 typical couples who
rely on the diaphragm to prevent pregnancy will have an accidental
pregnancy. In general, how well each type of birth control method
works depends on a lot of things. In the case of a diaphragm, the
two most important things to be sure of are that it fits correctly
and that is used
every time
a couple has sexual intercourse.
Protection Against STIs
The diaphragm
does not
protect against
sexually transmitted infections (STIs)
. Couples having sex must always use
condoms
along with the diaphragm to protect against STIs.
Abstinence (not having sex) is the only method that always
prevents pregnancy and STIs.
Possible Side Effects
Most women who use a diaphragm have no problems with it. The
side effects that some women have include:
- Spermicides may irritate the vagina and surrounding
skin.
- Strong odors or vaginal discharge may appear if the diaphragm
is left in too long.
- The rubber or latex in the diaphragm may cause an allergic
reaction (this is rare).
-
Toxic shock syndrome
(TSS) is a rare complication if the diaphragm is left in too
long.
Who Uses It?
Girls who can take responsibility for sex in advance use
diaphragms. If a girl chooses to use a diaphragm, she must also
always have a supply of spermicide. In addition, the diaphragm is
good for anyone who wants to have sex during her period - the
diaphragm catches the blood before it leaves the vagina.
The diaphragm isn't good for anyone who is uncomfortable or
uneasy with the thought of reaching into her vagina. And it may not
be a good choice for girls with certain medical conditions, such as
frequent urinary tract infections.
How Do You Get It?
A doctor must fit a girl with a diaphragm. During a pelvic exam
the doctor will measure a girl's vagina and then determine
which size of diaphragm is right for her. The doctor or nurse will
then teach her how to insert and remove the diaphragm. Some doctors
may even ask a girl to practice at home and then come in while
wearing the diaphragm to check that she has done it right. A
diaphragm that's inserted incorrectly can result in
pregnancy.
During the annual exam, the doctor will check that the diaphragm
still fits correctly. The diaphragm may not fit correctly if a girl
has gained or lost 10 pounds, had a baby, had an abortion, or was
fitted when she was a virgin and she is now having sex.
How Much Does It Cost?
A diaphragm usually costs about $30 to $50. It should be
replaced every 2 years. There is also the cost of the doctor's
visit and a fitting fee. Many health insurance plans cover these
costs and family planning clinics (such as Planned Parenthood)
charge much less. In addition, the cost of spermicide is about
$0.50 to $1.50 per use.
Reviewed by:
Larissa Hirsch, MD
Date reviewed: February 2007
Originally reviewed by:
Neil Izenberg, MD, and George A. Macones, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation/KidsHealth. All rights reserved.