A diaphragm is a barrier method of birth control made of a soft, flexible rim latex (rubber) or silicone dome-shape which is placed over the cervix, behind the pubic bone before intercourse; therefore preventing the sperm from reaching the uterus and stopping pregnancy occurring.
In order for this method of contraception to be effective, the woman must be examined and fitted for the diaphragm by her doctor or nurse practitioner. After the examination, a prescription will be provided for the precise size of diaphragm needed, which can be collected at a pharmacy.
Diaphragms must be specially fitted to each individual woman's anatomy so that they completely cover the woman's cervical opening and to make sure that they are the right size, since they come in different sizes. They must also be checked by a doctor or nurse every 12 months and specially if the user gains or loses more that 3 kilograms (6.6 pounds - 0.4 stones) or has any reproductive issues such as the birth of a baby, miscarriage or an abortion. They must also be re-evaluated for size and fittings at each one of these check ups.
The exact use of the diaphragm should be explained carefully by a healthcare professional to ensure its effectiveness for a maximum protection.
A diaphragm must always be used with a spermicidal gel. The spermicidal gel must be applied inside, and around the diaphragm's edges.
The ingredient for spermicides, is nonoxinol-9. Be aware though that even though diaphragms do not have any side effects or medical risks, some people can be very sensitive to the spermicides used in them and since it can cause allergies, it should not be used by those who find them irritating.
Nonoxinol-9 is a chemical which both kills the sperm ejaculated by a man and also helps with lubrication. However, research has indicated that nonoxinol-9 may increase the risk of catching certain STIs.
Spermicidal jelly or creams can be bought without prescription at a pharmacy.
Unless there are some sort of specific medical problem such as an abnormally shaped or prolapsed uterus, all women should be able to use a diaphragm without any problems.
A diaphragm can be inserted up to 6 hours before intercourse begins but should not be removed until 6 to 8 hours after. If the device is put in place more than 2 to 3 hours before sex takes place, more spermicide is required. The effect of spermicides normally wears out after a couple of hours so you should make sure that more is applied after that time. If the diaphragm is inserted or removed too soon, the spermicide wont be effective so be aware of that fact.
A diaphragm should not be left in place for any longer than 30 hours.
In addition to this, when intercourse happens several times in a short period of time, more spermicidal gel or cream will be required each time and without disturbing the diaphragm. This will be easily accomplished by using the special applicator that it is provided with the spermicide.
A diaphragm can be inserted and removed by women as they find them necessary.
When using the diaphragm, first it must be folded and then inserted into the vagina. When it is released, it expands to cover the cervix.
Unfortunately it can take some practise getting the diaphragm in place and removing it every time, so it is best that all women should practise several times in front of a healthcare provider in order to get familiar with the process and to make sure it feels comfortable and is correctly position every time.
Every woman will find the easiest most comfortable way to insert the diaphragm, in their own time. Some women prefer to use a plastic applicator that they can buy at pharmacies, while others will prefer inserting it directly with their fingers.
For some standing up with one foot up on a chair, bed or the toilet will be an easier position for insertion, while other women find it better squatting down instead.
Until the insertion of the diaphragm becomes second nature, a couple should use a second form of contraception at the same time.
Sometimes men like to learn to insert the diaphragm in order to add it as a form of foreplay before sex takes place.
Men should not feel the diaphragm at all during intercourse if it is the correct size, and it is properly inserted.
The diaphragm may help protect against cancer of the cervix and some sexually transmitted infections (STI).
Another additional benefit with a diaphragm, is that it blocks menstrual blood from reaching the vagina if inserted for protection against pregnancy during the menstrual cycle, so therefore sex can take place without having to worry about the menstrual flow.
Diaphragms must be washed with mild soap in warm water, dried out and returned to its container each time it is used and removed from the vagina.
Unfortunately, the average rate of effectiveness of the diaphragm for preventing pregnancy is only 85%.
With careful use up to 8 to 15 women in 100 will get pregnant in the first year of use. For those who are less careful is up to 20 women in 100.
Diaphragms can develop tiny holes, cracks or tears, and should be examined regularly by the user for damage by holding it up to the light. It is always best to have a spare one of the proper size at hand just in case any damaged is discovered.
Diaphragms that are carefully looked after normally last around 2 years.
Sometimes, and although rare, the diaphragm can move out of place during intercourse so at this point you must make sure that all action is stopped in order to re-adjust it to the right position again.
Diaphragms do not normally cause any pain, but can cause irritation in the vaginal wall, press uncomfortably against a full bladder or even a full bowel; so if it does cause some sort of pain, a woman must visit her doctor or family planning clinic as soon as possible, and use a different method of contraception in the meantime while the problem gets sorted out.
Unfortunately cystitis in women can also be a problem if they use diaphragms and will required treatment, if the problem persists, it is best to consult with a doctor.
A very similar device to a diaphragm is the cervical cap. These are small, flexible latex cups that fit directly over the cervix. Just like diaphragms, they come in different sizes but cap the cervix rather than block it, to prevent sperm from travelling into the uterus and fallopian tubes, and fertilizing an egg.
Cervical caps must be correctly sized and fitted just like diaphragms do, and the woman must be taught on how to place the cap securely by her doctor or nurse practitioner. Unfortunately they are much more complicated to insert than the diaphragm.
When using a cervical cup with a spermicide, they are 83% effective for preventing pregnancy.
One of the benefits of the cervical caps is that they can stay in place for up to 48 hours without requiring a re-application of spermicide, which makes them slightly more convenient when having repeated intercourse.
Women who are allergic to latex should not use a cervical cap.
Another big problem when using a cervical cap is, that if it is left in place for longer than it is recommended, a woman faces the risk of toxic shock syndrome (TSS), a rare but very serious infection.
Never confuse a diaphragm with a cervical cap.
I hope you find all this information helpful, enjoy a safe sex life!
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