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Quick GuideBirth Control Methods, Side Effects, Effectiveness
The diaphragm is a soft, flexible, dome-shaped latex cup which is inserted into the vagina prior to intercourse. The rim of the cup contains a coil spring of metal which serves to hold it in place. The diaphragm blocks access to the cervix so that sperm cannot pass from the vagina into the uterus. The diaphragm must be covered on both sides and especially around its rim with spermicidal jelly, cream, or foam in order to form a tight seal with the vaginal walls.
A woman should insert the diaphragm into her vagina no more than 4 hours prior to intercourse. Following coitus, she should check the diaphragm should be checked to ensure that it was not mechanically dislodged. The diaphragm must be left in place for at least 6-8 hours following intercourse, at which time it should be removed. Additional spermicidal jelly or foam must be inserted into the vagina each act of intercourse.
Since diaphragms are only available with a prescription, a woman must see a health care practitioner to have a diaphragm properly fitted (they come in a range of sizes), and to learn proper insertion techniques. There are no known long-term health risks associated with using the diaphragm and spermicide method of birth control. Some women may find spermicides to be irritating, but changing brands of spermicides may help. There is also an increased risk of urinary tract infections with diaphragm use. One possible reason is that the diaphragm puts increased pressure on the urethra or the spermicide may contribute to irritation leading to infection. (The cervical cap is not associated with increases in urinary tract infections.)
The diaphragm may be appealing to women because it offers a safe temporary (not permanent) birth control that is under her control.
When the diaphragm and spermicide are used correctly, they are thought to have over an 82% success rate (18 pregnancies/100 women per year). To ensure protection, it is important to check the diaphragm after every use for rips or holes after each usage. This is best accomplished by filling the diaphragm with water and then holding it up to the light to observe for leakage. Also, the fit of the diaphragm should be checked annually, following pregnancy, and after significant weight loss.
Using a diaphragm does not confer protection against sexually transmitted infections, although the spermicide does give partial protection against gonorrhea and Chlamydia. It can, however, be used with condoms in order to confer some protection against sexually transmitted diseases (STDs).