A vaginal diaphragm is a soft, rubber dome stretched over a flexible ring. It is one of the barrier methods of birth control for women. Before sexual intercourse, you insert the diaphragm with some spermicide into the vagina. The diaphragm provides a cuplike barrier over the cervix. (The cervix is the opening of the uterus.) The diaphragm holds spermicide over the cervix to destroy sperm, thus preventing pregnancy.
Several sizes and types of diaphragms are available. Each woman's body requires special measurement and fitting by a medical professional to make sure that the diaphragm fits correctly.
The diaphragm can be put into the vagina up to 3 hours before intercourse. Each time before you use it, hold the diaphragm up to a light and look closely for any tears, holes, or weak spots. Before you insert the diaphragm, you must put spermicidal jelly or cream in the middle and around the rim of the diaphragm.
The physical position you use for inserting the diaphragm depends on your preference. The positions usually suggested are:
lying on your back with your knees up
stooping with your knees bent and wide apart
standing with one leg propped up on a stool or chair with your knees slightly bent.
You must leave the diaphragm in place for 6 to 8 hours after having sex so that the spermicide can destroy all of the sperm. If you are going to have sex again within this 6-hour period, do not remove the diaphragm. Put more spermicide into the vagina using the plastic applicator that comes with the spermicide. To have intercourse safely again after 6 hours, remove the diaphragm, wash it with soap and water. Recoat the diaphragm with spermicide and then reinsert it.
To take out the diaphragm, pull the rim gently with your index finger and remove it from the vagina. After each use, wash and dry the diaphragm. Store it in a dry container.
It is a good idea to urinate before you insert the diaphragm and after you take it out. This helps reduce the chance of getting an infection.
You should get a new diaphragm every 1 to 2 years.
The diaphragm has several benefits, such as:
It is one of the most reliable (90% to 98%) barrier methods of birth control if it is well fitted and properly used.
It helps reduce the risk of sexually transmitted diseases. However, it does not protect against sexual transmission of AIDS unless your male partner also uses a latex condom.
It is reusable and relatively inexpensive.
It is small and easy to carry.
Some of the disadvantages of a diaphragm are:
A prescription is required from a medical professional.
If it is not correctly fitted, it may cause discomfort.
Practice is needed to become comfortable and skilled in using a diaphragm.
It can be inconvenient to use, clean, and store.
You must keep a supply of spermicidal jelly or cream on hand at all times.
In some cases an allergic reaction to the rubber or spermicide causes a sensation of burning, itching, or redness.
Reexamination by a medical professional is necessary after pregnancy, abortion, pelvic surgery, or significant weight loss or gain (more than 20 pounds). The size of the diaphragm may need to be changed so that it fits correctly.
Some women may not be able to use a diaphragm because of changes in their body structure (for example, after childbirth).
It may (rarely) cause discomfort and reduce pleasure during intercourse.