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Diaphragms

What is a diaphragm?

The diaphragm is a round silicone cup that holds spermicidal jelly or cream against the cervix. Although it may prevent some sperm from entering the cervix, it does not and cannot fit snugly enough to protect against pregnancy by itself. Therefore, spermicide is essential for the diaphragm to work.

How is a diaphragm used?

The diaphragm may be inserted no more than two hours before sexual intercourse.  After coating the bowl of the diaphragm with spermicidal cream or jelly, grasp the diaphragm between the thumb and forefinger, pinch the edges together, and insert into the vagina. up behind the pubic bone.  Check to be sure your cervix is covered by the smooth dome of the diaphragm.

There are three positions you may assume to insert the diaphragm.  Use the one most comfortable for you.

Remember to leave the diaphragm in place for at least 8 hours after intercourse and to remove it as soon as possible thereafter.  If you have intercourse again before removing the diaphragm, insert an applicator of spermicide into the vagina before each act of intercourse.

We do not recommend wearing your diaphragm for more than 24 hours. Do not use your diaphragm as your birth control method during your menstrual period. Either abstain or use condoms if you are sexually active at this time.

How do I care for my diaphragm?

  • After each use wash the diaphragm with mild soap and warm water, rinse it well, and dry it.  
  • Check it for holes by holding it up to a light and stretching the silicone dome with your fingers.  If you find a hole in your diaphragm, call the consulting nurse right away to discuss the risk of pregnancy and whether to take emergency contraception
  • Store the diaphragm in its container in a cool, dry, safe place.
  • Do not use your diaphragm when using any vaginal medication, like those used to treat yeast infections.

How effective is the diaphragm?

Depending on the frequency of intercourse, research has shown that if the diaphragm is used consistently and correctly, it is 90-96% effective in preventing pregnancy. To increase effectiveness, you may use condoms with your diaphragm.

What are some common errors in use that result in decreased effectiveness?

  1. Not inserting the diaphragm soon enough.  It should always be in place before the penis is anywhere near the vagina.
  2. Not adding more spermicide every time you have sex.
  3. Not using the diaphragm every time you have sex.

Questions and answers

  1. Will the diaphragm fall out when I stand up and walk around?
    • No, you can move around freely without the diaphragm falling out.  It is not possible for the diaphragm to get lost in your body.
       
  2. Can I go to the bathroom with my diaphragm in place?
    • Yes, you can urinate without worry. However, if you have a bowel movement, check afterwards to be sure the diaphragm is still in place.
       
  3. Will the diaphragm bother my male partner?
    • A properly fitted and inserted diaphragm should not be noticed by either you or your partner.
       
  4. When do I need to replace my diaphragm?
    • If you take care of it in the way described above, your diaphragm should last about 2 years.  However, you may need a different size diaphragm if you experience any of the following:
      • A weight change of 10 pounds or more
      • Pelvic surgery
      • Pregnancy— including abortion and miscarriage
         
  5. Can my diaphragm use cause problems?
    • Most women who have learned to use a diaphragm and use it correctly have no side effects.  However, the following side effects have been reported by some users:
      • Irritation or allergy from the silicone or spermicide
      • Urinary tract infections
      • Very rarely, toxic shock syndrome (TSS).  Primary symptoms of TSS are sudden high fever (102° or higher) and vomiting, diarrhea, fainting or near fainting when standing up, or a rash that looks like a sunburn. Other signs include aching of muscles and joints, redness of the eyes, sore throat, and weakness. If you have a sudden high fever and one or more of the other symptoms, remove your diaphragm and call the clinic immediately.
      • Frequent use of spermicides containing nonoxynol-9 has been associated with genital lesions, which could increase the risk for HIV transmission. 
         
  6. How do I get a diaphragm?
    • You will need to have had an annual exam within the last year. Contact Hall Health to schedule an appointment for your diaphragm fitting and to talk with the family planning counselor. While there is a cost to the diaphragm itself, there's no additional cost associated with the fitting.

Additional resources

Hall Health's website contains information about the Pill, Progestin-only pills (POPs), the OrthoEvra Patch, NuvaRing, the IUD and Nexplanon.  We also offer information about when you need a Pap test.

Bedsider.org provides information about many different birth control methods.

Planned Parenthood's website offers information on the effectiveness of different kinds of birth control methods.

If you have any questions and are a UW student or established Hall Health patient, you may call one of our Consulting Nurses for further information.

 

Authored by: Hall Health Center Women's Health Clinic staff

Reviewed by: Hall Health Center Women's Health Clinic staff, January 2014