What is the Diaphragm?
The diaphragm is a small dome made of soft rubber that is filled with spermicide and inserted into the vagina before sex. It sits over the cervix, or the opening to the uterus, creating a physical barrier that prevents sperm from entering the uterus. Any sperm that does reach the cervix is caught in the cup so that it does not enter the uterus, and is killed by the spermicide. To ensure that all sperm is killed after intercourse, women should wait 6 to 8 hours after intercourse before removing the diaphragm.
How effective is the Diaphragm?
On average, the diaphragm is just under 90% effective, with about 12 in 100 women getting pregnant every year using the diaphragm as their only method of birth control. This average can rise to only about 6 out of 100 unplanned pregnancies with perfect use. The discrepancy is caused in large part to either misplacing the diaphragm before sex, or neglecting to insert it entirely. The diaphragm does not prevent against STDs.
What are myths associated with the Diaphragm?
1. The diaphragm prevents against STDs.
The most common myth associated with the diaphragm is that it can be used to prevent HIV and STDs. This myth prevails because of its barrier mechanism, meaning that it works to prevent sperm from entering the uterus, which creates the sense that there is STD protection. While the diaphragm is very effective in preventing pregnancy, it does not prevent sperm from entering the vagina and therefore cannot protect against STDs. When having sex with a new or untested partner, it is important to use a condom to prevent the spread of STDs.
2. The diaphragm is difficult to use.
While many women experience a small amount of difficulty situating the diaphragm over their cervix during the first few insertions, the routine quickly becomes second nature and women tend to find insertion very easy. If you experience persistent problems with insertion, the diaphragm is probably not properly fitted.
3. Diaphragms are custom-fitted.
Although diaphragms are fitted to you, they are sized on a standardized scale and are not custom built for each woman. When a healthcare provider fits you for a diaphragm, she is measuring which standard size is best for you. Your prescription will represent the required diaphragm size, which most pharmacies will have on hand.
4. Diaphragm size does not change.
Over the course of her life, a woman’s body will change and, as a result, her diaphragm size will likely fluctuate. This can happen naturally and gradually, or can happen in response to a major body change such as childbirth. A diaphragm prescription is typically written for two years, after which point the woman must get refitted to check for size changes, and have her prescription renewed.
5. My partner will be able to feel my diaphragm.
With properly fitted diaphragms, your partner should not be able to feel the contraceptive during intercourse. In rare instances, however, intercourse can dislodge the diaphragm, in which case he may be able to feel it. If your diaphragm becomes dislodged during intercourse, it can be reinserted and will remain effective as long as ejaculation does not occur. If dislodgement happens frequently, consult your doctor as it may mean that your diaphragm no longer fits or that you are not inserting it correctly.
What are disadvantages of the Diaphragm?
Most women who use the diaphragm do not experience any complications. However, certain side effects can occur. The most common side effect is developing frequent urinary tract infections, as bacteria can get caught in the diaphragm if it remains in the vagina for too long. To avoid these infections, it is important to urinate before insertion and after intercourse. If the problems persist, it may mean that the diaphragm needs to be refitted. The proper size of the diaphragm can be checked by your healthcare provider.
Where can I get the Diaphragm?
Before getting a diaphragm, you need to go to your doctor to get fitted for the proper diaphragm size. After getting fitted, you can pick up a diaphragm with a prescription from a pharmacy. Talk to your doctor about scheduling a fitting if you think that the diaphragm might be the best birth control option for you.