Diaphragm

What is a diaphragm?

A diaphragm is a soft rubber cap which is often used with a spermicidal jelly or cream. It is inserted in the vagina and placed over the cervix. The diaphragm prevents conception by holding spermicidal jelly or cream against the cervix and preventing the sperm from reaching the uterus. The diaphragm is a popular and effective birth control method, but does not protect against many STDs.

Your doctor must make a measurement in the vagina to choose the correct size for the diaphragm. He or she will show you how to insert the diaphragm. Be sure to insert it yourself and have the doctor check that it is in properly. When the diaphragm is in correctly, neither partner should feel it.

How effective is the diaphragm?

The diaphragm can be 95% effective if used properly. However, because of occasional misuse, the real rates of effectiveness are actually lower.

How is a diaphragm used?

The diaphragm is a birth control method that requires some time and planning. Before intercourse, one must coat the diaphragm with spermicidal jelly and then insert it. If some of the spermicide gets on the vulva then it may be wiped off after insertion. This will insure that it does not interfere with oral sex. After intercourse, the diaphragm must remain inside the vagina for six to eight hours. If intercourse occurs again within the six to eight hours then add another applicator full of spermicide.

After it has been removed, the diaphragm should be washed with mild soap and water, dried, dusted with cornstarch (not talcum powder because it destroys rubber) and replaced in its container. Check regularly for holes. This can be accomplished by holding it up to water or filling it with water. Furthermore, there may be displacement of the diaphragm when the penis is withdrawn and reinserted repeatedly. If you loose weight or give birth you may need to be refitted because you may need a different size.

There are three types of diaphragms available:

• coil spring diaphragm - prescribed to women with strong vaginal tone (good strength of the vaginal muscles) and no genital abnormality
• flat spring diaphragm - for women with a shallow pubic arch or moderate descent of bladder or rectum
• arching spring diaphragm - is for women with weak vaginal tone moderate descent of the pelvic organs or with the uterus bent far forward or backward.

Practical concerns involved when using a diaphragm

The diaphragm is a birth control device which is effective in stopping pregnancy but ineffective when stopping the spread of STDs. The first concern when using a diaphragm is whether it will become part of your regular sexual routine. Some women find a diaphragm to be a hassle, and it does take a bit of perseverance. The second concern is that while the diaphragm can be used during menstruation, there is a slight risk of Toxic Shock Syndrome. Finally, the size and care of the diaphragm are important. If a diaphragm is too large, it will cause some discomfort and the woman may experience difficulty with urinating. This is usually easily solved by switching to a smaller diaphragm. If a diaphragm is not removed it may cause a foul smelling discharge, low back pain and general pelvic discomfort.