Options for Sexual Health

How do I insert the cap?

1. Before inserting the cap, empty your bladder and wash your hands.
2. Check the cap carefully for holes, tears, or cracks.
3. Fill the cap 1/3 full of spermicidal cream or jelly.
4. Find the position that is best for you to insert the cap (e.g., one foot on a chair, squatting...).
5. Feel for your cervix with your longest finger. It will feel like the end of your nose. If you have trouble finding your cervix, bear down as if you are trying to have a bowel movement. This will help push it closer to your finger.
6. Using one hand, open the lips of your vagina, and with the other hand squeeze the rim of the cap together firmly and put it into the vagina. Tip the cap so the open part is facing toward the back and aim for your cervix.
7. Push the cap all the way up the vagina to the cervix. It should attach to the cervix easily. Most women feel nothing as it slips on but a few can tell when it takes hold.
8. Press the rim of the cap around the cervix and pinch the rounded end to establish the suction that helps hold it in place.
9. Check to see if your cervix is covered by pressing on the dome of the cap, then sweep your finger around the cap. You should feel your cervix through the cap, not beside it. Check the suction by tugging on it.
10. If the cap is not in the right place, try to push it onto your cervix or take it out and try again.
11. You may find it harder to insert the cap after sexual arousal, because the vaginal tissues are more puffed up and firmer. Think about putting the cap in earlier, even if you are not sure you will need it or keep some condoms handy.
12. The cap should be in place ½ hour before intercourse for good suction to develop. If you have intercourse more than once, you do not have to put in more spermicidal cream or jelly.
13. Be sure to check that the cap is still in place over your cervix before and after each act of intercourse.

CAUTION
Leave the cap in place for at least 6 hours after the last intercourse.
Do not leave the cap in place for more than a total of 24 hours.

How do I remove the cap?

1. Empty your bladder and wash your hands.
2. Take the cap out in the same position you used to put it in. It may be easier to sit on the toilet as it relaxes the muscles and lets the uterus and cervix move down so the rim of the cap is easier to reach.
3. Insert your longest finger into your vagina and press on the rim of the cap until the suction is broken and you can tip it off the cervix. Once you've broken the suction, gently put your finger over the rim and inside the cap and pull it out.
4. If you have trouble breaking the seal, bear down while trying. If it's too hard to get out stop trying for a while and try again later. Call your doctor if you can't remove it on the second try.
5. Wash the cap with a mild soap and water.* Rinse well and examine it for any cracks or holes by holding it up to the light or seeing if it will hold water without leaking.
6. Dust the cap with cornstarch and store in its box away from heat, oils, or inks.
7. Be sure to rinse off the cornstarch before using again.

*If you have had a cervical or vaginal infection or if there's any bad cap odour, wash it in warm soapy water, soak it in isopropyl (rubbing) alcohol for 20 minutes, rinse well with water, and then dry it out.

Recommendations

• During the first 8 to 10 times you use the cap, also use a spermicide and condoms for back-up. Check the cap before and after intercourse to make sure it stays in place.
• Use the cap every time you have intercourse except during your period.
• To avoid infections, including toxic shock, do not use the cap any time you have vaginal bleeding or have any vaginal, cervical or pelvic infection. Be careful to wash your hands and the cap as instructed.

When do I return to the clinic?

• Two to four weeks after initial fitting to check the fit, and then annually. It is important to continue with regular Pap tests.
• To re-fit the cap after having a baby, a miscarriage or late abortion, or a gain or loss of 10 pounds.

If you experience any of the following symptoms call your clinic, physician or go to the nearest emergency department

Reviewed by Danielle Chard, RN, BSc Nursing, Director of Clinic Services 11/21/07