Options for Sexual Health

What is a diaphragm?

• A diaphragm is a soft, thin dome-shaped rubber cup with a flexible rim.
• Spermicidal jelly is placed inside the dome of the diaphragm.
• The diaphragm is placed high in the vagina to hold the spermicide against the cervix.
• The diaphragm comes in various sizes and must be fitted by a clinician to be effective.

How does the diaphragm work?

The diaphragm acts as a barrier between the opening of the cervix and semen which contain sperm. The fit may not be tight enough to stop all the sperm from getting past the diaphragm; therefore, the spermicide is used to kill the sperm.

• It can be inserted several hours before intercourse, but it must be left in the vagina for at least 6 hours following the last episode of intercourse. Additional spermicidal jelly should be inserted into the vagina before each act of intercourse without removing the diaphragm.
• It can be left in for up to 24 hours total time.
• You use it only when having intercourse. It is NOT meant to be used as a menstrual product.
• The diaphragm is not considered to be an effective method of protection against sexually transmitted infections.

How effective is it?

The contraceptive effectiveness of this method of birth control ranges from 84% (actual use) to 94% (perfect use).

Advantages

• It is female controlled and does not required partner assistance
• There is an immediate return to fertility as it offers contraception only when needed
• It can be used for 2-3 years (if cleaned and stored properly)
• It can be inserted several hours before intercourse
• It can be left in for up to 24 hours total time (intercourse may be repeated in that time frame; however, additional spermicide should be inserted into the vagina while leaving the diaphragm in place. (Please read Spermicide fact sheet for side effects, advantages, and disadvantages).

Disadvantages

• Reduces spontaneity
• Need to be comfortable touching your vagina
• Requires visit to clinic or physician for fitting

Are there any problems using a diaphragm?

• If you or your partner is allergic to spermicidal jelly, you will need to be fitted with a silicone diaphragm if you choose this method of contraception.
• The use of a diaphragm can increase the risk of getting a urinary tract infection in some women. The diaphragm must be carefully washed and dried after use to avoid infections.
• The wrong-size diaphragm can cause cramping or pelvic pain and will not provide effective protection against pregnancy. Refit your diaphragm after a 10 pound weight gain or loss.
• Although rare, cases of toxic shock syndrome (TSS) have been reported with diaphragm use during the menstrual period. It is recommended that a diaphragm not be used if you are bleeding from your vagina for any reason or have a vaginal, cervical or pelvic infection.
• Use another method of birth control such as foam and condoms during your period.

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