Using the Diaphragm

Because the diaphragm comes in many sizes, a physician will fit the client with the correct size.
During the fitting, the client will assume the Pap position; this enables the physician to take 'measurements'.
The client will then get an opportunity to practice insertion and removal of the diaphragm; the physician will double check to ensure correct placement.

Insert your diaphragm before intercourse. It can be inserted up to 6 hours before intercourse. Once inserted, it is immediately effective.

Before inserting empty your bladder and wash your hands.
Take the diaphragm and hold it up to the light. Check the diaphragm for any tears or holes in the cup or for cracks along the rim before each use.
Squeeze at least a tablespoon of spermicidal jelly into the cup, and spread it around the rim and inside the cup with a clean finger.
Press the rim of the diaphragm together with the spermicide inside the dome.
While standing, squatting, or lying, gently push it all the way into the vagina with the dome side facing down and the jelly side directed toward the cervix.
Push the diaphragm in as far as it will go, making sure that the front rim is tucked up under the pubic bone. It should cover the cervix, which feels like the end of your nose.
Now you are ready to have intercourse. You can use more spermicide or lubrication if you want. For extra lubrication we recommend spermicidal jelly, or a water-based lubricant such as KY jelly.
If you put your diaphragm in more than 6 hours before having intercourse, you should insert more spermicide (such as an applicator of contraceptive jelly or foam, VCF film or suppository) into your vagina without removing the diaphragm.
Before each act of intercourse you should also insert more spermicide (as above) into your vagina, without removing the diaphragm.
The diaphragm needs to be used with a spermicide every time you have intercourse.

After you take out your diaphragm, wash it with a mild soap like Ivory. Rinse and dry it well and put it away in its compact. Keeping your diaphragm away from heat and light will decrease the chance of weakening the rubber.
A regularly used diaphragm can last two to three years.
Products such as baby, body, or face powder seem to damage the rubber and should be avoided. You can dust your diaphragm with plain cornstarch, but be sure to wash it off before using again.
Oil-based products like Vaseline or cold cream damage the diaphragm.

Until you are sure the diaphragm is staying in place or until your first return visit, use a back-up method of birth control such as condoms or oral contraceptive pills.
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.

Return to the clinic or doctor for a fit check approximately four weeks after getting your diaphragm.
It is recommended to have a refitting annually, and after a weight gain or loss of 10 or more pounds, after abortion, or after a pregnancy.
During a routine yearly exam and Pap test your clinic doctor will check the fit and examine the diaphragm.
If you feel irritation or discomfort, make a diaphragm check appointment.

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

Concerns or problems inserting and/or removing the diaphragm
If the diaphragm becomes dislodged during intercourse
Abnormal vaginal bleeding, discharge, bad smell or other irritation
Pain or discomfort
Signs of toxic shock syndrome, such as sudden high fever, dizziness, rash that looks like a sunburn, sore throat, weakness, achiness, vomiting, diarrhea, or redness of the eyes.

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