Diaphragm

Female Contraception - Diaphragm or capDiaphragms are domes made of soft silicone. You insert them into your vagina before sex to cover the cervix, so that sperm cannot get into the womb. You need to use spermicide with them, which kills the sperm. They are useful for women who do not want to use a hormonal or long lasting contraceptive.

Benefits:

  •  Easy to use yourself
  • Suitable for unplanned sex – can be put in up to two hours before sex
  • No health risks
  • Can be reused for up to a year
  • No effect on periods
  • Fertility returns to normal when removed.

Disadvantages:

  • They are typically 82% effective; meaning 18 in every 100 women will be pregnant within a year of using this method.
  • You have to leave your diaphragm in for six hours after you’ve finished having sex.
  • Some women find they get a bladder infection or some irritation from using a diaphragm, or from the spermicide.
  • The diaphragm does not protect you against STIs, so you may need to use condoms as well.

Inserting a diaphragm

Your doctor or nurse will show you how to put in a diaphragm. Diaphragms come with instructions and are all inserted in a similar way:

  • With clean hands, put a small amount of spermicide on each side of the diaphragm (also putting a little spermicide on the rim may make the diaphragm easier to put in).
  • Put your index finger on top of the diaphragm and squeeze it between your thumb and other fingers
  • Slide the diaphragm into your vagina, upwards. This should ensure that the diaphragm covers your cervix.
  • Always check that your cervix is covered – it feels like a lump, a bit like the end of your nose
  • If your cervix is not covered, take the diaphragm out by hooking your finger under the rim or loop (if there is one) and pulling downwards, then try again
  • Some women squat while they put their diaphragm in; others lie down or stand with one foot up on a chair – use the position that's easiest for you
  • You can insert a diaphragm up to three hours before you have sex – after this time, you will need to take it out and put some more spermicide on it
  • You may be fitted with a temporary diaphragm by your doctor or nurse. This is for you to practice with at home. It allows you to learn how to use it properly, see how it feels and find out if the method is suitable for you. During this time, you are not protected against pregnancy and need to use additional contraception, such as condoms, when you have sex
  • When you go back for a follow-up appointment with your doctor or nurse, wear the diaphragm so they can check that it is the right size and you have put it in properly. When they are happy that you can use a diaphragm properly, they will give you one to use as contraception.

Removing a diaphragm

A diaphragm can be easily removed by gently hooking your finger under its rim, loop or strap and pulling it downwards and out. You must leave all types of diaphragm in place for at least six hours after the last time you had sex.
You can leave them in for longer than this, but do not leave them in for longer than the recommended time of 30 hours (including the minimum six).

Looking after your diaphragm

After using, you can wash your diaphragm with warm water and mild unperfumed soap. Rinse it thoroughly, then leave it to dry. You will be given a small container for it, which you should keep in a cool, dry place.
Never boil a diaphragm.

  • Do not use disinfectant, detergent, oil-based products or talcum powder to keep it clean, as these products can damage it
  • Your diaphragm may become discoloured over time, but this does not make it less effective
  • Always check your diaphragm or cap for any signs of damage before using it
  • You can visit your GP or nurse when you want to replace your diaphragm. Most women can use the same diaphragm for a year before they need to replace it. You may need to get a different size diaphragm if you gain or lose more than 3kg (7lb) in weight, or if you have a baby, miscarriage or abortion.

How effective is it?

When used correctly with spermicide, a diaphragm is 92-96% effective at preventing pregnancy – this means that between four and eight women out of every 100 who use a diaphragm as contraception will become pregnant within a year. With typical use, a diaphragm is only 82% effective.

What makes it less effective?

  • Not using spermicide, or having sex 3 hours or more after you apply spermicide
  • You do not apply extra spermicide each time you have sex
  • Removing the diaphragm before 6 hours after sex
  • If it's damaged, for example, it has holes or has torn
  • If it is not the right size for you and does not cover your cervix
  • You use oil based products, such as baby lotion, bath oils, moisturiser or some vaginal medicines (for example, pessaries).

For more information visit the FPA website.