A diaphragm is a dome-shaped, flexible cup made of silicone or latex, serving as a barrier method of birth control. Inserted into the vagina before intercourse, it covers the cervix, preventing sperm from reaching the uterus. Diaphragms are used with spermicide, a substance that immobilizes or kills sperm, enhancing effectiveness. This hormone-free method prevents pregnancy.
Getting Started with Your Diaphragm
Before using a diaphragm, obtain a prescription from a healthcare provider. During this visit, a professional will conduct a pelvic exam to ensure proper fitting, as diaphragms come in various sizes to accommodate individual anatomy. Some newer “one-size-fits-most” diaphragms are available, but a fitting is still advisable to confirm suitability. Once you have your diaphragm, always inspect it for any holes, tears, or weak spots by holding it up to a light or filling it with water before each use.
Wash hands thoroughly with mild soap and water before handling the diaphragm to prevent introducing bacteria. Apply spermicide directly to the diaphragm, typically a teaspoon (5 mL) placed into the dome and spread around its rim. This enhances the diaphragm’s effectiveness.
Step-by-Step Insertion
Select a comfortable position for insertion, such as squatting, standing with one leg elevated, or lying down, similar to inserting a tampon. With clean hands, fold the diaphragm in half by pinching the rim, making it narrow and easier to guide into the vaginal canal.
Gently slide the folded diaphragm into your vagina, aiming it downwards and backwards towards your tailbone. Push the diaphragm as far back as it can comfortably go. Once inserted, use your finger to ensure the front rim is tucked securely behind your pubic bone. The diaphragm should cover your cervix completely, which you can verify by feeling for your cervix through the dome; it typically feels like a soft lump or the tip of your nose. If the diaphragm feels uncomfortable or misplaced, remove it and attempt insertion again until it sits snugly and covers the cervix.
Diaphragm Removal and Care
After intercourse, the diaphragm must remain in place for a minimum of six hours for the spermicide to work effectively. Do not leave it inside for more than 24 to 30 hours, as prolonged use increases the risk of infections, including urinary tract infections and, rarely, toxic shock syndrome. To remove, wash your hands, then insert your index finger into your vagina, hook it under the rim, and gently pull it downwards and out.
After removal, clean the diaphragm with warm water and mild, unscented soap, rinsing thoroughly to remove all residue. Allow it to air dry completely. Store it in its provided case in a cool, dry place away from direct sunlight to maintain its integrity and typical lifespan of one to two years. Avoid using oil-based products, powders, or strong chemicals, as these can damage the material.
Important Considerations for Use
The diaphragm can be inserted up to two to six hours before intercourse, offering flexibility. If more than two hours pass between insertion and intercourse, or if you engage in sexual activity multiple times, insert an additional dose of spermicide without removing the diaphragm to ensure continued protection.
Be aware of signs that the diaphragm may not be fitting correctly, such as discomfort, slipping, or if you can feel your cervix outside the diaphragm. If you experience persistent pain, unusual vaginal discharge, or suspect the diaphragm is no longer the correct size due to significant weight changes (more than 3-4.5 kg), childbirth, abortion, or miscarriage, consult your healthcare provider for a refitting. Diaphragms do not offer protection against sexually transmitted infections (STIs).