There are several good techniques used to
evaluate the breast. This video illustrates one of these methods, using the
Vertical Strip Technique.
A diaphragm is a latex-covered, flexible ring
that fits inside the vagina, covering the cervix.
It prevents pregnancy by keeping sperm away
from the cervix (the latex is impenetrable), and by holding spermicidal
cream up against the cervix so that the few sperm who successfully find
their way around the diaphragm are eliminated by the spermicide.
It can be inserted up to several hours prior
to intercourse, and should remain in place for at least 6 hours after
intercourse. If multiple episodes of intercourse occur, additional
contraceptive cream may be placed in the vagina, but diaphragm should not be
The diaphragm is very effective, with only
about 5 failures per 100 women per year. Reasons for failure include
non-use, improper positioning, or suboptimal use in addition to simple
Diaphragms should be individually fitted. One
commonly-used size is a 65 mm diaphragm (65 mm in diameter), but sizes range
from 60 to 95 mm. A properly-fitted diaphragm will cover the cervix
completely, will not move in the vagina, and will be so comfortable that the
woman will not know that she is wearing it. Should a pelvic aching occur
several hours after insertion, the diaphragm is too large and a smaller one
should be substituted. If the woman complains that the diaphragm is
uncomfortable or painful for her, the size should be rechecked and changed.
Her partner should not be able to feel the diaphragm under ordinary
Click Here to watch the video.
To remove the diaphragm, insert a finger into
the vagina to hook the rim of the cervix. Pull it straight out and the
flexible rim will fold as it comes out.
After each use, the diaphragm should be
washed with warm water and soap, rinsed well, and allowed to dry before
returning it to its' case.
Women with latex allergy cannot use the
diaphragm as it will cause a reaction. There are non-latex diaphragms
available, but they may prove difficult to obtain.
Women who are sensitive to nonoxynol-9, the
active ingredient in spermicidal creams, may or may not tolerate the
A diaphragm is generally a good choice for
women for whom a 5% failure rate each year is acceptable. It offers
reasonably reliable contraception when needed without the potential side
effects of hormonal contraception and infectious complications of IUDs. It
has less of an "artificial" feel than condoms.
A diaphragm is generally a poor choice
for women who are relatively inexperienced sexually as it requires a
moderate degree of manual dexterity, moderate familiarity with external and
internal reproductive anatomy, and sexual circumstances that allow for
either pre-positioning or a brief interruption in lovemaking in order to
place the diaphragm correctly.