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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 dislodged.
 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 method failure.
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
circumstances.
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 diaphragm.
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. |
