Diaphragm

The diaphragm is a birth control device consisting of a round dome of latex free material that covers a flexible metal spring. The diaphragm, which is used with spermicidal cream or jelly, is inserted into the vagina before intercourse and remains in place at least six hours after intercourse. A diaphragm is measured and fitted by a skilled clinician and should fit comfortably over a woman's cervix.

The diaphragm prevents pregnancy in two ways:

  1. blocks the entrance to the cervix so that sperm cannot enter the uterus
  2. spermicidal cream or jelly placed on the diaphragm kills sperm on contact.

Effectiveness

The diaphragm can be up to 98 percent effective in preventing pregnancy when used correctly and consistently. However, the typical user of the diaphragm will have an effectiveness rate between 80 percent and 90 percent. Couples can reach maximum effectiveness rates by carefully following the directions for use each time they have intercourse.

Using the Diaphragm

A woman should have practice inserting and removing the diaphragm before leaving the clinician's office so she feels comfortable before using it for the first time—this might take some practice.

Before sexual intercourse

  1. Wash your hands thoroughly with soap and water.
  2. Check for holes or tears in the diaphragm by holding it up to a light or filling it with water.
  3. Place about one tablespoon of spermicidal cream or jelly in the dome of a dry diaphragm. This is the side of the diaphragm that faces towards the cervix. Spread the spermicide around the dome area and the rim.
  4. While in a comfortable position (squatting, sitting, standing or lying down), compress the sides of the diaphragm together with the fingers on one hand while the vaginal lips are spread apart with the other hand.
  5. Using the index finger as a guide, gently insert the diaphragm as far back in the vagina as it will go. It should be placed securely behind the pubic bone. Insertion can also be done by the partner.
  6. Check to ensure that the cervix is covered by the dome of the diaphragm by inserting a finger into the vagina. (The cervix feels like the tip of your nose.)
  7. If the diaphragm is in place for more than six hours before intercourse occurs, insert another application of spermicidal cream or jelly without removing the diaphragm.
  8. Before each subsequent act of intercourse, an additional application of spermicidal cream or jelly must be inserted.

After sexual intercourse

  1. The diaphragm must stay in place for at least 6 hours after the last act of intercourse but no longer than 24 hours. Do not douche during this time. If you have intercourse more than once within the 6-hour time your diaphragm must remain in place, an additional dose of spermicidal cream or jelly is recommended. Use a plastic applicator to insert spermicide into your vagina and don’t remove the diaphragm until 6 to 8 hours following your last act of intercourse.
  2. To remove the diaphragm, insert a finger between the diaphragm and the upper wall of the vaginal to break the seal, and gently pull the diaphragm out.
  3. The diaphragm should be washed with mild soap and water, checked for holes and tears, air dried and return to its case.

Do not use a diaphragm with oil-based lubricants or vaginal medications such as Femstat® cream or Monistat® cream. Latex deteriorates when exposed to these products.

Advantages

  • Highly effective when used correctly
  • Dangerous side effects are rare
  • Used only when needed
  • Helps a woman become more familiar with her body
  • Intercourse does not have to be interrupted since the diaphragm can be inserted up to six hours before intercourse or inserted as part of foreplay
  • May offer some protection against certain sexually transmissible infections (STIs)

Potential Disadvantages

  • Must be used with each act of intercourse
  • May interfere with sexual spontaneity
  • Must be used with spermicidal cream or jelly each time
  • Rare allergies to latex rubber or spermicide
  • May put some women at increased risk for urinary tract infections and vaginitis
  • Possible risk of Toxic Shock Syndrome if left in place more than 24 hours

We encourage you to talk further with your clinician to help you decide if the diaphragm is right for you.

Appointments

Appointments can be made in person or by phone. If you are unable to keep your appointment, please call and cancel. Otherwise, you will be charged for the visit.

To schedule or cancel appointments, call: 814-898-6217

For more information about healthcare issues, visit the Health Center website.

This content is reviewed periodically and is subject to change as new health information becomes available. This information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis, or treatment by a healthcare professional.