Contraception (Birth Control)
What is a diaphragm?
A diaphragm (DYE-uh-fram) is a form of birth control. It’s a flexible, dome-shaped, rubber cup. To use it, a woman puts it inside her to cover the opening of her uterus. A diaphragm keeps sperm from getting to the egg during sex. If the diaphragm is properly fitted and inserted, a woman should not feel it, and neither should her partner.
Always use a diaphragm along with a spermicide (a cream that kills sperm). If there is even the tiniest gap between the rim of the diaphragm and the walls of the vagina, sperm can enter the uterus. The spermicide gives extra protection against pregnancy.
How effective is the diaphragm?
With typical use, about 16 out of 100 women can become pregnant in a year. Even if the diaphragm and spermicide are used correctly and consistently every time you have sex, 6 out of 100 women can become pregnant in a year.
Who shouldn’t use a diaphragm?
Your doctor will tell you if you can use a diaphragm. You may not be able to use it if:
- you have an allergy to latex or spermicide
- you have a history of repeated urinary tract infections
- you have a history of TSS (toxic shock syndrome)
- your vagina’s shape will not allow the diaphragm to have a stable fit
- you are not able to insert the diaphragm correctly
How is a diaphragm used?
Diaphragms come in different sizes. During your exam, your doctor will try different sizes and choose the size that best fits you. You will learn how to insert and remove the diaphragm correctly while in the office. This includes putting spermicide in the cup of the diaphragm before putting it in your vagina.
Your diaphragm is re-usable and needs to be inserted each time you have sex. Protection begins as soon as the diaphragm and spermicide are inserted. You should have sex within 6 hour of inserting your diaphragm for it to be effective.
Leave it in long enough
The diaphragm must remain in place for at least 6 hours after the last time you have sex. If you take the diaphragm out too early, you increase your risk of becoming pregnant. If you want to have sex again before the 6 hours are up, do not remove the diaphragm to put more spermicide in it. Simply leave the diaphragm in and put more spermicide into your vagina before having sex.
If you want to have sex again, and it has been at least 6 hours, take the diaphragm out and clean it. Then put more spermicide in the diaphragm, and put the diaphragm back in your vagina.
Don’t leave it in too long
If you leave the diaphragm in for more than 24 hours, you could get an infection. This could lead to TSS (toxic shock syndrome).
Symptoms of TSS include:
- sudden high fever (usually 102 F or higher)
- a rash that looks like sunburn
TSS can be fatal. Call your doctor right away if you have any of these symptoms.
Care of your diaphragm
- Wash your diaphragm in mild soap and warm water. Rinse it well, and pat it dry.
- Store it in its container after use.
- Do not boil it.
- Do not use antiseptic solution (like alcohol) on it.
- Do not stretch it.
- Do not use oil-based lubricants (like Vaseline, other petroleum jelly, or baby oil) with it.
- Check it frequently for holes, rips, or tears.
Your diaphragm should last at least a year. You might need a new size if you have a baby or gain or lose more than 10 pounds.
If you have any questions or concerns about your diaphragm or how to use it, call your doctor.
Use condoms the right way
To protect against STDs (sexually transmitted diseases), use condoms the right way.
Except for not having sex (abstinence), latex condoms give the best protection from many STDs including HIV, the virus that causes AIDS. Condoms are helpful only if used the right way. Use a latex condom every time you have sex. Always put the condom on before the penis touches or enters the vagina. If you or your partner has an allergy to latex, you should use a plastic (polyurethane) condom.
Important steps for using condoms the right way:
- Check the expiration date.
- Check the condition of the package.
- Open the package carefully.
- Hold the condom by the last 1/2 inch at the tip, and squeeze out the air.
- If the penis is uncircumcised, pull back the foreskin.
- Place the condom on the tip of the penis.
- Unroll the condom to the base of the penis. Smooth out any extra air.
- If you want or need to use lubricant on the condom, only use water-based lubricants like K-Y Jelly or Surgilube. Do not use oil-based lubricants. They can weaken condoms and cause them to break. Do not use petroleum jelly, cooking or vegetable oil, mineral or baby oil, massage oil, butter, margarine, oil-based creams, or lotions.
- Immediately after ejaculation, hold the condom firmly by the rim at the base of the penis, and pull the penis and condom out of the vagina together, while the penis is still erect.
- Look carefully at the condom to see if there is a hole in it. If you are not sure, fill the condom with water to see if it leaks.
- Discard the condom. Wrap it in tissue, and throw it away. Do not flush it down the toilet.
- Never re-use a condom.