Diaphragm

A diaphragm is a shallow, dome-shaped cup made of silicone. You insert the diaphragm into your vagina. It covers your cervix and keeps sperm out of your uterus. You need to use it with spermicide for it to work effectively.

Quick facts:

  • Effective immediately, can be put in hours before sex, and does not affect your hormones.
  • Effectiveness: the diaphragm is fairly effective – better with spermicide.
    • Perfect use:

      94%

    • Typical use:

      88%

  • Side effects: no problems for most, but irritation or urinary tract infections are possible
  • Effort: high – you have to put it in place every time you have sex. But you can leave it in for up to 24 hours.

Diaphragm

Quick facts:

A diaphragm is a shallow, dome-shaped cup made of silicone. You insert the diaphragm into your vagina. It covers your cervix and keeps sperm out of your uterus. You need to use it with spermicide for it to work effectively.

  • Effective immediately, can be put in hours before sex, and does not affect your hormones.
  • Effectiveness: the diaphragm is fairly effective – better with spermicide.
    • Perfect use:

      94%

    • Typical use:

      88%

  • Side effects: no problems for most, but irritation or urinary tract infections are possible
  • Effort: high – you have to put it in place every time you have sex. But you can leave it in for up to 24 hours.

You are comfortable with your body. If you are not comfortable putting your fingers inside yourself, a diaphragm is not the best option for you. It is a little like putting in a tampon. If you can do that, you can probably manage a diaphragm.

It takes discipline. You have to remember to insert your diaphragm before you have sex. And you need to remember it every time you have sex. It takes a bit of self-discipline and planning. But you can carry it with you if you want.

Availability. There are two kinds of diaphragms commonly available, but if you want to use this method then we recommend looking at the “find my method” section to determine what is available in your country.

Allergy issues. If you are allergic to silicone or spermicide, you should not use a diaphragm.

The pregnancy question. You will be able to get pregnant as soon as you stop using the diaphragm. If you do not want to be pregnant, use another method of birth control as soon as you stop using the diaphragm.

A diaphragm can be inserted just before sex. You can also insert it a few hours before.No matter when it goes in, you have to be sure to leave it in for at least 6 hours after you have sex. If you are going to have sex again that day, just leave the diaphragm in place and insert more spermicide way up in your vagina. Do not leave your diaphragm in for more than 24 hours.

 Before you put it in. Add about 5 mL of spermicide to the inner part of the diaphragm. Spread a little of it around the rim, as well. (Not too much, or it will be too slippery to hang on to.) Some spermicide options are specifically designed for diaphragms, and may come with an applicator you can use if you are going to have sex more than once within six hours (you will need to add additional spermicide). Any kind of contraceptive gel or spermicide will do, except for the film or insert/suppository types. Do not forget to check the expiration date. If it is expired then you need to buy new spermicide.

How to put it in. Inserting a diaphragm sounds more difficult than it is. Here are the steps:

  1. Wash your hands with soap and water. Let them air dry without touching anything.
  2. Check your diaphragm for holes and weak spots. Filling it with clean water is a good way to check – if it leaks, there is a hole. A hole in your diaphragm means that it is not working properly and you could get pregnant.
  3. Put about 5 mL or so of spermicide in the cup. Spread some around the rim too.
  4. Sitting or standing, spread your legs.
  5. Separate the outer lips of your vagina with one hand. Use the other hand to pinch the rim of the diaphragm and fold it in half.
  6. Put your index finger in the middle of the fold to get a good, firm grip. (you will be touching the spermicide)
  7. Push the diaphragm as far up and back into your vagina as you can.Make sure to cover your cervix.

 Having sex again? You need to leave the diaphragm in for 6 hours after sex. If you have sex a second time within those 6 hours, first insert more spermicide. The 6-hour clock starts again, counting from the last time you have sex.

How to take it out. Here is how:

  1. Wash your hands again. Use soap and water. Let your hands air dry, without touching anything.
  2. Put your index finger inside your vagina and hook it over the top of the rim of the diaphragm.
  3. Pull the diaphragm down and out.

Are you having trouble? Ask your doctor about getting an inserter, or consider switching to another method.

Finally, take good care of your diaphragm and it can last for several years.

  1. After you take it out, wash it with mild soap and warm water.
  2. Let it air dry.
  3. Do not use powders or oil-based lubricants (like Vaseline, lotion, or cold cream) on your diaphragm.

Tips and tricks

When you are inserting the diaphragm, make sure the vast portion of the spermicide stays inside the fold, where it will be most effective.

Everyone is different. What you experience may not be the same thing as another woman.

The Positive: there are actually lots of things about birth control that are good for your body as well as your sex life.

  • You can put a diaphragm in hours in advance
  • You can have sex as many times as you like while it is in (as long as you add more spermicide each time)
  • Neither you nor your partner should be able to feel it
  • Does not affect your hormones
  • Decreases the risk of pelvic inflammatory disease and tubal infertility
  • Can be used while breastfeeding

The Negative:

  • Some women have a hard time inserting the diaphragm
  • It can cause vaginal irritation
  • Some women wind up getting frequent urinary tract infections
  • You have to use it every time you have sex, no matter what
  • If you are allergic to spermicide or silicone, you should not use a diaphragm
  • Can get pushed out of place by large penises, heavy thrusting, or certain sexual positions
  • You need a prescription
  • Hard to remember to use if you have had alcohol

We are here to help you. If it still does not feel right, we have ideas for other methods. Just remember: If you change methods, make sure you use another method while you switch.

What if the diaphragm is causing irritation?

  • The irritation could actually be from an allergy to spermicide. If the irritation is mild, try another type of spermicide.
  • Still not working? If the irritation is more severe or sticks around once you try different types of spermicide, think about trying a method that does not require any.
  • Try a different method: implant; IUD; patch; pill; ring; shot

What if the diaphragm is hard to insert and/or remove?

  • This might get easier with practice. If you have not yet read our section on how to use it, you might want to check that out.
  • Still not working? If practice has not helped, you might want to choose a method you do not have to insert inside you. If you really want to stick with a barrier method, check out one that you do not have to put inside you, like male condoms.
  • Try a different method: implant; IUD; condom; patch; pill; ring; shot

Why do I keep getting urinary tract infections?

  • Some women do get urinary tract infections from using the diaphragm. It might help if you urinate before inserting the diaphragm. Urinate again after you have sex.
  • You can also check with your doctor to make sure your diaphragm fits correctly.
  • Still not working? If you are still having UTIs and want to switch methods, consider a method you do not have to insert yourself each time you have sex.
  • Try a different method: implant; IUD; patch; pill; shot