Diaphragm contraceptive

What is a contraceptive diaphragm and how does it work?

A diaphragm is a flexible, reusable, dome-shaped cap that is inserted into the vagina to prevent unwanted pregnancy. It is one of the barrier methods of contraception like condoms or cervical caps.

It works simply by blocking the entrance to the uterus, preventing sperm from entering and reaching the egg. However, without spermicide, the diaphragm is not effective enough, so it is always used together with special substances that kill or immobilize sperm.

It is a convenient option for those who want a hormone-independent method of contraception; but before using it, it is important to consult a doctor to find the right size and learn how to insert it correctly.

What materials are used for vaginal diaphragms?

Contraceptive diaphragms are usually made of silicone, latex, or rubber. If you are allergic to latex, be sure to tell your doctor to find a safe option.

In this sense, when using lubricants, choose water-based or silicone-based lubricants - they won't degrade the material. On the other hand, oil-based lubricants can damage the diaphragm, making it ineffective and increasing the risk of pregnancy.

It is important to monitor the condition of the diaphragm: if it is torn, cracked or changed shape, it should not be used - this reduces protection and can lead to an unwanted pregnancy.

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What is the correct way to use a vaginal diaphragm?

Before inserting the diaphragm, wash your hands and add spermicide, which is applied inside the dome and around the edges of the rim. The amount depends on the type of diaphragm, so it is better to read the instructions beforehand 

How to insert the diaphragm?

1. Find a comfortable position - like when inserting a tampon or menstrual cup. You can lie on your back, squat or put one leg up on a chair.
2. Pull your labia apart with one hand and use the other hand to grip the diaphragm with the dome downward.
3. Squeeze the sides of the diaphragm to make it narrow, and gently insert it along the back of the vagina toward the tailbone.
4. Push it in as far as you can, then use your index finger to push the rim to cover the cervix. You should feel it under the dome - it usually feels like a small soft bump or the tip of your nose.
5. After insertion, add a little more spermicide.

If the diaphragm is inserted correctly, you won't feel it - even while walking, sneezing, or having sex. If you feel discomfort, it may not be the right size or the insertion may have been incorrect, in which case it is better to consult your doctor.

When and how to insert the diaphragm correctly?

The diaphragm can be inserted 2 hours before sex, but not before, otherwise the spermicide will stop working.

If it's been more than 2 hours since insertion, add more spermicide before the act itself. Also, if you plan to have sex again, do not remove the diaphragm, but just put an additional dose of spermicide into the vagina.

After sex, do not remove the diaphragm immediately - leave it in for at least 6 hours to allow the spermicide to take effect. Regardless, don't keep it in for longer than 24 hours to avoid irritation and risk of infection.

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What is the correct way to remove the diaphragm?

First wash your hands with soap and water to make sure everything is clean. Then:

1. Carefully insert your finger into the vagina and feel the rim of the diaphragm.
2. Gently pry it up with your finger to interrupt suction and pull it down and out.
3. Wash the diaphragm with warm water and mild soap and let it air dry.
4. Store in a container in a cool, dry place, away from sun and moisture.

Keep an eye on the condition of the diaphragm - if it appears cracked or damaged, it is better to replace it.

How do you know it's time to replace your birth control diaphragm?

The diaphragm can be used for up to two years if it remains in good condition. However, there are times when it needs to be replaced sooner, especially if there have been changes in the body.

It is recommended that you see a doctor to have your diaphragm checked or replaced if:

• Pelvic organ surgery has been performed .
• Frequent urinary tract infections have started .
• There has been a weight change of 5 pounds or more.
• The diaphragm slips, feels uncomfortable, or seems inappropriate.
• There has been pregnancy, childbirth, abortion or miscarriage.
• There is discomfort or pain during sexual intercourse.

It is also important to regularly check the diaphragm for damage. To do this, you can stretch the silicone or latex under a bright light and inspect it for cracks or holes. You can also run water through it - if liquid leaks out, the diaphragm should be replaced.

How reliable is the vaginal diaphragm?

When used correctly, the vaginal diaphragm prevents pregnancy in 94% of cases. However, this figure is only achieved with perfect use - if inserted correctly and used every time.

To increase its effectiveness, it is recommended to use condoms in addition; as this will not only reduce the likelihood of pregnancy, but also provide protection against some STIs, which the diaphragm itself does not.

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Pros and cons of using a vaginal diaphragm

Like any method of contraception, the vaginal diaphragm has its advantages and disadvantages.

Advantages

• Reusable - can be used for up to two years by simply flushing after use.
• Doesn't require daily monitoring - unlike the pill, you don't have to think about it every day.
• Hormone-free - does not affect the body's natural hormonal balance.
• Minimal side effects - unless there are allergies or other medical contraindications.
• Does not depend on the partner - you can prepare in advance and do not worry whether there is a condom at hand.
• Suitable for spontaneous sex - the diaphragm can be inserted several hours before intercourse, which does not interrupt the process.
• Quick return to fertility - you can simply remove the diaphragm if you decide to conceive.

Disadvantages

• Does not protect against STIs - need an additional method if preventing infections is important.
• Requires use of spermicide - must be applied each time before sex.
• Can be uncomfortable to use - insertion and removal may seem difficult or uncomfortable.
• There is a risk of shifting - the diaphragm can shift during sex, reducing its effectiveness.
• Not suitable for everyone - a doctor's advice is needed before purchase.

Who should not use a diaphragm?

• If it has been less than 6 weeks after childbirth.
• If allergic to latex or spermicide.
• If there is a risk of genitourinary infections.
• If you have HIV or are at high risk of STIs (if you change partners frequently and have no barrier protection).
• If there is a history of toxic shock syndrome (TSS).

The diaphragm is an effective method of contraception, but it is not suitable for everyone. In this sense, if you have high fertility or an unstable sexual schedule, it may be worth considering other options.