How to Use a Diaphragm, Know its Safety, Effectiveness, Risks, Side Effects for Birth Control

What is a Diaphragm for Birth Control?

A cap or a diaphragm is a dome-shaped reusable cup, made of silicone or latex, which fits over the cervix. The diaphragm is used with spermicidal gel or cream, which prevents the sperm from successfully fertilizing an egg. There are many types of diaphragm namely arching spring diaphragm, coil spring diaphragm, flat spring diaphragm and wide seal rim diaphragm. These are available in different sizes, but the standard size is 75 mm across. To get a perfect fit, the individual may need to undergo a physical examination conducted by their health care provider.

What is a Diaphragm for Birth Control?

How to Use a Birth Control Diaphragm?

A healthcare provider will generally explain how to rightly use a birth control diaphragm. In case, the user faces any difficulty in inserting or removing the diaphragm, they can approach their healthcare provider and learn how to use the diaphragm properly. An inserter device may prove helpful too.

When using the diaphragm, 1 teaspoon of spermicide should be applied in the dome and spread around the rim. Then, the diaphragm should be folded in half with the dome pointing downwards and the two sides of the rim touching each other. While holding the vagina open with the other hand, the folded diaphragm should be pushed into the vagina. It should be inserted as far as possible into the vagina with its back aiming towards the tail bone. The front rim of the diaphragm should be pushed up behind the pubic bone using a finger. The position of the diaphragm must be checked by placing the finger on the dome. One should feel their cervix through it. The cervix is basically the area that feels firm, but not bony.

In case the diaphragm was not positioned correctly, the individual would need to get it removed and restart the process all over again. The diaphragm can be set in place approximately 1 hour before having sex, and it should stay in place for at least 6 hours after intercourse. It should however not be left in the vagina for more than 24 hours. If the user intends to have another intercourse within 6 hours, they must place more spermicide in the vagina, without removing the diaphragm. One should remember that diaphragms do not offer protection from getting STI’s or sexually transmitted infections. By using a condom along with a diaphragm, one can decrease their risk of contracting these diseases and unwanted pregnancy too.

How Safe And Effective Is A Diaphragm for Birth Control?

The diaphragm can be 94% effective in preventing pregnancy if used consistently and correctly. It will prove to be most effectual if it is well fitted, rightly placed over the cervix, used together with spermicide and kept in for at least 6 hours. Its effectiveness can be further increased and the risk of pregnancy be decreased if the man uses a condom or pulls out before ejaculation. Although considered safe for most women, diaphragms they may not be suitable for some and these individuals are advised to consult a doctor for other alternatives.

All forms of birth control have both advantages and disadvantages. A diaphragm can be a good option of birth control because:

  • It helps the women to keep unwanted pregnancy at bay.
  • Safe to use during breastfeeding.
  • Easy to carry in a pocket or purse.
  • Does not impact the hormone levels.
  • Immediately effective and reversible as well.
  • Can be inserted many hours prior to vaginal intercourse.
  • Generally not felt by either of the partner.
  • Less invasive than hormonal treatment or IUD and does not need regular doctor’s visit.

It is considered safer for use than oral contraceptives by women above the age of 35 years and by ones who smoke, since there is no risk of cardiovascular problems.

However, some troubles faced when using a diaphragm for birth control are problems with insertion, the chances of the diaphragm moving because of heavy thrusting, sexual position or penis size and the fact that it needs to be inserted before every act of vaginal intercourse. After every full term pregnancy, miscarriage, pelvic or abdominal surgery, weight change of 20% or abortion after 14 weeks, a woman would need to be refitted for her birth control diaphragm. A diaphragm should be replaced in every 1 to 2 years. Certain substances, like petroleum jelly, should not be used along with a diaphragm, as they can cause erode its material.

What Are The Risks And Side Effects With Use of Diaphragm for Birth Control?

Although diaphragm generally do not pose any health risks and rarely cause any serious problems, certain issues like vaginal irritation and urinary tract infections (UTIs) can occur due to its use. Urinating prior to applying the diaphragm and post intercourse can help keep UTI at bay. Vaginal irritation may occur as a reaction to the spermicide or silicone sensitivity. When facing this issue, it is advisable to use a different spermicide. Most spermicides contain nonoxynol-9, which can become an irritant when used many times in a day or if the user is infected with HIV. It can raise the risk of contracting STIs and HIV. Ones concerned about vaginal irritation or a UTI should speak to their doctor without delay. Toxic shock syndrome (TSS) affects nearly 2.4 in every 100,000 users, but this happens usually after leaving the device inserted for over 24 hours. When using a diaphragm, if one experiences symptoms like discomfort, genital irritation, burning with urination, irregular bleeding or spotting, swollen or red vagina or vulva, unusual vaginal discharge or high fever, they should consult a physician at once.

According to studies, diaphragm used perfectly proves 94% effective. However, its overall success rate is 88% owing to the fact that people do make mistakes while using diaphragm. It must be remembered that any birth control method can only prove successful in avoiding pregnancy if used according to the instructions. A diaphragm for birth control is available at a family planning clinic or with a health care provider and must be fitted rightly by a medical expert for maximum effectiveness.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 9, 2019

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