Vaginal Diaphragm

A vaginal diaphragm is a flexible, reusable dome-shaped cup that you put inside your vagina to prevent pregnancy. The cup covers your cervix and works as a barrier. It blocks sperm from getting inside your uterus.

You insert a diaphragm up to two hours before you have sex. It should be kept in your vagina for at least six hours after sex. They’re made of rubber, silicone or latex.

You’ll need a prescription from your healthcare provider to get one. They’ll go over when to use a diaphragm and how to insert and remove it. During your visit, they may do a pelvic exam to make sure it fits correctly.

Diaphragms can help you avoid getting pregnant, but they don’t prevent sexually transmitted infections (STIs). Using them with a spermicide makes them a more effective birth control option.

How do you insert a diaphragm?

Wash your hands with soap and water and then add the spermicide to your diaphragm. The amount of spermicide you need varies depending on the kind you’re using. Read the instructions carefully. Place the spermicide inside the “cup” and the rim of the diaphragm.

To insert the diaphragm:

1. Find a position that’s comfortable for you. It may be easier to insert when lying on your back, squatting or standing with one leg propped on a chair.
2. With one hand, part your vagina lips and find your vaginal opening. Hold the diaphragm with your other hand so the dome part points toward your palm.
3. Pinch the sides of the diaphragm together so it’s small enough to fit inside your vagina. Gently slide the diaphragm inside your vagina, along the back wall. Aim in the direction of your tailbone. Push it as far back as it will go.
4. Once it’s inside your vagina, use your pointer finger to nudge the rim so it’s covering your cervix. You should be able to feel your cervix through the dome of the diaphragm. It may feel like a soft lump or even like the tip of your nose.
5. After you’ve inserted it, apply spermicide inside your vagina.

You shouldn’t be able to feel a diaphragm, including when you walk, sneeze or have sex. If you feel it, double-check with your provider to make sure it’s the right size.

How do you remove it?

First, wash your hands. Then:

1. Insert your pointer finger inside your vagina and feel for the rim of the diaphragm.
2. Slide your finger underneath the rim to break any suction between your diaphragm and vaginal walls. Pull downward and out.
3. Wash your diaphragm with soap and water and allow it to air dry. Place it in its container and store it in a cool, dry place, away from sunlight.

When should you insert and remove a diaphragm?

• Insert it a few hours before sex. A good rule of thumb is to have sex within two hours of inserting your diaphragm. Waiting too long to have sex after inserting your diaphragm may cause the spermicide to become less effective. If it’s been longer than two hours, reapply spermicide to your vagina. If you have intercourse more than once while wearing it, reapply spermicide each time.
• Remove it between six and 24 hours after sex. Removing it too early may prevent the spermicide from killing all the sperm, putting you at risk of pregnancy. Keeping it in place for too long increases your risk of infection and toxic shock syndrome (TSS).

Is a diaphragm a good form of birth control?

Diaphragms can prevent pregnancy up to 94% of the time with perfect use. But it’s hard to use them perfectly. With typical use, they prevent pregnancy 83% of the time. This means about 17 in 100 people who use a diaphragm will get pregnant.

Why do they have a high failure rate?

They’re slightly less effective than other birth control methods. This is mostly because it’s harder to follow the directions and use diaphragms correctly.

How often should I replace it?

You can wash and reuse it for up to two years. You may need to replace it earlier if your body changes and you need a new size. See your provider about checking and replacing your diaphragm if:

• You’ve had pelvic surgery
• You’re getting frequent urinary tract infections (UTIs)
• You’ve lost or gained 10 pounds or more
• Your diaphragm is slipping or moving around
• You’ve given birth or had a miscarriage
• It’s causing pain or discomfort

You should replace your diaphragm if you notice any tears or holes. Gently stretch it with your fingers to look for any holes or tears. Then, run water through it to make sure there aren’t any leaks.

What are the benefits of diaphragm birth control?

Vaginal diaphragms are:

• Reusable: You can wash and reuse the same diaphragm for up to two years.
• Low maintenance: You only have to worry about your diaphragm on the days you have sex.
• Hormone-free: They don’t interfere with your body’s natural hormone production.
• Low risk of side effects: You shouldn’t experience side effects unless there’s a complication.
• Good for sexual spontaneity: You can insert a vaginal diaphragm a few hours before sex so you don’t have to interrupt the sexual “flow” to get a condom.
• Easily reversible: If you want to become pregnant, simply stop using the diaphragm.

What are the disadvantages?

Vaginal diaphragms can:

• Lead to pregnancy if you don’t use them correctly each time
• Be hard to use at first
• Feel uncomfortable until you learn to insert your diaphragm correctly

Always use water-based or silicone-based lubricants during sex. Oil-based lubricants may damage the material, causing it to break or tear.

What are the risks of using diaphragm contraceptive?

They don’t usually cause side effects with correct use. In some cases:

• The materials in the diaphragm and the chemicals in the spermicide may lead to skin irritation. Let your provider know if you’re allergic to latex, silicone or spermicide.
• Spermicide may damage the lining of your vagina, causing irritation or burning. The damage may put you at risk of getting an STI.
• They may increase your risk of urinary tract infections (UTIs).
• Wearing one beyond 24 hours without washing it can put you at risk of TSS.

Who shouldn’t use a diaphragm?

Don’t use one if:

• You’ve given birth fewer than six weeks ago
• You’re allergic to the material in the diaphragm or the chemicals in spermicide
• You’re susceptible to UTIs or have an active vaginal infection
• You’re HIV-positive or at high risk for contracting an STI
• You’ve previously had TSS

When to call a doctor

Contact your healthcare provider if you experience any of the following:

• Symptoms of TSS (high fever, weakness, vomiting, diarrhea, a rash that resembles a sunburn)
• Symptoms of a UTI (painful or frequent urination, vaginal discharge)
• Blood in your diaphragm when you’re not on your period
• Vaginal pain or itching

Can you feel a diaphragm when it’s inserted?

You shouldn’t be able to feel it. If you do, let your provider know. It’s possible your diaphragm is the wrong size or that it’s shifted.

Can your partner feel a vaginal diaphragm?

Usually, no. But it does happen in rare cases. See your provider if your diaphragm feels unpleasant or painful for either you or your partner.

Why aren’t they used anymore?

Many women still use them. But they aren’t as common as other birth control methods. This is mostly because other types are easier to use and more reliable.