A vaginal diaphragm is a barrier form of birth control. When used with spermicide, it prevents pregnancy by blocking sperm from reaching your uterus. It has an 87% effectiveness rate. Diaphragms don’t protect against STIs. Using a diaphragm and a condom together greatly reduces your pregnancy risk while providing protection against STIs.
A vaginal diaphragm is a flexible, reusable dome-shaped cup that you place inside your vagina to prevent pregnancy. Like condoms, sponges and cervical caps, vaginal diaphragms are a barrier method of birth control. They prevent pregnancy by blocking sperm from reaching your uterus and fallopian tubes, where fertilization occurs. Diaphragms should always be used with spermicide, a chemical that immobilizes or kills sperm so that they can’t swim to your uterus.
You’ll need a prescription from your provider to get a vaginal diaphragm. You can purchase spermicide without a prescription.
Vaginal diaphragms can reduce your risk of pregnancy, but they don’t prevent sexually transmitted infections (STIs). To reduce your risk of contracting an STI, use a condom with your diaphragm.
Vaginal diaphragms are made of rubber, silicone or latex. Tell your provider if you are sensitive to these materials (like a latex allergy). Use water-based or silicone-based products if you use a lubricant during sex. Oil-based lubricants may damage the material, causing your diaphragm to break or tear. Using a damaged diaphragm during intercourse puts you at risk of pregnancy.
Diaphragms cover your cervix, which is the opening between your vagina and uterus. They create a barrier separating sperm ejaculated into your vagina during intercourse and your uterus. Vaginal diaphragms are used with spermicide. Spermicides are available as a foam, cream, gel, or suppository that you can apply to your diaphragm. Spermicide immobilizes sperm so they don’t reach your uterus.
You’ll need a prescription from your healthcare provider to get a vaginal diaphragm. During your visit, your provider may perform a pelvic exam to ensure it fits correctly. They’ll teach you how to insert and remove your diaphragm.
Wash your hands with a mild (unscented) soap and water and add the spermicide to your diaphragm. The amount of spermicide you need varies depending on the kind you’re using, so read the instructions carefully. Place the spermicide inside the dome of the diaphragm. Apply spermicide to the rim of the diaphragm.
To insert the diaphragm:
You shouldn’t be able to feel a diaphragm inside you — including when you walk, sneeze or have intercourse. If you feel your diaphragm, double-check with your provider to ensure it’s the right size and inserted correctly.
First, wash your hands with soap and water. Then:
Avoid douching or wait until six hours after intercourse to douche. Douching can rinse out the spermicide too early.
You can wear a diaphragm for up to two years unless you experience a life event that requires replacing it. As your body changes, you may need a different size diaphragm to accommodate those changes. See your provider about checking and replacing your diaphragm if:
You should replace your diaphragm if you notice any tears or holes. Use your fingers to stretch the silicone or latex under a direct light source and check for tears. Run water through your diaphragm and check for leaks. If you see any signs of breakage, it’s time to replace your diaphragm.
Vaginal diaphragms can prevent pregnancy 94% of the time. This number reflects ideal conditions when you use your diaphragm consistently and correctly each time. With typical use, diaphragms prevent pregnancy 87% of the time.
Use your diaphragm with another birth control method, like condoms, to reduce your pregnancy risk. Condoms provide the added benefit of protecting against some STIs.
Vaginal diaphragms are:
Also, regaining your fertility is as easy as removing your diaphragm. You don’t have to wait to try for a baby should you decide to become pregnant.
Vaginal diaphragms may:
One of the biggest disadvantages of vaginal diaphragms is the learning curve. It may take some work at first to learn how to insert your diaphragm. While you’re getting the hang of it, use an additional form of birth control to prevent pregnancy.
Vaginal diaphragms don’t usually cause side effects with correct use. In some cases:
Don’t use a vaginal diaphragm if:
Vaginal diaphragms may not be the best choice if your body’s natural fertility and your sexual lifestyle increase your pregnancy chances. You may need a more effective form of birth control, like a LARC. Your chances of pregnancy increase if you’re under 30 and have sex frequently (three or more times a week).
Contact your healthcare provider if you experience any of the following:
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. You may need a different size diaphragm, or you may need to ensure that you’re inserting it correctly. In some instances, you may need to try a different form of birth control.
A note from Cleveland Clinic
Weigh the pros and cons of getting a vaginal diaphragm with your provider. They aren’t as effective as other forms of birth control, like IUDs. Still, diaphragms greatly reduce your pregnancy risk when used correctly and consistently. Keep in mind that diaphragms don’t protect against some STIs like condoms do. Talk to your provider about your best options for preventing pregnancy while reducing your risk of STIs.
Last reviewed by a Cleveland Clinic medical professional on 07/01/2022.
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