The diaphragm helps prevent pregnancy. Among various benefits, the diaphragm:
- Allows prompt return to fertility
- Can be used as a backup method of birth control
- Can be used during breast-feeding beginning six weeks after childbirth
- Can be inserted up to six hours before sex and left in place for up to 24 hours
- Doesn't require a partner's cooperation
- Has few, if any, side effects
The diaphragm isn't appropriate for everyone, however. Your health care provider may discourage use of the diaphragm if you:
- Are allergic to silicone, latex or spermicide
- Are at high risk of or have HIV/AIDS
- Are at high risk of pregnancy — you're younger than age 30, you have sex three or more times a week, you've had previous contraceptive failure with vaginal barrier methods, or you're not likely to consistently use the diaphragm
- Have vaginal abnormalities that interfere with the fit, placement or retention of the diaphragm
- Have frequent urinary tract infections
- Have a history of toxic shock syndrome
- Have significant pelvic organ prolapse, such as uterine prolapse — when the uterus descends into the vagina from its normal position in the pelvis
- Recently gave birth or had a miscarriage or an abortion
The diaphragm doesn't offer reliable protection from sexually transmitted infections (STIs).
In a year of typical use of the diaphragm and spermicide, an estimated 21 out of 100 women will get pregnant. Without the use of spermicide, however, an estimated 29 out of 100 women will get pregnant in a year of typical use of the diaphragm.
Consistent and correct use is essential to the effectiveness of the diaphragm. For example, you may get pregnant when using a diaphragm if:
- You don't use the diaphragm every time you have sex
- The diaphragm becomes dislodged from the cervix during sex
- You don't use spermicide
- You remove the diaphragm within six hours after having sex
Spermicide applied to the diaphragm may rarely damage the cells lining the vagina, causing:
- An increased risk of contracting STIs
- Vaginal irritation
- Urinary tract or vaginal infection
Contact your health care provider if:
- The diaphragm slips out of place when you walk, sneeze, cough or strain
- You or your partner experience pain during or following use of the diaphragm
- You have signs or symptoms of toxic shock syndrome, such as sudden high fever, diarrhea, dizziness, vomiting, muscle aches or a rash that looks like sunburn
- You're unable to remove the diaphragm
The diaphragm comes in different sizes. Your health care provider will fit you for the diaphragm and demonstrate how to insert and remove the diaphragm. He or she may confirm that the diaphragm is in the correct position by doing a pelvic exam.
Before you use the diaphragm for the first time, practice inserting the diaphragm until you're comfortable with it. You may want to use a backup method of contraception, such as a male condom, when you're first using the diaphragm.
Always use the diaphragm with spermicidal cream, foam or gel. Avoid use of body lotions near your vagina and vaginal medications when using the diaphragm. If you're using a diaphragm and douche, wait until at least six hours after sex to avoid washing away spermicide.
Make sure you regularly check your diaphragm for puncture marks or cracks. To search for holes, hold your diaphragm up to the light and gently stretch the rubber between your fingers or fill the diaphragm with water. Replace your diaphragm at least every two years.
You may need to have your diaphragm checked and possibly refitted if:
- Your diaphragm no longer fits snugly or comfortably
- You've given birth or had an abortion
- You've had pelvic surgery
- You've gained or lost more than 20 pounds (about 9 kilograms)
- You have repeated urinary tract infections
- You or your partner feels pain or pressure during sex