What Is It? The diaphragm is a dome-shaped
bowl made of thin, flexible rubber that sits over the cervix (the area between
the vagina and the uterus).
How Does It Work? The
diaphragm keeps sperm from entering the uterus by blocking the cervix. For added
protection, spermicide
is put into the bowl of the diaphragm and along its edges before inserting the
diaphragm high into the vagina so it covers the cervix.
The diaphragm is inserted up to 6 hours before having sex. More spermicide
must be used for each time you have sex while wearing the diaphragm. After sex,
it must be left in for at least 6 hours, but no longer than 24 hours. The diaphragm can be removed by placing a finger into the vagina to
pull it out.
After each time the diaphragm is removed, it must be washed, rinsed, and
dried, then stored in its case. It should not be dusted with baby powder and
should never be used with oil-based lubricants such as mineral oil, petroleum
jelly, or baby oil. These substances can cause the rubber to become brittle and
crack. Other vaginal creams, such as yeast medicines, can also damage the
rubber.
How Well Does It Work? Over the course of 1 year, 16 out
of 100 typical couples who rely on the diaphragm to prevent pregnancy will have
an accidental pregnancy. Of course, these are average figures and the chance of
getting pregnant depends on whether you use this method correctly and every time
you have sex.
In general, how well
each type of birth control method works depends on a lot of things. These
include whether a person has any health conditions or is taking any medications
that might interfere with its use. It also depends on whether the method chosen
is convenient - and whether the person remembers to use it correctly all the
time.
Protection Against STDs The diaphragm
does not protect against sexually transmitted diseases (STDs). For those having
sex, condoms
must always be used along with the diaphragm to protect against STDs.
Possible Side Effects Most women who use a diaphragm have no
problems. The side effects that some women have include:
- Spermicides may irritate the vagina and surrounding skin.
- Strong odors or vaginal discharge may appear if the diaphragm is left in
too long.
- The rubber or latex in the diaphragm may cause an allergic reaction (this
is rare).
- Toxic shock syndrome (TSS) is a rare complication.
Who Uses It? Young women
who can take responsibility for sex in advance use diaphragms. You must also
always have a supply of spermicide if you choose to use a diaphragm.
In addition, the diaphragm is good for anyone who wants to have sex during her
period - the diaphragm catches the blood before it leaves the vagina. The
diaphragm isn't good for anyone who is uncomfortable or uneasy with the thought
of reaching into her own vagina.
How Do You Get It? A doctor must fit a
patient with a diaphragm. During a pelvic exam the doctor will measure your
vagina and then determine which size of diaphragm is right for you. The doctor
or nurse will then teach you how to insert and remove the diaphragm. Some
doctors may even ask you to practice at home and then come in while wearing the
diaphragm to check that you've done it right. A diaphragm that's inserted
incorrectly can result in pregnancy.
During your annual exam, the doctor will check that your diaphragm still fits
correctly. Your diaphragm may not fit correctly if you have gained or lost 10
pounds, had a baby, had an abortion, or were fitted when you were a virgin and
are now having sex.
How Much Does It Cost? A diaphragm usually
costs about $30 to $40 and should be replaced every 2 years. There is also the
cost of the doctor's visit and a fitting fee. Many health insurance plans cover
these costs and family planning clinics (such as Planned Parenthood) charge much
less. In addition, the cost of spermicide is about 25 cents per use.
Remember, abstinence
(the decision to not have sex) is the only method that always
prevents pregnancy and sexually transmitted diseases (STDs).
Updated and reviewed by: George A. Macones,
MD Date reviewed: April 2003 Originally
reviewed by: Neil Izenberg,
MD
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