If you are thinking about becoming sexually active, or if you are already engaging in sexual activity, you may be thinking about investing in a reliable form of birth control. When used effectively, birth control methods can help to guard against unplanned pregnancies, and may even help to protect against certain STDs.

The diaphragm is a very popular choice for women when it comes to contraception. A very comfortable and affordable option, the diaphragm can be washed and reused, and has been proven to be very effective against pregnancy.

What is the Diaphragm?

The diaphragm is a type of barrier birth control that is used to prevent sperm from entering the uterus. Made out of a thin, flexible silicone rubber, the diaphragm looks much like a small dome or cup. Designed with a flexible ring around the top, the diaphragm is inserted into the vagina prior to sexual intercourse. The diaphragm should be used along with a spermicidal cream or jelly in order to increase its effectiveness. Diaphragms are available by prescription from your health care provider.

How Does the Diaphragm Work?

The diaphragm works by creating a barrier between sperm and your uterus. The diaphragm slides into place behind your pubic bone, completely covering your cervix. This prevents any sperm deposited during sexual intercourse from swimming through your cervix and into your uterus, where fertilization of an egg could take place.

Spermicide placed inside of the dome and around the rim of the diaphragm helps to kill any sperm that comes into contact with it. As a result, sperm is prevented from slipping around the diaphragm and swimming into your uterus.

Fitting a Diaphragm

Unlike other birth control options, diaphragms need to be fitted by your health care provider. It is essential that you get a diaphragm that is well fitted because improperly fitted diaphragms can lead to pregnancy. During a pelvic exam (in which your health care practitioner feels your ovaries, fallopian tubes, and cervix) your vagina will be measured in order to determine the size of your diaphragm.

Your doctor will insert a number of different sized rubber rings inside your vagina. Your diaphragm will correspond to the largest sized ring that you find comfortable.

It is important to get your health care provider to check the fitting of your diaphragm every year or so. If you gain or lose weight, become pregnant, or give birth to a baby, it is likely that your diaphragm will no longer fit properly. This could increase your chances of pregnancy. Diaphragms need to be replaced every two to three years. They typically cost between $30 and $70.

Using a Diaphragm

When you are fitted for your diaphragm, your health care provider will teach you how to insert, remove, and use your diaphragm properly. Diaphragms can be inserted up to six hours prior to intercourse. However, you will need to add more spermicide inside of your vagina every two hours, or each time you have sexual intercourse. For this reason, it is usually recommended that you insert your diaphragm no more than two hours prior to sexual intercourse.

Before inserting your diaphragm, you will need to place spermicide jelly or cream inside of the cup of the diaphragm. About a teaspoon is required. Also rub spermicide around the rim and edges of the diaphragm. To insert the diaphragm, pinch the rim of the cup together, so that the diaphragm folds in half. Push it inside of your vagina until the diaphragm cannot move anymore. Fold the tip of the diaphragm up behind your pelvic bone. You should not be able to feel the diaphragm.

You should not remove the diaphragm until at least six hours after you have had sexual intercourse. Do not leave the diaphragm inside your vagina for more than 24 hours. To remove, place your finger under the rim of the diaphragm and pull down and out. Be careful not to puncture the rubber diaphragm with your fingernail.

Wash the diaphragm with warm water and soap and place it inside of its protective case. Do not put talcum powder, vaginal creams, or oil-based lotions on the diaphragm; this can cause it to crack and increase your risk of pregnancy.

How Effective is the Diaphragm?

When used correctly, the diaphragm is a very effective way of guarding against an unplanned pregnancy. However, as with the cervical cap and Lea’s Shield, the failure rate associated with the diaphragm does vary, depending upon how you use it. It is essential that your diaphragm fits well and that you use it every time you have sexual intercourse. You must also use it in combination with a spermicidal cream or jelly. When used perfectly, the diaphragm is more than 91% effective.

Advantages of Using the Diaphragm

The diaphragm is associated with a number of advantages:

  • The diaphragm is easy to insert and remove.
  • The diaphragm is inexpensive and reusable.
  • When inserted correctly, the diaphragm cannot be felt by either partner.
  • The diaphragm does not affect future fertility or your menstrual cycle.

Disadvantages of Using the Diaphragm

The diaphragm does come with a few disadvantages:

  • If left in for more than 24 hours, the diaphragm can increase your risk of Toxic Shock Syndrome (TSS).
  • Continual use of spermicide can irritate the lining of your vagina and possibly increase your risk of contracting an STD.
  • The diaphragm can increase the likelihood of bladder infections.
  • The diaphragm does not protect against STDs. In order to protect against STDs, it is imperative that you use a condom every time you have sex.

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