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The diaphragm is a barrier method of
birth control. It is a round, dome-shaped device made
of rubber that has a firm, flexible rim. It fits inside a woman's vagina and
cervix. It should always be used with a sperm-killing
cream or jelly (spermicide). There are different types of diaphragms:
A woman inserts her diaphragm no sooner than 6 hours
before having sexual intercourse. To be effective, it must be used with a
spermicide. The diaphragm must be left in place for 6 hours after intercourse
and can be left in place up to 24 hours.
The type of diaphragm that works
best for you will depend on your vaginal muscle tone and the shape of your
pelvis. Diaphragms come in different sizes, so you must visit a health
professional to be fitted and get a prescription for the right size and type of
diaphragm. At this visit, you will be taught
how to use and care for the diaphragm. A return visit with the diaphragm
already in place is usually needed to be certain that you are using it
You will need to be refitted for the right size of
A small weight gain or loss or a therapeutic abortion
usually does not require a new diaphragm size.
diaphragm every 1 to 2 years to avoid an unintended pregnancy. With time and
repeated use, small holes can form in the rubber. Rubber can also weaken over
time and tear more easily.
the diaphragm user failure rate is 16%. This means that 16 women in 100 become
pregnant in the first year of typical use. Not using the diaphragm with every
act of intercourse is the most common reason for failure. The "perfect use"
failure rate is 6%, with a pregnancy in 6 of every 100 women who carefully use
the diaphragm every time they have sex.1
not fully protect against
sexually transmitted infections (STIs), including
infection with the
human immunodeficiency virus (HIV). Also, the use of
spermicides with nonoxynol-9 may increase your risk of getting HIV/AIDS. So be
sure to use a condom for STI protection unless you know
that you and your partner are infection-free.
Failure rates for
barrier methods are higher than for most other methods of birth control.
It is important to check your diaphragm for any cracks,
holes, or other damage that would reduce its effectiveness. Do not use any
petroleum-based vaginal creams, oils, or ointments, which can damage the
rubber. But water-based personal lubricants, such as Astroglide and K-Y Jelly,
are safe to use.
Trussell J (2007). Choosing a contraceptive:
Efficacy, safety, and personal considerations. In RA Hatcher et al., eds.,
Contraceptive Technology, 19th ed., pp. 19–47. New
York: Ardent Media.
May 3, 2012
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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