The diaphragm is not nearly as popular as it was before the introduction of the Pill, but even in 2001, it is still used by a sizeable number of women in the UK.

Used properly, the diaphragm is an efficient and safe type of contraception. But in order for it to be effective, the woman must be carefully taught how to insert it correctly.

Each diaphragm will last several years if it is carefully looked after, so this is an inexpensive contraceptive method, apart from the ongoing expense of the spermicidal cream or gel that must always be used with it. (However, you can, if you wish, obtain the cream or gel free of charge on an NHS prescription.)

Who can use the diaphragm?
Diaphragms can be used by most women without any kind of inconvenience or discomfort. It is a good option for a woman who cannot take the Pill for some reason or another, or for women who dislike the idea of hormonal contraception. It also suits women who are older and in regular relationships.

What examinations do you go through to have a diaphragm?
If you want a diaphragm, your own GP or, more likely, a doctor at a Family Planning Clinic will measure you for it. This is done during a pelvic examination.

How do you use a diaphragm?
The diaphragm looks like a little hat without a brim. It is elastic and and can be folded so that it goes into the vagina easily. Before you insert it, spermicidal cream is smeared on the diaphragm to give more protection. A diaphragm without spermicidal cream will not be effective in preventing pregnancy.

The diaphragm is placed high up in the vagina, so that it covers the cervix. When the diaphragm is placed correctly, it cannot be felt by either the woman or the man during intercourse.

It is easy to use a diaphragm and detailed instructions will accompany it. However, it is essential that you insert it for the first time in the company of your doctor or Family Planning Nurse so that they can check you are getting it in the right place.

Once you have your diaphragm, you can take care of it by washing it carefully after use and putting it away in its box.

What are the advantages to this method?
One of the key advantages to the diaphragm is that it can allow sex to be spontaneous. A woman can easily insert the diaphragm whenever she expects she may be having sex that day. If she inserts it more than three hours before she makes love, however, she should use some extra spermicide.?

Diaphragms should always be left in place for at least six hours after sex.

However, when sex does not occur, it is quite safe for a woman to leave the diaphragm in or even to go to sleep wearing it. A diaphragm should not be left in place for more than 30 hours.

There is another advantage for women who feel particularly sexy during their periods, but whose men might be squeamish at the sight of blood during intercourse at those times. With a diaphragm in place, there is usually no sign at all that the woman has a period, so the couple can make love as normal.

What are the disadvantages?
Lovemaking can be disturbed if you suddenly find yourself in a sexual situation and have to insert your diaphragm before intercourse can take place.

You may also have to insert more spermicide either if your diaphragm has been in place for a while before intercourse takes place, or if you have sex more than once in any one session.

Is the diaphragm an effective type of contraception?
A diaphragm is an effective form of contraception if spermicidal cream is always applied before sexual intercourse and if it is left in the vagina for six to eight hours after the intercourse has finished. An extra portion of spermicidal cream can be put in the vagina if the intercourse continues for hours but the diaphragm has to stay where it is.

If used correctly, the diaphragm is 92 to 96 per cent effective against pregnancy. Obviously, the pregnancy rate is higher if it is not used properly.

Are there any side effects?

A few women have an allergy to the material that the diaphragm is made from.

Cystitis is a problem for a few users.

Some people are sensitive to spermicide.

How long will your diaphragm last?
You should keep an eye on your diaphragm to make sure it is OK and get a replacement immediately if it has perished or if it gets damaged in any way.

You will also need to see your doctor if your weight changes by more than 3kg either way, or if you resume wearing a diaphragm after a pregnancy.

Please note that if for any reason the diaphragm doesn't suit your particular vaginal shape, there is an alternative. The closely related 'contraceptive cap' is also a good method. It is smaller, and fits over your cervix, so you have to be very sure that you can find your own cervix, and fit the cap over it.

Nearly all caps are fitted in Family Planning Clinics. There are three brands available.

The Dumas Vault cap.

The Prentif Cavity Rim.

The Vimule.

BACK

How to give up smoking

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use