When used correctly with spermicide, a diaphragm is 92-96% effective at preventing pregnancy – this means that between four and eight women out of every 100 who use a diaphragm as contraception will become pregnant within a year.
There are no serious health risks.
You only have to think about it when you have sex.
You can put a diaphragm in several hours before you have sex.
It can take time to learn how to use it.
Some women develop cystitis (a bladder infection) when they use a diaphragm. Your doctor or nurse can check the size – switching to a smaller size may help.
If you lose or gain more than 3kg (7lbs) in weight, or have a baby, miscarriage or abortion, you may need to be fitted with a new diaphragm.
By using condoms as well as a diaphragm you'll help to protect yourself against sexually transmitted infections (STIs).
A contraceptive diaphragm is inserted into the vagina before sex, and it covers the cervix so that sperm can't get into the womb (uterus). You need to use spermicide with it (spermicides kill sperm).
The diaphragm must be left in place for at least six hours after sex. After that time you take out the diaphragm and wash it. They're reusable. Diaphragms come in different sizes – you must be fitted for the correct size by a trained doctor or nurse.
Inserting a diaphragm
Your doctor or nurse will show you how to put in a diaphragm. Diaphragms come with instructions and are all inserted in a similar way.
with clean hands, put a small amount of spermicide on each side of the diaphragm (also putting a little spermicide on the rim may make the diaphragm easier to put in)
put your index finger on top of the diaphragm and squeeze it between your thumb and other fingers
slide the diaphragm into your vagina upwards
this should ensure that the diaphragm covers your cervix
always check that your cervix is covered – it feels like a lump, a bit like the end of your nose
if your cervix is not covered, take the diaphragm out by hooking your finger under the rim or loop (if there is one) and pulling downwards, then try again
some women squat while they put their diaphragm in, others lie down or stand with one foot up on a chair – use the position that's easiest for you
you can insert a diaphragm up to three hours before you have sex – after this time you will need to take it out and put some more spermicide on it
You may be fitted with a temporary diaphragm by your doctor or nurse. This is for you to practise with at home. It gives you the chance to learn how to use it properly, see how it feels and find out if the method is suitable for you. During this time you are not protected against pregnancy and need to use additional contraception, such as condoms, when you have sex.
When you go back for a follow-up appointment with your doctor or nurse, wear the diaphragm so they can check that it is the right size and you have put it in properly. When they are happy that you can use a diaphragm properly, they will give you one to use as contraception.
Removing a diaphragm
A diaphragm can be easily removed by gently hooking your finger under its rim, loop or strap and pulling it downwards and out. You must leave all types of diaphragm in place for at least six hours after the last time you had sex.
You can leave them in for longer than this, but do not leave them in for longer than the recommended time of 30 hours (including the minimum six).
Looking after your diaphragm
After use, you can wash your diaphragm with warm water and mild unperfumed soap. Rinse it thoroughly, then leave it to dry. You will be given a small container for it, which you should keep in a cool, dry place.
Never boil a diaphragm.
Do not use disinfectant, detergent, oil-based products or talcum powder to keep it clean, as these products can damage it.
Your diaphragm may become discoloured over time but this does not make it less effective.
Always check your diaphragm or cap for any signs of damage before using it.
You can visit your GP or nurse when you want to replace your diaphragm. Most women can use the same diaphragm for a year before they need to replace it. You may need to get a different size diaphragm if you gain or lose more than 3kg (7lb) in weight, or if you have a baby, miscarriage or abortion.
Advantages and disadvantages
A diaphragm has the following advantages:
you only need to use a diaphragm when you want to have sex
you can put it in at a convenient time before having sex (but do not forget to use extra spermicide if you have it in for more than three hours)
there are no serious associated health risks or side effects
you are in control of your contraception
A diaphragm has the following disadvantages:
it is not as effective as other types of contraception
it only provides limited protection against sexually transmitted infections (STIs)
it can take time to learn how to use it
putting it in can interrupt sex
cystitis (bladder infection) can be a problem for some women who use a diaphragm
latex and spermicide can cause irritation in some women and their sexual partners
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