How does it work?

They form a barrier at the entrance to the womb (cervix) which stops the man’s sperm getting through to join the egg.

To be effective, diaphragms need to be used with a contraceptive gel to inactivate any sperm that are present.

How effective is it?

If used according to instructions, latex diaphragms are 92-96% effective when used correctly and with contraceptive gel. This means that between four and eight women in 100 will get pregnant in a year. If they are not used according to instructions, more women will get pregnant. How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions.

Where do you get a diaphragm?

You can get a diaphragm from family planning clinics and some general practices. A trained nurse or doctor must fit you. After you have had a fitting and know your size you can purchase future ones from the chemist. Diaphragm fitting is available on the GMS (medical card scheme) but you will have to pay for the device yourself.

What are the advantages?

• You only have to use it when you have sex
• It has no serious health risks
• You can put it in at any convenient time before you have sex

What are the disadvantages?

• Can disrupt sex
• Some people find the contraceptive gel messy
• It can take time to learn how to use it
• Not suitable for people who are sensitive to the chemicals in contraceptive gel
• Cystitis can be a problem for some women who use a diaphragm. Ask the doctor or nurse to check the size of your diaphragm if you suffer from cystitis

Who is it suitable for?

Most women can use a diaphragm. A diaphragm may not be suitable if you:

• have vaginal muscles which can’t hold a diaphragm
• have a cervix of an unusual shape or in an awkward position or you cannot reach it
• are sensitive to the chemicals in latex or the contraceptive gel
• have repeated urinary infections
• have a vaginal infection (wait until after the infection has cleared)
• have ever had toxic shock syndrome
• do not feel comfortable touching your vagina

If you have a high risk of getting a sexually transmitted infection (STI), for example if you or your partner has more than one partner, it may be advisable not to use a diaphragm.

How do I put in a diaphragm?

Instructions on how to use a diaphragm come with it and a doctor or nurse will show you how to put it in.

Do not remove the diaphragm for at least 6 hours after intercourse. You can leave it in longer but not more than 24 hours without removing and cleaning it.

How to care for your diaphragm

After use, clean it by washing gently in warm water with unscented soap. Rinse with warm water and dry thoroughly. Never boil it and avoid disinfectants, detergents, carbolic and strongly perfumed soap, Vaseline and any other oil based lubricant. These spoil the device. Inspect your device regularly for tears and holes by holding it up to the light. Never stretch it with sharp fingernails.

It is important that the device should retain its circular shape. If it gets out of shape, just bend the rim gently to restore. When not in use keep it in its box in a cool, dry place.

A diaphragm will be less effective if:

• you don’t use it every time you have sex
• it doesn’t cover your cervix
• you don’t have the right size
• you use it without contraceptive gel
• you have sex three hours or more after you put it in and you don’t use extra contraceptive gel
• you don’t use extra contraceptive gel with your diaphragm after having sex the first time
• you remove it too soon (less than six hours after the last time you had sex)
• you use oil-based products such as baby lotion, bath oils or some vaginal medicines (pessaries) with latex diaphragms. These can damage the latex.

What if I have my period?

Ideally diaphragms should not be used during your period because of a possible risk of toxic shock syndrome (TSS). However do not worry if your period starts while the diaphragm is in place. The blood will collect inside and eventually run over. You can safely remove it at any time.

You can do all the usual things you do while the diaphragm is in place without feeling its presence. You can go to the toilet as usual.

Special precautions

You may need a different size diaphragm if you put on or lose more than 3 kilos (7 pounds) in weight. This is because your internal measurements may change when your weight does. Similarly a new size may be required after having a baby, miscarriage or abortion.

Only use products with your barrier method recommended by the family planning centre. If you have any difficulty with the method always come back to the doctor. In any case come back for a check visit as advised.