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The Diapragm with Spermicide: Answers to Your Questions

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The Diaphragm with Spermicide:
Answers to Your Questions

What is a diaphragm?
Is it effective?
How does it work?
How do I use a diaphragm?
How do I insert the diaphragm?
How do I remove the diaphragm?
Side effects
Other instructions
Care and storage of the diaphragm
What are the advantages and disadvantages of using a diaphragm?
Is the diaphragm the right method for me?

The information provided here is meant to give you general information about diaphragms and does not replace the need to talk to a health care provider if you would like to use a diaphragm as a contraceptive method.


What is a diaphragm?

A diaphragm is a shallow rubber cup. You put a contraceptive jelly (spermicide) into the diaphragm. You then put the diaphragm into your vagina. The diaphragm covers the opening to the womb.

Is it effective?

The diaphragm is effective when it is used correctly every time you have sexual intercourse.

NOTE: There is ongoing research to test the use of various substances, including common spermicides, as microbicides to prevent HIV infection and other STI transmission but it is not conclusive. Nonetheless, using the diaphragm with spermicide will offer you added protection. Aside from strict abstinence, latex condoms offer the best protection against HIV infection and sexually transmitted infections.

How does it work?

The diaphragm and jelly keep the man's sperm out of the woman's womb. The jelly contains a chemical (spermicide) to kill the sperm. The woman must use the diaphragm and jelly every time she has sexual intercourse.


How do I use a diaphragm?

As with any other method, you should talk to your doctor or a family planning counselor at a local clinic or hospital before using a diaphragm as a contraceptive method. The following instructions are provided to help you decide whether a diaphragm may be right for you.

  • You must use the diaphragm with contraceptive jelly or cream to prevent pregnancy.
  • You must use the diaphragm every time you have sexual intercourse.
  • You should insert the diaphragm into your vagina within six hours before sexual intercourse.
  • If you have intercourse more than once while wearing the diaphragm, use the applicator to insert extra spermicide into the vagina, without removing the diaphragm.
  • Leave the diaphragm in place for at least six hours after intercourse, but not for more than 24 hours.

How to insert the diaphragm:

  • Wash your hands with soap.
  • Hold the diaphragm with the dome down, like a cup.
  • Squeeze about one tablespoon of spermicide into the dome; then smear a little of the spermicide around the rim with your finger.
  • You may insert the diaphragm while you are in any position that is comfortable for you (standing, squatting, sitting on the toilet, lying on your back, etc.).
  • Fold the diaphragm in half for insertion after applying spermicide. Spread the lips of your vagina with your other hand. Push the diaphragm all the way into your vagina.
  • Check the position of the diaphragm with your finger. The diaphragm should cover your cervix, which is the entrance to your womb. Your cervix feels like the tip of your nose. You must feel the cervix through the diaphragm.

How to remove the diaphragm:

  • Wash your hands with soap.
  • Place your finger behind the front rim of the diaphragm. Then pull the diaphragm down and out of the vagina. Be sure your fingernails are short enough to avoid tearing the diaphragm.
  • You may remove the diaphragm while you are in any position that is comfortable for you (standing, squatting, sitting on the toilet, lying on your back, etc.).

Side effects

Return to the health facility if you have any of the problems listed below. Be sure to tell your health care provider that you are using a diaphragm.

  • Irritation in your vagina that bothers you
  • Pain with urination

Other instructions

  • A woman who has just delivered a baby may be fitted for a diaphragm six weeks or more after delivery, after the uterus has returned to normal size. The diaphragm with spermicide is safe for breastfeeding women and their babies.
  • A woman who has just had a first-trimester abortion may be fitted for the diaphragm immediately after the procedure. A woman who has just had a second-trimester abortion must wait until the uterus has returned to normal size (four weeks after the abortion).
  • Do not use oil-based medications or lubricants (such as petroleum jelly or vegetable oils) when using the diaphragm. Oil-based products can cause holes in the rubber or latex.
  • You will need to be fitted for a new diaphragm after pregnancy, pelvic surgery, or a weight change of more than 20 pounds (10 kg).
  • Bring the diaphragm with you when you return to the health facility.

Return to the health facility if:

  • You are not happy with the method.
  • You think you are pregnant.
  • You want information about, or want to start using, another family planning method.
  • You think there is any chance you may have been exposed to HIV infection or any other STI.

Care and storage of the diaphragm:

  • After removing the diaphragm, wash it with soap and water; then rinse and dry it. Store the diaphragm in the container that it came in.
  • Store the diaphragm in a cool, dry place.
  • Check the diaphragm for tears or holes of any size before or after each use. To look for holes, you can hold the diaphragm up to the light, or fill it with water to see if there are leaks. If the diaphragm has a tear or hole, do not depend on it to prevent pregnancy.
  • Return to the health facility for a new diaphragm once a year or sooner if you find tears or holes or if you gain or lose more than 20 pounds (10kg).

What are the advantages and disadvantages of the diaphragm?

Advantages:

  • The diaphragm with spermicide may offer protection against some sexually transmitted infections.
  • The diaphragm may be discontinued by the woman on her own.

Disadvantages:

  • The diaphragm with spermicide has not been proven to be protective against HIV infection.
  • The diaphragm may cause irritation in the vagina if the woman is sensitive to the spermicide.
  • Inserting the diaphragm may interrupt lovemaking.
  • A trained health care worker must measure the woman for the diaphragm and teach her how to put it in and take it out.
  • Some women who use the diaphragm contract bladder infections.
  • Spermicide may be expensive and difficult to find.

Is the diaphragm the right method for me?

There are a number of factors that you should consider before deciding whether the diaphragm is right for you. These questions can help you determine whether the diaphragm might be an effective contraceptive method for you.


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