Patient Information: Birth Control

Diaphragm Contraceptive Device

The diaphragm is a dome shaped rubber cup, with a spring inside the rim. You must be fitted for a diaphragm by a doctor. The diaphragm must be used with spermicidal cream or jelly. There are several brands of spermicidal creams and jellies. They can be purchased, without a prescription, at drug stores. Contraceptive foam should not be used with the diaphragm.

The diaphragm fits inside the vagina and covers the opening to the uterus. It blocks sperm from entering the uterus. The spermicidal cream or jelly used with the diaphragm kills any sperm that swim over the rim of the diaphragm. The diaphragm is not an effective method of birth control if used without spermicidal cream or jelly. To prevent pregnancy, the diaphragm must be used every time you have intercourse. .

How to Use Your Diaphragm

1. Fill the dome of the diaphragm with one teaspoon of spermicidal cream or jelly. Spread the cream around the inside and rim of the diaphragm with your finger.
2. To insert the diaphragm, you may squat, lie down, or stand with one foot raised. The diaphragm may be inserted immediately before intercourse, or up to four hours before having intercourse.
3. Squeeze the sides of the diaphragm together. Insert it, cream side up, into your vagina, pushing down and back as far as it will go.
4. Check to be sure the diaphragm is properly placed. You should be able to feel your cervix through the diaphragm. Your cervix will feel something like the tip of your nose. The rim of the diaphragm should rest just behind your pubic bone.
5. Leave the diaphragm in for at least six to eight hours after having intercourse. If you have intercourse more than once, leave the diaphragm in and insert one applicator full of spermicidal cream or jelly into your vagina. Remember to leave the diaphragm in place for at least six to eight hours after the last time you had intercourse.
6. To remove the diaphragm, hook a finger over or under the rim. Pull down and out.
7. After use, wash your diaphragm with mild soap and water. Rinse and pat dry. Dust the diaphragm with corn starch. Store the diaphragm in its carrying case. Check your diaphragm after every use for tears or punctures. To do this, hold the diaphragm up to the light, or fill with water and examine closely. Never use products like Vaseline, cold cream or baby powder on your diaphragm. They can damage the rubber.
8. With time, the diaphragm may develop an odor. This can be controlled by soaking the diaphragm for a few hours in vinegar and water or lemon juice and water.

There are several advantages to using a diaphragm. The diaphragm is relatively inexpensive. When used correctly, it is effective in preventing pregnancy. There are very few side effects associated with the diaphragm.

Problems with the diaphragm are very rare. A few men and women are allergic to spermicidal creams and jellies. They may experience itching and irritation. If this happens, try switching brands. If that does not help, consult your doctor. The problem can usually be solved by switching to a different brand. If you are troubled by discomfort or pain when the diaphragm is in place, check with your doctor.

You may need a different size or brand of diaphragm. Use of the diaphragm has been associated with toxic shock syndrome. Because of this, you should not leave it in place for longer than 24 hours. Symptoms of toxic shock syndrome include high fever, diarrhea, vomiting, muscle aches and a sunburn-like rash. If these symptoms occur, consult your doctor.

You will need to be refitted for a new diaphragm after a pregnancy, if you have a 10 to 20 pound weight change, or if you have a major abdominal or pelvic surgery. Bring your diaphragm with you to your yearly gynecological check-ups. Purchase a new diaphragm when the rubber becomes thin or torn.

If you have any questions or concerns, do not hesitate to contact the clinic at 319-356-2294, 8 a.m. to 5 p.m. Monday through Friday, or after hours, and ask for the gynecology resident.

Peer Review Status: Internally
Peer Review Date: 2004