Is a Diaphragm the Best Option for Me?

Diaphragm. Michael Matisse/Photodisc/Getty Images

A diaphragm is a flexible, dome-shaped cup with a bendable rim. It is made of soft silicone or latex. You bend the diaphragm in half and insert it into the vagina. A diaphragm covers the cervix to help prevent pregnancy.

History of the Diaphragm:

Diaphragms have been used as a birth control method since the 1830s.  You need a prescription to get a diaphragm. They are actually considered to be the first major contraceptive innovation for women who wanted the ability to protect themselves from unintended pregnancy.

Over the years, there have been many improvements in the design and effectiveness of diaphragms -- so they are still a popular birth control choice for many women. In fact, with typical use, they are 88% effective, and with perfect use, they are 94% effective.

How the Diaphragm Works:

A diaphragm acts as a physical barrier. It blocks the opening of the uterus. This way, sperm cannot reach and fertilize an egg.

Before you insert your diaphragm, you need to coat it with a spermicidal cream or jelly -- so, if any sperm manage to get over the rim of the diaphragm, they will hopefully be killed by the spermicide. The diaphragm is held in place by your vaginal muscles.

How to Use a Diaphragm:

You will find that with a little bit of practice, a diaphragm is very easy to use. Your doctor should show you how to insert and take out your diaphragm. You should keep practicing at home until you feel comfortable with using your diaphragm.


  • You must keep your diaphragm in place for six hours after the last time you had sex.
  • If you have sex again, make sure to insert more spermicide deep in your vagina.
  • If you have sex more than six hours after you have inserted the diaphragm, you also need to add more spermicide deep in your vagina.
  • Do not leave your diaphragm in place for more than 24 hours.

Types of Diaphragms:

Diaphragms come in different sizes and designs. This increases your chances of finding one that is a good fit for you. Other than size, there are two kinds of diaphragms:

  • A flat ring option: This type of diaphragm can be squeezed into a flat oval before being inserted. The flat ring type has a thinner rim. It also comes with an applicator -- which makes insertion a little easier.
  • An arcing or coil spring option: This type of diaphragm forms a bent circle when squeezed. You can insert an arcing or coil spring diaphragm with your fingers.

The Advantages of Using a Diaphragm:

Why should you consider using a diaphragm? A diaphragm can offer you the following advantages:

  • It is hormone-free -- so it has no effect on a your natural hormones.
  • It is reversible, so your fertility immediately returns when you take it out.
  • A diaphragm cannot usually be felt by either partner.
  • There are very few side effects (urinary tract infections and vaginal irritation are the most common side effects).
  • Breastfeeding mothers can use a diaphragm.
  • It is effective immediately.
  • A diaphragm can be easily carried in your purse.
  • It may lower the risk of catching certain sexually transmitted diseases -- though you should still use another method of protection against STDs (like condoms).
  • Diaphragms may prevent some types of precancerous changes in the cervix (but more research is needed to know more about this).
  • It can be inserted hours ahead of time, so it does not interrupt sexual activity.

Who Can Use a Diaphragm?

Most women can use a diaphragm. But, a diaphragm may not be for you if your uncomfortable touching your vagina or  if you have allergies to latex or spermicide (some women who have a mild reaction to spermicide find that switching spermicide brands can help).

Additional conditions that may rule out diaphragm use include:

How Can I Get a Diaphragm?

If you want to use a diaphragm, you need to get fitted for one by your doctor. Once this happens, your doctor can gibe you a prescription. Diaphragms may be purchased at a pharmacy. The cost of a diaphragm fitting and the actual diaphragm will vary based upon your insurance.

    Keep in mind that you may need to be refitted for a new diaphragm if you have:

    • Abdominal or pelvic surgery.
    • A full-term pregnancy.
    • A miscarriage or abortion (after 14 weeks of pregnancy).
    • A 20% change in weight -- or if you have gained or lost more than 10 pounds

    You should also be fitted for a new diaphragm if your present one is two or more years old.

    Is It True That My Diaphragm Can Protect Me from STDs?

    There is some evidence that diaphragm use may protect you against some sexually transmitted diseases. Research has shown that compared to women using no birth control, those who use a diaphragm have at a 65% lower chance of getting gonorrhea and trichomoniasis. The frequency of chlamydia is also reduced in diaphragm users. This may be because the cervix is the site of infection for gonorrhea and chlamydia (and the diaphragm covers the cervix) -- and because spermicide may destroy the trichomoniasis parasite. Check to see if the spermicide you use with your diaphragm contains nonoxynol-9. Frequent use of nonoxynol-9 may cause damage to your vaginal tissue. This irritation may put you at a higher risk for getting a STD or infection. It is best to not rely on your diaphragm to protect you against sexually transmuted infections.


    Klein DA, Arnold JJ, Reese ES. "Provision of contraception: Key recommendations from the CDC." American Family Physician. 2015 May 1; 91(9):625-633. Accessed via private subscription.

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