Birth Control Diaphragm: How To Use, Advantages & Drawbacks

The birth control diaphragm's efficacy is technique-sensitive and works when inserted correctly.

Written by Anshuman Mohapatra • 

Birth control diaphragm is a dome-shaped, reusable contraceptive made of latex or silicone. The device must be inserted vaginally before having intercourse. It covers the cervix and is often used with a spermicide, such as a spermicidal cream. This contraceptive is moderately effective and has a few side effects. However, Birth control diaphragms are non-hormonal and do not affect the menstrual cycle.

Read this post to understand about the safety, efficacy, side effects, and the ways to use these diaphragms.

How Effective Are Birth Control Diaphragms?

According to the NHS UK, birth control diaphragms are 92-96% effective when used with a spermicide (1). The correct insertion of the diaphragm and the use of spermicide play an essential role in the contraceptive’s effectiveness.

The efficacy of the diaphragm could also decrease due to the following reasons.

  • Damage to the diaphragm
  • Incorrect size
  • Removal in less than six hours since intercourse
  • Use of certain lubricants, which may damage the diaphragm

What Are The Types Of Birth Control Diaphragms?

According to the American Academy of Family Physicians (AAFP), birth control diaphragms come in four varieties apart from their sizes (2). Traditionally, the diaphragms were latex-based, but several diaphragms are now made of silicone.

  • Arching spring: The device comes with a tension spring that helps build suction while applied in the vagina. It is easy to use and suitable for women with low vaginal musculature.
  • Coil spring: It comes with a soft and flexible ring. The device can be introduced using a diaphragm introducer tool.
  • Flat spring: It has a softer and more flexible ring than a coil spring device. It needs a diaphragm introducer tool for insertion. Women with firm vaginal musculature may use such a device.
  • Silicone wide seal rim: It is appropriate for women who have allergies to latex. The device comes in arching and coil spring variants.

How To Use A Birth Control Diaphragm?

You may visit an OB-GYN to learn the correct usage of birth control diaphragms. You may also get the device inserted by a doctor. Nevertheless, the diaphragm is an easy-to-fit device and can be worn at home through the following steps (3).

  1. Wash your hands with mild soap and clean water.
  1. Check the expiration date of the spermicidal gel and do not use it beyond the date. Examine the diaphragm for any cracks.
  1. Apply the spermicidal agent thoroughly in the diaphragm and around the rims.
  1. Squeeze the rim of the diaphragm into the vagina and allow it to pass down until it stops.
  1. Using a finger, examine whether the diaphragm covers the cervix adequately. If not, the diaphragm can be removed and fitted again.
  1. The diaphragm should be removed after six hours of insertion.
  1. To remove a diaphragm, use a finger to slide the rim and pull out the diaphragm gently.

Who Can Use A Diaphragm?

Adult women can safely and effectively use diaphragms during intercourse. Moreover, far from the common misunderstanding, using a diaphragm does not affect feelings during love making (3).

Women may choose other contraceptives over a diaphragm if they:

  • Recently had a baby or had induced or spontaneous abortion recently
  • Are allergic to rubber, latex, or silicone

How Does A Birth Control Diaphragm Work?

The vaginal diaphragm is a dome-shaped device, which covers the cervix. Several diaphragms come with a spring attached to the rim, which seals the cervix.It works as a physical barrier that restricts sperms from entering the uterus.

A diaphragm is always used along with a spermicidal gel, which is vital for its effectiveness. The spermicide and diaphragm work together to stop viable sperm from entering the uterus.

What Are The Advantages Of A Birth Control Diaphragm?

Several advantages make birth control diaphragms an appropriate choice and effective contraceptives (4).

  • The diaphragms do not have hormones and do not interfere with the menstrual cycle.
  • The cost of the device is usually covered through health insurance and government policies.
  • They are reusable and may last several years, depending on the manufacturer’s instructions.
  • A correct fitting allows comfortable grip, and the device cannot be felt during sex.
  • The use of a diaphragm may alleviate the risk of getting pelvic inflammatory disease and tubal infertility.

Are There Drawbacks Of Birth Control Diaphragms?

Diaphragms have their share of disadvantages like any other contraceptive device.

  • Diaphragms are made of rubber, silicone, or latex. Women with allergies to these materials should seek other contraceptives.
  • The lack of access to a spermicide renders the diaphragm ineffective.
  • The correct insertion of the diaphragm requires practice. The woman may have to consider the use of other contraceptives, such as a male condom, until she is confident of inserting the diaphragm correctly.
  • It offers negligible protection against sexually transmitted infections.
  • The removal of the diaphragm within six hours of intercourse may render it ineffective.

Leaving the diaphragm for too long, almost 24 hours, could increase the risk of the following conditions (5) (6).

  • Urinary tract infections (UTIs) and vaginal irritation: Diaphragms and spermicides may affect the natural bacterial flora of the vagina, increasing the risk of UTI and vaginal irritation.
  • Toxic shock syndrome (TSS): It is a rare condition caused by bacterial toxins, affecting various organs. The diaphragm blocks the natural vaginal discharge, causing the enrichment of toxic bacteria such as staphylococcus. The enterotoxins secreted by the harmful bacteria cause the TSS.

How To Maintain The Birth Control Diaphragm?

Diaphragms are reusable cervical barrier devices, and proper care is required to extend the longevity of the device. You may check the manufacturer’s instructions on cleaning and maintaining the device after use. Below are some of the steps usually followed after each use of a birth control diaphragm.

  • The diaphragm should be removed after six hours post-intercourse and rinsed with clean water.
  • It is essential to check the diaphragm for any damage each time after use. Minute holes can be inspected by pouring some water on the diaphragm and looking for leakage.
  • The diaphragm should be air-dried and kept for storage in a clean and dry container.
  • The spermicide should be stored in a cool and dry place.

Never boil diaphragms or use disinfectants to disinfect them. Diaphragms should only be used with water-based lubricants to prevent any damages, which could render them ineffective.

What Is The Cost Of Birth Control Diaphragms?

The cost usually includes that of the diaphragm, the spermicide gel, and the applicable charges of the physician for examination and fitting. The affordable care act in the US and health insurance usually covers the diaphragm cost. A diaphragm can cost up to $250, and a spermicide gel will cost around $5- 15 for a kit (7) (8).

When To See A Doctor?

Good training and regular practice are vital to have a comfortable and effective fitting. If you use birth control diaphragms regularly, you may consider medical advice if you experience the following symptoms (9).

  • Change in the color and smell of the natural vaginal discharge
  • Fever and body pain
  • Abdominal pain
  • Pain while urinating
  • Vaginal irritation and itching

Frequently Asked Questions

1. Are diaphragms more effective than condoms?

Diaphragms may not be more effective than condoms because they do not protect against sexually transmitted infections. Moreover, diaphragms are only effective when used correctly (10).

2. Can my partner feel a diaphragm during intercourse?

If the diaphragm is of the right size and at the correct position, neither you nor your partner feels it during intercourse.

Vaginal diaphragms are safe and effective contraceptives that do not interfere with hormones and provide full control to the woman. It is essential to insert them correctly and use them with spermicide for maximum effect. The device, when fitted properly, seamlessly stays in place and is not felt by your or your partner during intercourse.

Key Pointers

  • Birth control diaphragm is a reusable contraceptive inserted vaginally and often used with a spermicide.
  • Some advantages are they do not have hormones, are reusable, and are not felt during intercourse.
  • However, they do not protect against sexually transmitted diseases, and their removal within six hours of intercourse makes them ineffective.
  • Vaginal diaphragms are generally safe, but consult a doctor if you experience abdominal pain, vaginal itching, etc.


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