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The diaphragm is a barrier method of birth control. It is a round, dome-shaped device made of rubber that has a firm, flexible rim. It fits inside a woman's vagina and covers the cervix. It should always be used with a sperm-killing cream or jelly (spermicide). There are different types of diaphragms:
A woman inserts her diaphragm no sooner than 6 hours before having sexual intercourse. To be effective, it must be used with a spermicide. The diaphragm must be left in place for 6 hours after intercourse and can be left in place up to 24 hours.
The type of diaphragm that works best for you will depend on your vaginal muscle tone and the shape of your pelvis. Diaphragms come in different sizes, so you must visit a health professional to be fitted and get a prescription for the right size and type of diaphragm. At this visit, you will be taught how to use and care for the diaphragm. A return visit with the diaphragm already in place is usually needed to be certain that you are using it correctly.
You will need to be refitted for the right size of diaphragm after:
A small weight gain or loss or a therapeutic abortion usually does not require a new diaphragm size.
Replace your diaphragm every 1 to 2 years to avoid an unintended pregnancy. With time and repeated use, small holes can form in the rubber. Rubber can also weaken over time and tear more easily.
On average, the diaphragm user failure rate is 12%. This means that 12 women out of 100 become pregnant in the first year of typical use. Not using the diaphragm with every act of intercourse is the most common reason for failure. The "perfect use" failure rate is 6%, with a pregnancy in 6 out of 100 women who carefully use the diaphragm every time they have sex.footnote 1
Diaphragms do not fully protect against sexually transmitted infections (STIs), including infection with the human immunodeficiency virus (HIV). Also, the use of spermicides with nonoxynol-9 may increase your risk of getting HIV/AIDS. So be sure to use a condom for STI protection unless you know that you and your partner are infection-free.
Failure rates for barrier methods are higher than for most other methods of birth control.
It is important to check your diaphragm for any cracks, holes, or other damage that would reduce its effectiveness. Do not use any petroleum-based vaginal creams, oils, or ointments, which can damage the rubber. But water-based personal lubricants, such as Astroglide and K-Y Jelly, are safe to use.
Trussell J, Guthrie KA (2011). Choosing a contraceptive: Efficacy, safety, and personal considerations. In RA Hatcher et al., eds., Contraceptive Technology, 20th ed., pp. 45–74. Atlanta: Ardent Media.
Current as of:
October 8, 2020
Author: Healthwise StaffMedical Review: Sarah Marshall MD - Family MedicineAdam Husney MD - Family MedicineKathleen Romito MD - Family MedicineRebecca Sue Uranga
Current as of: October 8, 2020
Sarah Marshall MD - Family Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Rebecca Sue Uranga
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