Diaphragm for Birth Control: Is It Right for Me?
With more than 15 methods of safe and effective birth control options approved by the US Food and Drug Administration, it’s possible to find one that matches your individual needs. Ideally, your method of contraception aligns with your lifestyle, childbearing plans, age, and medical condition. For some women, the diaphragm checks these boxes.
A diaphragm is a nonhormonal method of birth control that covers the cervix to prevent semen from reaching and fertilizing an egg. While it doesn’t use hormones, a diaphragm is only available from a health care provider because it must be properly fitted to be effective.
Joan Bergstrom, MD, FACOG, MBA, and the OB/GYNs at Women’s Health Services in Arlington, Texas, are birth control specialists who provide complete family planning services for women. If you’re considering using a diaphragm, we can discuss the pros and cons of this method and any other options you may be considering so you can feel confident with your choice.
How a diaphragm works
A diaphragm is a reusable latex or silicone cup that is used to prevent pregnancy. This dome-shaped device is inserted into your vagina to block sperm from entering your uterus.
The diaphragm covers your cervix, the opening of the uterus. When a diaphragm is fitted correctly, the firm, flexible rim of the device keeps it in place during intercourse.
Proper use of a diaphragm involves coating the rim and the inside of the dome with spermicidal cream or jelly before inserting it.
Getting the right diaphragm
You can only obtain a diaphragm through a health care provider. After a physical examination, your provider gives you a prescription for the type and style of diaphragm you need.
There are four styles of diaphragms available in different sizes, which makes it easy for most women to find one that fits well:
Arching spring diaphragm
An arching spring diaphragm is the easiest to use because you can insert it with your fingers. It has a firm ring and is often recommended if you have weak vaginal muscle tone.
Flat spring diaphragm
The flat spring diaphragm has a thin rim that can be squeezed into a flat oval for insertion. It works well if you have strong vaginal muscle tone. This design also uses an introducer tool for insertion.
Coil spring diaphragm
The coil spring diaphragm is flexible with a soft rim. This design works well if you have average vaginal muscle tone. An introducer tool is used to insert this style, though you can also use your fingers.
Wide seal rim diaphragm
The silicone wide seal rim diaphragm may be appropriate if you are allergic to latex. It is available in coil spring or arching spring styles.
Effectiveness of a diaphragm
With perfect use, a diaphragm is 94% effective in preventing pregnancy. However, with actual use, diaphragms are typically about 88% effective, with about 12% of diaphragm users becoming pregnant annually.
You can increase the effectiveness of a diaphragm by following these guidelines:
- Use your diaphragm every time you have vaginal intercourse
- Always use a spermicide with your diaphragm
- Insert your diaphragm up to two hours before sex
- Always leave your diaphragm in place for at least 6 hours and not more than 24 hours after intercourse
- If you have sex again before it’s time to remove the diaphragm, insert a new dose of spermicide into your vagina
- Visit your health care provider to ensure proper fit after pregnancy, cervical surgery, or experiencing 10 or more pounds of weight loss or weight gain
- Replace your diaphragm every one to two years
It’s important to remember that a diaphragm does not protect you from sexually transmitted infections (STIs), so you should use a condom in addition to a diaphragm. Using a condom with a diaphragm also provides another layer of protection against pregnancy.
Advantages of using a diaphragm
Many women appreciate the fact that a diaphragm allows them to be in control of pregnancy prevention when they need it without depending on their partner. A diaphragm usually doesn’t interfere with the experience of either partner during sex.
Since you only use a diaphragm when you’re going to have sex, it doesn’t affect your body every day. This hormone-free method doesn’t change your natural cycle, so you can begin to plan for pregnancy as soon as you're ready, without a waiting period.
While some women may experience more frequent urinary tract infections and vaginal irritation as a result of the diaphragm, there are few serious side effects to using a diaphragm.
Who shouldn’t use a diaphragm
A diaphragm may not be appropriate for you if you have any of the following characteristics:
- Inability to use a diaphragm consistently and correctly
- Severe sensitivity or allergy to latex, silicone, and/or spermicide
- Uterine or vaginal physical abnormality
- History of frequent UTIs and/or toxic shock syndrome
- Poor vaginal muscle tone
- Recently experienced surgery to the cervix or recently given birth
To determine the most appropriate type of contraception for your lifestyle and reproductive health, make an appointment with Dr. Bergstrom and the team at Women’s Health Services today.