women s health issues
Barrier Contraceptives
Diaphragm
The diaphragm, a dome-shaped rubber cup with a flexible rim, is inserted into the vagina and positioned over the cervix. A diaphragm prevents sperm from entering the uterus. Some diaphragms come in various sizes and must be fitted by a health care professional, who also teaches the woman how to insert it. If a woman has gained or lost more than 10 pounds, has had a diaphragm for more than a year, or has had a baby or an abortion, she must be refitted for a diaphragm because the vagina’s size and shape may have changed. A new type of diaphragm is considered to be one size fits most women. It is made of silicone. Older diaphragms are made of latex. The silicone diaphragm is softer and more durable than the older diaphragms. A diaphragm should cover the entire cervix without causing discomfort. Neither the woman nor her partner should notice its presence. A spermicidal cream or gel (which kills sperm) should always be used with a diaphragm. The cream or gel is placed on the inside of the cup (nearest to the cervix) in case the diaphragm is displaced during intercourse. The diaphragm is inserted up to 2 hours before intercourse and should remain in place for at least 6 and probably 8 hours but no more than 24 hours. If intercourse is repeated while the diaphragm is in place, additional spermicidal cream or gel should be inserted into the vagina to continue protection. Diaphragms can be washed and reused. A woman should inspect the diaphragm regularly for tears. During the first year of latex diaphragm use, the percentage of women who become pregnant is approximately 6% with perfect use and about 12% with typical use (the way most people use it). 