Birth Control Barrier Methods (cont.)
The diaphragm is a shallow latex cup with a spring mechanism in its rim to hold it in place in the vagina. Diaphragms are manufactured in various sizes. You need a pelvic examination and measurement of the diagonal length of your vaginal canal so your health care provider can determine the correct diaphragm size.
You insert the diaphragm with spermicide before sex. The spermicidal cream or jelly is applied to the inside of the dome, which then covers your cervix. Your doctor will show you how to insert it and how to know it is in place.
It prevents pregnancy by acting as a barrier to the passage of semen into the cervix. Once in position, the diaphragm provides effective contraception for 6 hours. After that time, if you have not removed the diaphragm, you will add fresh spermicide with an applicator. After intercourse, the diaphragm must be left in place for at least 6 hours after sex but not more than 24 hours.
- How effective: Effectiveness of the diaphragm depends on the age of the user, experience with its use, continuity of use, and the use of spermicide. Typical failure rate within the first year is estimated to be 20%.
- Advantages: The diaphragm does not use hormones. The woman is in control of her birth control. The diaphragm may be placed by the woman in anticipation of intercourse.
- Disadvantages: Prolonged use during multiple acts of intercourse may increase the risk of UTI. Use for longer than 24 hours is not recommended due to the possible risk of toxic shock syndrome. The diaphragm requires professional fitting. Poorly fitted diaphragms may cause vaginal erosions. Diaphragms have a high failure rate. Use of a diaphragm requires brief formal training. The diaphragm may develop odor if not properly cleansed. This method does not protect against STDs.
Francisco Talavera, PharmD, PhD
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