Diaphragm

From Encyclopedia of Sex and Sexuality

A barrier method of birth control made of rubber. When in place it covers the cervix, preventing sperm from reaching the woman’s eggs. It is shallow and dome-shaped with a flexible rim. It requires a clinical examination and fitting, and cessation of use immediately restores a woman’s fertility. The diaphragm is always used with a contraceptive cream, foam, or gel, which is applied to the outer surface of the diaphragm to kill sperm, which otherwise would live up to seven days. The diaphragm must be removed from the vagina after twenty-four hours.

The diaphragm must be of the correct size, which is why a clinician is required for the initial fitting. The clinician will also provide instructions on how to insert and remove the diaphragm and the conditions of its use.

The diaphragm is not suitable for all women. Among the conditions that would preclude the use of the diaphragm are: poor vaginal muscle tone, a tipped or sagging uterus, and recurrent urinary tract infections. The diaphragm should not be used during menstruation.

A diaphragm may be inserted up to six hours before intercourse. It is folded in two and, after insertion into the vagina, pushed up so that it covers the cervix. It must stay in place for at least eight hours after intercourse, and if intercourse occurs again, additional spermicide should be applied while the diaphragm stays in place. In typical use, the diaphragm has an 18 percent failure rate for a year of use, which is reduced to 6 percent with perfect use. Some women are allergic to the rubber of the diaphragm, and some can develop bladder infections from its use. More rarely seen are cases of toxic shock syndrome. Diaphragms offer some protection against sexually transmitted diseases, but in these days of AIDS, it is not enough. They are convenient and relatively inexpensive. The examination and fitting will cost about $50 to $85 and the diaphragm itself from $13 to $25.

Some women are uncomfortable placing something inside their vagina, while other women have fingers that are too short to comfortably use diaphragms. However diaphragms do not interrupt sex play if inserted in advance, nor can they be felt by either partner. They may, however, become dislodged during the female superior position of sexual intercourse.