One of the most used forms of contraception is the diaphragm. It is a hollow cap with a flexible latex or silicone rim. Its main function is to prevent sperm from coming into contact with the egg. The diaphragm itself is not enough. Therefore it is used in combination with a spermicidal cream. Even though the use of the diaphragm has a 95% success rate (better than condoms when combined with spermicides), there is still a small chance that it will fail. Part of the failure is due to incorrect insertion of the diaphragm. To make sure your diaphragm is comfortable and effective, start with Step 1 below.
Steps
Part 1 of 4: Correctly Insert a Diaphragm
Step 1. Wash your hands and empty your bladder
Before inserting the diaphragm, wash your hands and empty your bladder. Wash the diaphragm with warm water and mild soap. Wash it and dry it with a clean cloth.
Hands carry bacteria around - washing them first ensures that the diaphragm is clean inside the vagina
Step 2. Check the aperture before using it
Hold the diaphragm up to the light for a better view. Spread the diaphragm along the edges, from all sides. This is to make sure there are no holes or tears on the contraceptive.
For a double check, pour water into the diaphragm. There should be no leakage in the contraceptive
Step 3. Apply spermicide before inserting
Never forget the spermicides (gel or cream) before inserting it, otherwise the effectiveness of the diaphragm will be enormously reduced. That's how:
- Get a spermicidal gel and apply at least a tablespoon inside the cap.
- Grab the diaphragm between your fingers and thumb.
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Spread the spermicide over the rim and into the cap with your fingers.
Should another intercourse occur, additional spermicide should be applied. Do this without removing the diaphragm. You can follow the instructions you find in the spermicide package. Most spermicidal products come in a tube with an applicator. You can simply insert the applicator as deep as you can to make sure you reach the cervix, then squeeze the tube. Insert a tablespoon of spermicidal gel into the vagina, if applicable
Step 4. Insert the diaphragm up to 6 hours before intercourse
You can insert the diaphragm while lying down, curled up, with the leg up or standing. Hold the diaphragm so that the inside of the shell faces the vagina. Imagine putting a hat on your cervix. The gel inside should cover the cervix.
If you are unfamiliar with the cervix, think of your vagina as an entrance. The vaginal walls widen easily, but the cervix is at the end of the entrance, firm and round. When you reach the end of the vaginal walls, you can feel the cervix as if touching the tip of the nose. Some women say the cervix resembles the labia when fertile
Step 5. Gently push the diaphragm along the vagina until it reaches the cervix
Imagine that the diaphragm is a hat and the cervix is the head. You should be able to cover the cervix with the diaphragm. Feel the cervix against the diaphragm and try to understand if you have completely covered it or not. Feel the diaphragm and make sure it sits comfortably.
If it feels slack, you may have misplaced it. We will talk more about how to place it in the next section
Step 6. Wash your hands after placing the diaphragm
Do not remove it immediately after having sex. This will increase the chances of pregnancy. Wait at least 6 hours after intercourse before removing the diaphragm.
However, just like a tampon, don't leave it in your body for more than 24 hours. It is not hygienic and can lead to complications. The advantages, disadvantages and any problems will be discussed in the last section
Part 2 of 4: Taking Care of the Diaphragm and Removing It
Step 1. Always remove the diaphragm 6-8 hours after intercourse
If the diaphragm is left in the body for a longer period, you are at risk for infections. Here's how to remove it:
- Insert your index finger into the diaphragm, towards the tip and slightly to the side.
- Rotate your palm down and back, hooking your index finger firmly on the tip, inside the top edge of the diaphragm, breaking the contact.
- Pull the diaphragm with your fingernails.
- Wash your genitals completely after removing it.
Step 2. After removal, wash the diaphragm with warm water and a mild soap
Do not use strong, fragrant soaps, as they may weaken the gum. After washing it, dry it using a dry cloth or towel. Since you are likely to reuse the diaphragm, try to clean it as best you can.
If you prefer, you can sprinkle it with cornstarch. Then put it back in its case
Step 3. Replace the device after 2 years or as advised by your doctor
Do not place it in direct sunlight, as it is made of rubber and the heat could damage its integrity. If you don't take care of it, you will need to replace it before this time.
If you notice damage on the diaphragm, do not use it. If you have any doubts, don't use it. Talk to your doctor or bring it if you have any questions
Part 3 of 4: Choosing the Right Aperture
Step 1. Choose the right type of aperture for you
Here are the options:
- Arched spring diaphragm. This is the most common and easiest type to insert. In this type, there are two tabs that form an arc for easier insertion.
- Spiral spring diaphragm. This type has a soft and flexible edge, but does not form an arc when folded. Women with weaker muscle tone in the vagina may have advantages with this type. This type of diaphragm has a tool for insertion.
- Flat spring diaphragm. This type is similar to the spiral one, only it has a thinner and more delicate edge. Here, too, you will find an insertion tool. A flat spring diaphragm is suitable for women who have strong muscle tone of the vagina.
Step 2. Choose between silicone and latex diaphragms
Silicone is a good alternative for latex allergic women. However, the silicone diaphragm is less common and may be difficult to find around. If you are interested, search for it online.
- Some women are allergic to latex products, so using a diaphragm made from this material could trigger an allergic reaction. In some cases, latex allergy can lead to anaphylactic shock. Rashes, redness, restlessness are common and initial symptoms of an allergy. This can be treated with medicines such as antihistamines.
- In severe cases, breathing difficulties and loss of consciousness may occur in women with anaphylactic shock, this is a high-risk emergency. If this happens, seek medical help ASAP.
Step 3. Get a diaphragm that you position using rings or having your doctor place it
There is a high incidence of diaphragms moving during sexual intercourse due to poor positioning. You have two options for knowing the right placement for you: using placement rings (which don't have a cap) which can be ordered from the manufacturer or by going to the doctor.
- While you can find out the size of your diaphragm using the positioning rings, going to the doctor may be a wise choice. A gynecological check-up is necessary for the correct positioning of the diaphragm, because it exists in different shapes and sizes. If it is not positioned correctly, the risk of unwanted pregnancy increases. The whole procedure can take about 10-20 minutes. It should cause only mild discomfort.
- Once you get the right size, your doctor will teach you how to insert the diaphragm yourself. Further demonstrations are needed to ensure proper use of the diaphragm.
- Relocation is especially necessary after weight loss, pregnancy and miscarriage.
Step 4. Make sure you are using a diaphragm that is safe for you
It is important to consult a doctor to assess whether you are a suitable candidate for the use of intrauterine devices. There are some contraindications for intrauterine devices, so it is important to inform your doctor about your health conditions, such as allergies, uterine problems, etc.
If you are not a good candidate for this type of contraception device, alternatives will be offered to you
Part 4 of 4: Exploring the Pros and Cons of the Diaphragm
Step 1. Learn about the advantages and disadvantages of using the diaphragm
Here are the pros and cons of using this type of contraceptive:
- Compared to the use of hormonal contraceptives, intrauterine devices such as the diaphragm do not produce side effects and risks associated with hormones. They also don't interfere with sexual intercourse. The diaphragm can be inserted several hours before intercourse, unlike oral contraceptives which must be taken regularly and every day.
- That said, using the diaphragm can be very uncomfortable especially during insertion, as some women are not comfortable with touching. There are also cases where the diaphragm dislocates during intercourse, leading to an unwanted pregnancy. It also does not protect against sexually transmitted diseases.
Step 2. Know that you are at increased risk of urinary tract infections using the diaphragm
Women who use intrauterine devices are at risk for urinary tract infections. Urethritis (inflammation of the urethra) and chronic cystitis (bladder infection) caused by pressing the edge of the diaphragm against the urethra can increase using the diaphragm.
- For urinary tract infections to occur, bacteria must enter the bladder or through the urethra. Inserting intrauterine devices is one way to increase the chances of them entering the urethra. Bacteria invade the bladder mucosa and other urinary tract infections. Since they are attached to the urinary tract epithelium, they cannot be eliminated by urination.
- Fortunately, these infections respond well to drug treatments. However, it is possible that there is chronicity.
Step 3. Know that you are also at a higher risk of getting toxic shock syndrome
Women who use the diaphragm are at risk of bacterial infections because the insertion and removal of the diaphragm are invasive procedures. Although not commonly reported, toxic shock syndrome occurs in women who use the diaphragm as a contraceptive.
- Toxic shock syndrome is a condition where bacteria in the body produce toxins and experience shock symptoms such as hypotension and dizziness.
- Fortunately, this complication is preventable by maintaining good hand hygiene before inserting and removing the diaphragm. Also, do not forget to remove the diaphragm after more than 8 hours after intercourse, the longer you leave it, the more likely complications such as toxic shock syndrome will occur.
