A diaphragm is a safe barrier method of birth control. It works by stopping sperm from entering your uterus. Learn more about how to determine if this contraceptive is right for you.
A diaphragm is a small, dome-shaped cup you insert into your vagina. It’s a physical barrier that prevents sperm from reaching the egg.
Diaphragms are meant to be used with spermicide for added protection against pregnancy. Planned Parenthood reports that when always used perfectly, diaphragms can be up to 94% effective. In real-life use, their effectiveness is about 83%.
If you’re interested in trying a diaphragm for birth control, you’ll need to talk with a gynecologist, as they’re available via prescription. Many insurance companies cover all or some of the cost.
A diaphragm is most effective when it’s used with spermicide. Before insertion, try placing a teaspoon of spermicide into the dome and spreading it around the rim.
It’s important to avoid petroleum jelly or other oil-based creams in your diaphragm. These products may create small holes in the silicone.
How to put it in
Finding the best position to insert your diaphragm can take practice and patience. Inserting it is similar to inserting a tampon or menstrual cup. You can try lying down, squatting, or standing with one leg propped up. Whatever position you choose, the idea is that your legs should be wide open and your knees bent.
To use the diaphragm, follow these steps:
- Wash your hands thoroughly.
- Apply your spermicide to the diaphragm.
- Fold the diaphragm in half and hold it in one hand with the dome pointing down. Use your other hand to hold your vagina open.
- Place the diaphragm into your vagina, aiming for your tailbone as you insert.
- Once it’s inside, use your fingers to push the diaphragm as far into the vagina as you can.
- Use your finger to wrap the front rim up behind your pubic bone. It’s helpful to aim for your belly button.
After you place the diaphragm, you can check to see if it’s in correctly. Try inserting your finger into your vagina again to see if you can feel any part of your cervix. This part of your body is firm, like the tip of your nose. You should be able to feel your cervix only through the diaphragm. If any of your cervix is not covered by the device, remove the diaphragm and try reinserting.
Once it’s in place, you shouldn’t be able to feel the diaphragm. A properly placed diaphragm will stay in your body even if you cough, squat, sit, walk, or run.
If you’re having trouble inserting it, you can ask a doctor about getting an inserter or switching to another method altogether.
You should leave your diaphragm in for at least 6 hours after having sex. If you plan to have sex again that same day, leave it in and apply more spermicide into your vagina beforehand.
The United Kingdom’s National Health Service (NHS) advises that you should not leave the device in for longer than 30 hours. Doing so may lead to a serious bacterial infection called toxic shock syndrome.
How to take it out
Wait at least 6 hours after having sex to remove your diaphragm. Then, follow these steps:
- Wash your hands thoroughly.
- Find a comfortable position — lying down, squatting, or standing with one leg propped.
- Place your index finger into your vagina. Hook it over the rim of the diaphragm.
- Gently pull the diaphragm down and out of your vagina. Be especially careful not to tear any holes in the device with your fingernails.
Diaphragm aftercare
After you take your diaphragm out, take care to prevent bacteria from settling into the diaphragm. This will preserve the product’s longevity.
You should:
- Rinse it off and let it air dry.
- Inspect it for any holes or other damage. Try filling the dome with water to see if any water leaks through the silicone.
- Let it dry again before storing your diaphragm in a cool, dry container.
You should not use a damaged diaphragm. Any holes will allow sperm to enter the cervix and into the uterus.
With proper care, a diaphragm should last up to 1 year before it needs to be replaced.
With typical to consistently perfect use, a diaphragm is 83% to 94% percent effective, respectively, at preventing pregnancy. Still, one option doesn’t always meet the needs of all couples. Here are some pros and cons to consider.
Advantages
There are a number of advantages to using a diaphragm over other birth control options, including:
- Cost: It’s typically free or low cost and is often covered under the Affordable Care Act.
- Convenience: You can insert your diaphragm hours before having sex and have sex multiple times before it needs to be taken out. When placed correctly, neither you nor your partner should be able to feel the device.
- Nonhormonal: Diaphragms do not contain hormones, so they do not alter your own hormone levels or menstrual cycle. This also makes a diaphragm a safe option if you’re breastfeeding or chestfeeding, or would soon like to get pregnant. You can discontinue use and try to get pregnant right away.
- Lower risk of certain complications: Diaphragms also decrease your risk of developing pelvic inflammatory disease and tubal infertility.
Disadvantages
There are some drawbacks and other factors to consider about diaphragms, including:
- Allergic reactions: If you’re allergic to silicone or spermicide, this method will need to be avoided.
- Planning: Using a diaphragm also involves planning ahead for a prescription and placing the device before having sex. They aren’t necessarily a good option for spontaneous sex.
- Difficult to insert: Some people may find it difficult to insert the device into the vagina or that it causes uncomfortable irritation.
- Infection: Some people report frequent urinary tract infections (UTIs) while using diaphragms. They also do not protect against sexually transmitted infections (STIs). You and your partner will need to use a condom or other barrier method to prevent STIs.
- May move out of place: Diaphragms may get pushed out of place during sex.
If you have health insurance, it’s likely your plan fully covers the cost of a diaphragm. Diaphragms are free for people on Medicaid.
Without insurance, a diaphragm can cost up to $250, but it may cost more.
Diaphragms come in a variety of sizes. Some doctors’ offices may also charge an additional fitting fee. It’s a good idea to call your doctor’s office or insurance provider if you have coverage ahead of time to discuss costs and available options.
If you’re concerned about cost, many family planning clinics offer payment assistance programs. You can call ahead to get more information.
Consider making an appointment to chat with a doctor about a birth control option that will work best for you. Diaphragms are typically low cost, convenient, and often a long-lasting option if you’re looking for reliable options to prevent an unplanned pregnancy. Still, they may not be the right choice for every lifestyle.
Some questions you might consider asking our doctor include:
- Are there any reasons why I shouldn’t use a diaphragm or spermicide?
- How effective are diaphragms at preventing an unplanned pregnancy?
- How do I know if my diaphragm is placed correctly?
- What spermicides do you recommend using with diaphragms?
- What should I use to protect myself against STIs?
- What are my options if I end up getting irritation or UTIs from the device?
- What happens if I gain or lose weight?
- Does my insurance cover a diaphragm and associated costs?
Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.
A diaphragm is a safe method of birth control. It is a small, dome-shaped cup you insert into your vagina, which creates a physical barrier that prevents the sperm from reaching the egg.
Diaphragms are meant to be used with spermicide for added protection against pregnancy. When used perfectly consistently, diaphragms can be up to 94% effective.
If you have health insurance, your insurance provider will likely fully cover the cost of a diaphragm. Diaphragms are free for people on Medicaid.
The specific cost depends on various factors, including the selected size, where you purchase it, and whether you have health insurance.
