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Is the Diaphragm a Good Birth Control Option?
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The diaphragm is a type of birth control. It is a piece of material that is dome-shaped. The diaphragm gets inserted into the vagina and covers the cervix to reduce the risk of pregnancy. They are usually made from latex or silicone
Types of Diaphragms
There are actually four different types of diaphragms available depending on the needs of the individual. The most common is the arching spring diaphragm. It uses a firm rim and works best for people who have weak vaginal muscle tone. It is usually the easiest type to insert.
The coil spring diaphragm has a soft flexible rim. It’s typically recommended for those who have average vaginal muscle tone. The flat spring diaphragm is very similar except that it has a thin rim and works best for people with strong vaginal muscle tone.
There is also a wide seal diaphragm that is a silicon option. This would be the best option for those who are sensitive or allergic to latex.
You can meet with your primary care physician to determine which diaphragm is best for you. They will have to conduct a physical exam to measure you and determine the correct size. A diaphragm that is too small will not stay in place and fail to be effective while one that is too large will be uncomfortable to use.
How to Use a Diaphragm
The diaphragm is used each time that you have sex. It is inserted prior and removed after, cleaned and stored. It should not be used during your menstruation. It also should NOT be left in for more than 24 hours as this can lead to irritation, infection, or toxic shock syndrome.
Start off by washing your hands with soap and water. Apply the spermicide to the inside of the dome and around the rim. When the diaphragm is inserted, your legs need to open wide. It’s best to squat, lie down, or stand with one leg propped up. Once in position, you use one hand to fold the diaphragm in half with the dome pointing down. Use your other hand to hold the entrance to your vagina open. Put in the diaphragm aiming for your tailbone and push as far back into your vagina as you can. Then use one finger to push the front rim of the cup up behind your pubic bone. It helps if you think about aiming for your belly button.
Once inserted, it’s important to check the placement. Feel inside for your cervix through the dome of the diaphragm. Your cervix should feel firm but not bony, a bit like the tip of your nose. If you can’t feel your cervix, or if it is not covered, then the diaphragm is out of place. You will have to remove it and try again.
Once you’re ready to remove it, hook your finger on the front rim and gently pull it down and out. Be careful with your nails or you can accidentally tear a hole in it.
Caring for Your Diaphragm
When properly cared for, a diaphragm will last 1 to 2 years. It should be washed with water and mild soap after every use. Rinse it off and allow it to air dry. Once dry, place it in a container that is cool and dry.
The diaphragm should be checked for leaks, tears, or holes on a regular basis to ensure effectiveness. You can check it by filling the dome with water and inspecting for any damage. If any is found, do not use the diaphragm but see your doctor for a new one.
To protect the diaphragm, don’t wash it with any powders or explore it to any oil-based lubricants.
Is a Diaphragm Effective Birth Control?
When used correctly, the diaphragm is between 92-96% effective. This means that approximately 4-8 people out of every 100 who use it will get pregnant. This is when it’s used perfectly.
As with other methods of birth control, the effectiveness can decrease with user error. If the diaphragm isn’t covering the cervix correctly, it decreases the effectiveness. No one is perfect and it can be tough to get it perfectly in place every single time. Due to these difficulties, people often see the effectiveness more at around 88%. This means that 12 of every 100 people will get pregnant each year using this method.
It’s also important to note that if you gain or lose more an 8 lbs, have a vaginal surgery, or have given birth since getting your diaphragm, you should be examined to ensure that it is still the correct size for you.
You can increase the effectiveness of this type of birth control by also using it with a spermicide. The diaphragm effectively keeps the spermicide in place, near your cervix, to ensure that no sperm get past to fertilize the egg.
Benefits of Diaphragms
Some of the benefits of using this form of birth control include that they
- Are easy to use
- Can be inserted hours before having sex
- No prescription required
- No effect on hormones
- Comfortable to the point of not really being noticed by either partner
- A one-time purchase, good for up to 2 years
- Convenient and gives you total control
Are There Any Disadvantages?
As with all forms of birth control, there may some reasons you might want to take into account before choosing this type. Diaphragms can
- Be hard to use effectively
- Some people are uncomfortable touching their vulva to insert the diaphragm
- Some people have trouble reaching far enough to insert it correctly into place
- It can be pushed out of place by heavy thrusting, certain sex positions, or penis sizes. This may cause an adjustment to take place before or during sex.
- Suggested use of spermicide may cause irritation or urinary tract infections (UTIs)
- Weight loss or gain will require you to be re-examined and potentially change the size of the diaphragm
- Not widely available in Canada
Is it Safe?
Diaphragms are considered safe for most people. However, you should consider another birth control option if you
- Are sensitive to spermicides
- Have difficulty inserting inside yourself
- Have cuts in your vaginal or cervical tissue
- Experience frequent reproductive tract infections
- Have uterine cancer
- Have had recent surgery on your cervix
- Have recently given birth or had an abortion
- Have a history of toxic shock syndrome
If you are already using a diaphragm, you should consult your primary care physician if
- You experience burning when you pee
- The diaphragm is feeling uncomfortable
- Your vulva or vagina is red, sore, or itchy
- You have discharge that’s different from your normal discharge
- You have spotting or bleeding that’s different from your normal period
Any of the above can indicate that an infection or something else is wrong. It’s important not to stress because many of these problems are easy to treat but don’t avoid following up with your doctor about it.
You should also be watching out for any signs of toxic shock syndrome. It’s very rare but you should remove your diaphragm and talk to your doctor right away if you experience
- A sudden high fever
- Vomiting or diarrhea
- A rash that feels and looks like a sunburn
- Aching muscles and joints or sore throat
- Weakness, faintness, or dizziness
Does a Diaphragm Protect Against STIs
Sadly NO! This form of birth control will do absolutely nothing to prevent sexually transmitted infections. If you are concerned about STIs you should use recommended safer sex techniques to protect you and your partner against the risks. Birth control options are primarily focused on pregnancy prevention, not stopping the spread of infections and disease.
Choosing the Option that Works for You
Choosing the right birth control option can take some work. Not every option will work for you even if it sounds good to begin with. Don’t be afraid to work closely with your primary care provider to assess your needs and unique situation to determine which solution will be best for you.
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