The diaphragm is a reusable dome-shaped cup that fits over the opening to the cervix and prevents pregnancy.
For effective birth control, your diaphragm (see pictures below) has to fit well. Your doctor will examine you to find the correct size.
To be sure that you know how to use your diaphragm, you will need to practice putting it in and taking it out while you are in your doctor's office. Your doctor will check to see that the diaphragm fits right.
To lower your risk of getting pregnant, you must use your diaphragm correctly and use it every time you have sex. You must also use the diaphragm with spermicide (a gel or cream that kills sperm trying to enter the cervix) in order to prevent pregnancy. You can put the diaphragm in your vagina up to two hours before you have sex. If you put it in more than two hours before having sex, you will need to put more spermicide into your vagina.
Before you put the diaphragm in your vagina, put about one tablespoon of spermicidal gel or cream in the cup (see picture below). Smear some of the gel around the rim of the diaphragm. Do not use petroleum jelly or oil-based vaginal creams (such as Monistat). These can make tiny holes in the diaphragm.
You can put your diaphragm in while you are lying down, squatting, or standing with one leg up on a chair. Your legs need to be fairly wide open. Bending your knees can help. Once you're in position, follow these steps:
With your finger, feel for your cervix through the dome of the diaphragm. The cervix will feel firm, but not bony. It feels a bit like the tip of your nose.
If the diaphragm does not cover your cervix or if you cannot feel your cervix at all, the dome is not in the right place. This means that you need to remove the diaphragm, put more spermicidal gel on it, and insert it again.
The diaphragm should not fall out when you cough, squat down, sit on the toilet, or walk around. If your diaphragm stays in place when you do these things, the front rim is most likely in the right place above the pubic bone (see picture below).
The following are some important points to remember after you have sex:
To remove the diaphragm, "hook" the front rim with your finger and pull down and out. Be careful not to tear a hole in the diaphragm with your fingernails. You should not wear your diaphragm during your menstrual period. You will need to use another method of contraception during this time.
After you take the diaphragm out of your vagina, wash it with mild soap and water, rinse it, and allow it to air dry. Always store your diaphragm in its container. Store the container in a cool, dry place, away from sunlight.
Check your diaphragm often for holes, tears, or leaks. To do this, fill the dome with water and look for tiny leaks.
Replace your diaphragm after one to two years. Every year, your doctor should check to see that your diaphragm still fits correctly. You will need to be measured again if you have a baby, have pelvic surgery, or gain or lose more than 15 pounds.
Call your doctor if you have any of the following problems:
You also should call your doctor if your diaphragm gets a hole in it or does not seem to fit right. If your diaphragm has any of these problems, it needs to be replaced. If you keep using it, you could increase your risk of getting pregnant.
Written by familydoctor.org editorial staff