DIAPHRAGM

A diaphragm is a shallow, dome-shaped cup made of latex or silicone. It looks like Meg from Family Guy’s hat, except it’s off-white and only a few inches in diameter. You insert the diaphragm into your vagina, and it covers your cervix to keep sperm out of your uterus. One super important thing to remember: For a diaphragm to work effectively, you need to use it with spermicide.

EFFECTIVENESS
The diaphragm’s fairly effective, though it’s better with spermicide. It’s 94% effective if you use it perfectly or 88% effective the way most people use it.
SIDE-EFFECTS
There are no problems for most people, but irritation or urinary tract infections are possible.
COST
Free with insurance. $50-250 out-of-pocket.
WHERE TO GET THEM
See a health care provider for the initial fitting to determine the right size.
ADDITIONAL BENEFITS
Hormone free. Can be used while breastfeeding.
OTHER NOTES
You have to use it every time you have sex, no matter what. The required spermicide can make you more susceptible to STIs.

Comfortable with your body.

If you’re not okay with putting fingers inside yourself, a diaphragm probably isn’t for you. To be sure you know how to use your diaphragm, you can practice putting it in and taking it out while in your health care provider’s office. Your health care provider will check to make sure the diaphragm fits right.

It takes discipline.

You have to remember to insert your diaphragm each and every time you have sex, so it takes a bit of self-discipline and planning. But at least you can carry it with you in your purse, if you want to be prepared anytime.

Allergy issues.

If you’re allergic to silicone or spermicide, you shouldn’t use a diaphragm.

Not while you’re bleeding.

Don’t use a diaphragm while you’re having your period.

The pregnancy question.

You’ll be able to get pregnant as soon as you stop using the diaphragm. So protect yourself with another method if you don’t use it.

How to Use it

A diaphragm can be inserted just before sex, but it can also go in hours before that so it doesn’t get in the way of the moment. But no matter when it goes in, you have to be sure to leave it in for at least six hours after you have sex. If you’re going to have sex again that day, just leave the diaphragm in place and insert more spermicide way up in your vagina. But don’t leave your diaphragm in for more than 24 hours, either.

Before you put it in

Add about a teaspoon of spermicide to the inner part of the diaphragm and spread a little of it around the rim as well—but not too much, or it’ll be too slippery to hang on to! The spermicide Ortho Gynol II is specifically designed for diaphragms, and it comes with an applicator you can use if you’re going to have sex more than once within six hours, as you’ll need additional spermicide. Any kind of contraceptive gel or spermicide will do, however, except for film or insert/suppository types. Don’t forget to check the expiration date of the spermicide!

How to put it in

  1. Wash your hands. Soap and water, no shortcuts.
  2. Check your diaphragm for holes and weak spots. Filling it with water is a good way to check. If it leaks, you have a hole, which sort of defeats the whole purpose.
  3. Put a tablespoon or so of spermicide in the cup and spread some around the rim, too.
  4. Get comfy, like you’re going to put in a tampon.
  5. Separate the outer lips of your vagina with one hand, and use the other hand to pinch the rim of the diaphragm and fold it in half.
  6. Put your index finger in the middle of the fold to get a good, firm grip.  You’ll be touching the spermicide, but that’s fine.
  7. Push the diaphragm as far up and back into your vagina as you can, and make sure to cover your cervix, which feels like the tip of your nose.

Having another go at it?

You need to leave the diaphragm in for six hours after sex. If you have sex a second time within those six hours, first insert more spermicide. Ortho Gynol II comes with an applicator that measures how much you’ll need, and it gets it where it needs to go. Then the six-hour clock starts again, counting from the last time you had sex.

How to take it out

Of course, what goes in must come out. Here’s how:

  1. Wash your hands again.
  2. Put your index finger inside your vagina and hook it over the top of the diaphragm’s rim.
  3. Pull the diaphragm down and out.

Care + keeping

If you take good care of your diaphragm, it can last for several years.

  1. After you take it out, wash it with mild soap and warm water.
  2. Let it air dry.
  3. Don’t use powders or oil-based lubricants like Vaseline, petroleum jelly, baby oil or cold cream on your diaphragm.

Inserting a diaphragm may sound difficult, but with a bit of practice, it’s not so tough.

Still having trouble?

Ask your health provider about getting an inserter, or consider switching to another method.

Cost

Thanks to the Affordable Care Act, if you have health insurance, chances are good you’ll be able to get this birth control method with no out-of-pocket cost. Tricare, the military insurance, covers this method at Tricare-authorized providers. Medicaid also covers it.

With proper care, and if you don’t gain or lose more than 10–15 pounds, you can keep your diaphragm for up to 10 years, making it the best birth control value for your buck at the equivalent of 42 cents to $2.08 a month plus the cost of spermicide.

Where to get it

See a health care provider for the initial fitting to determine the right size.

You may still need condoms

A diaphragm provides no protection against STIs, and the required spermicide can actually make you more susceptible to them.

There are positive and negative things to say about each and every birth control method. And everyone’s different—so what you experience may not be the same as what your friends experience.

The Positive

  • You can put a diaphragm in hours in advance
  • You can have sex as many times as you like while it’s in
  • Neither you nor your partner should be able to feel it
  • It doesn’t affect your hormones
  • It decreases the risk of pelvic inflammatory disease and tubal infertility
  • It can be used while breastfeeding

The Negative

  • Some teens have a hard time inserting it
  • Can cause vaginal irritation
  • Some women get frequent urinary tract infections
  • You have to use it every time you have sex, no matter what
  • The required spermicide can make you more susceptible to STIs
  • If you’re allergic to spermicide or silicone, you shouldn’t use a diaphragm
  • It can get pushed out of place during some kinds of vaginal sex
  • You need a prescription
  • It’s hard to remember to use if you’re under the influence of drugs or alcohol

Don’t take our word for it. Check out the videos below to hear women and men talk about their experiences with the diaphragm.

 

Veronica, 24, diaphragm

 

Rachel, 25, diaphragm

 

Nicole, 21, diaphragm

 

Justin, 27, diaphragm

Expert dirt: “An under-the-radar method that’s pretty good for women who are great planners and comfortable with their own bodies.”