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Am Fam Physician. 2004;69(1):103

What is a diaphragm?

A diaphragm (say: die-ah-fram) is a shallow cup made of latex or silicone (see picture 1.) It is used for birth control.

Your doctor will measure your vagina to find the right size for your diaphragm. You will learn how to put the diaphragm in before you have sex and how to take it out after you have sex.

How does the diaphragm work?

The diaphragm covers your cervix. This is the opening to your uterus (also called the womb). The diaphragm keeps sperm from going into your uterus and fertilizing an egg.

Before you insert the diaphragm, you put spermicidal gel (or cream) in the cup (dome) and around the rim of the diaphragm (see picture 2). Because this gel kills sperm, it helps keep you from getting pregnant.

Is the diaphragm a good birth control method?

When a diaphragm fits right and is used correctly, it is at least as good as a male condom. If you do not use any birth control at all, there is an 85 percent chance that you will get pregnant within one year. If you use a diaphragm, this risk goes down to 6 percent.

Birth control pills, injections, and patches lower the risk of pregnancy to less than 1 percent. However, these birth control methods have more side effects than the diaphragm.

What are the benefits of using a diaphragm?

Unlike birth control pills, injections, and patches, the diaphragm does not affect your body systems. It also costs less. The diaphragm can be used if you are breastfeeding, have medical problems, or smoke.

Unlike use of male condoms, use of the diaphragm is completely up to the woman. The diaphragm can be put in right before you have sex or up to six hours before you have sex.

Using a diaphragm may keep you from getting a sexually transmitted disease, such as gonorrhea, a chlamydial infection, or HIV infection.

Are there drawbacks to the diaphragm?

Some women cannot use a diaphragm, because it will not fit well in their vagina.

Your vagina will have to be measured again if you have a baby, if you gain or lose more than 15 pounds, or if you have pelvic surgery. You may need a different diaphragm size.

Women who use a diaphragm tend to get more bladder infections.

It is very important to take your diaphragm out six to 12 hours after you have sex. You could get a serious infection, such as toxic shock syndrome, if you leave the diaphragm in your vagina for more than 24 hours.

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