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Am Fam Physician. 2005;71(2):248-250

to the editor: I found Dr. Allen’s article, “Diaphragm Fitting,”1 in the January 1, 2004, issue of American Family Physician helpful and informative. However, I would have appreciated specific details on how to contact the manufacturers for fitting diaphragms, as I have been unable to do so.

in reply: I sympathize with Dr. Pagnotta’s attempt to obtain diaphragm fitting rings. The marketing of diaphragms certainly is not the major emphasis of the pharmaceutical companies that produce them. My own fitting set is very old and was passed down from a retired gynecologist. But I do have several recommendations.

Most physicians who fit diaphragms will invest in a variety of sizes to keep in the office. The actual diaphragm may be easier to use than a fitting ring and can be demonstrated to patients who are interested. Diaphragms can be sterilized between patients according to instructions in the package insert. It is recommended that physicians have diaphragms in a size range of 60 to 90 mm (a total of seven diaphragms); these sizes will fit most women. The fitting diaphragm can then be sold to the patient and the clinic stock replenished, or the patient can be sent to the pharmacy to order the correct size.

Milex manufactures the Wide-Seal silicone diaphragm and offers a “free fitting set with order of 12 diaphragms” on their Web site ( The Milex sales representative who visits my office with a supply of pessaries also has been helpful with diaphragm information.

Latex diaphragms are available from several online pharmacies, including Westons Internet Home Health and Medical Equipment (, or your local pharmacy can order a variety of diaphragms for use in fitting. Ortho-McNeil makes latex diaphragms, and I recommend contacting one of their sales representatives. Ortho-McNeil did not respond to my e-mails or telephone calls when I asked about complimentary fitting rings or diaphragm sets. The contact number for Ortho-McNeil is 800-682-6532, and they can be found on the Web at

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This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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