Diaphragm

The diaphragm prevents pregnancy by holding a contraceptive agent against the cervix, keeping sperm from entering the uterus.  This method can be 98% effective, if used correctly.

The diaphragm, with the added spermicidal agent (either jelly or cream) is inserted into the vagina and, when correctly positioned, covers the cervix  (the external opening of the uterus).  These contraceptive agents kill sperm, and they MUST be used with the diaphragm.  The diaphragm, when used alone, is not a total barrier to sperm.  These spermicides are bought at the pharmacy and no prescription is needed.  Initially, try to buy an “applicator package” of cream or jelly.  With the applicator package, you will get a plastic applicator that you can used to insert more cream or jelly into your vagina, as needed, for repeated intercourse in less than six hours.

Some products that are available are:  Ortho-Gynol jelly, Gynol II, Ortho cream, Delfen cream, Koromex cream jelly and Ramses cream or jelly.  Jelly will give you more lubrication.  Contraceptive foams or suppositories SHOULD NOT be used with the diaphragm.

The diaphragm is fitted for you by a professional because different women need different types and sizes.

You will be given intructions for insertion at the time of your appointment by the physician.  He or She will allow you time to practice inserting and removing your diaphragm properly.

INSTRUCTIONS:

1.  Wash your hands with soap and water.

2.  Hold the diaphragm in front of a light to make sure that there are no holes or tears in the rubber before inserting it.  Do Not Stretch your Diaphragm.  Be careful not to puncture it with your fingernails.

3.  Fill the cup of your diaphragm one quarter (1/4) full of cream or jelly (spermicide).  Spread a small amount of the spermicide around the rinm of the diaphragm with your finger.

4.  Hold the diaphragm dome down (spermicide in the dome) with one hand and press the opposite sides of the rim together to fold the diaphragm.

5.  Spread the lips of the vagina with your free hand and insert the folded diaphragm into the vagina.  This can be done by squatting, lying down, or with one foot propped on a stool.  Point the diaphragm down and back.

6.  Gently push the diaphragm into the vagina as far as it will go.

7.  Proper placement is assured by inserting your finger far into the vagina to feel that your cervix is covered by the diaphragm.  The cervix is about the size of a quarter or fifty cent piece and is firm, like the end of your nose.  The near rim of the diaphragm should be behind the pubic bone.

IMPORTANT:  Make sure your diaphragm is covering the cervix and that it is firmly behind the pubic bone.

A.  Use the diaphragm every time you have intercourse, even when menstruating.   Use it even when you think you may be “safe”.  One of the most common causes of pregnancy for diaphragm users is trying to combine the diaphragm method with a casual rhythm method.

B.  The diaphragm should be inserted as close to the time of actual intercourse as possible.  Do not insert the diaphragm more than 3 hours prior to intercouse and some couples actually accomplish diaphragm insertion as part of the foreplay.  If the diaphragm has been in place for more than 3 hours before intercourse, you must put an applicator of jelly or cream into your vagina or into the diaphragm PRIOR to having intercourse.

C.  The diaphragm MUST be left in place for at least 6 hours after the last time you have intercourse.

D.  Each time you have intercourse, at any time before the six hours are up, insert an additional applicator full of cream or jelly into your vagina without displacing the diaphragm.

E.  Try to remove your diaphragm as close as possible to the 6 hours after the last time you have intercourse.  There is a slightly increased risk of infection when diaphragms are worn more than 24 hours continually, particularly during your menstrual cycle.

F.  Diaphragms should be used during a menstrual period.  Wash your hands before and after insertion and removal.  Remove the diaphragm 6 hours after the last time you have intercourse for hygienic reasons, as well as to discourage bacterial growth.

G.  In the superior position during intercourse (when you are on top of your partner), the penis may inadvertantly be placed between your diaphragm and your cervix thereby allowing NO PROTECTION.  Check with your finger to be certain the diaphragm is in the correct position, and if necessary, you may need to guide the penis at the time of insertion.

H. Please contact your physician if you have questions or concerns about your diaphragm.

We welcome new patients and most insurances are accepted. If you have further questions about your insurance coverage,  please contact your insurance company by calling the telephone number listed on your insurance card.