Diaphragm

You can buy diaphragms from pharmacies and some online stores.

The diaphragm may not be suitable if you:

• Have an unusually shaped or positioned cervix (entrance to the womb), or if you cannot reach your cervix
• Have weakened vaginal muscles (possibly as a result of giving birth) that cannot hold a diaphragm in place
• Have a sensitivity or an allergy to the chemicals in spermicide
• Have ever had toxic shock syndrome (a rare, but life-threatening bacterial infection)
• Have repeated urinary tract infections (an infection of the urinary system, such as the urethra, bladder or kidneys)
• Currently have a vaginal infection (wait until your infection clears before using a diaphragm)
• Are not comfortable touching your vagina
• Have a high risk of getting an STI – for example, if you have multiple sexual partners.

It can take time to learn how to use them.

Before use, check your diaphragm regularly for tears or holes by holding it up to the light and having a good look at it. Be careful with your fingernails and jewellery. If your diaphragm goes out of shape, squeeze it gently back into its circular shape.

Your diaphragm may become discoloured. Don’t worry, this will not make it less effective.

• You can insert a diaphragm up to two hours before you have sex – after this time, you will need to take it out and put some more spermicide on it, or use an applicator to apply more spermicide
• With clean hands, put a small amount of spermicide on each side of the diaphragm (also putting a little spermicide on the rim may make the diaphragm easier to put in)
• Put your index finger on top of the diaphragm and squeeze it between your thumb and other fingers
• Slide the diaphragm into your vagina, upwards. This should ensure that the diaphragm covers your cervix
• Always check that your cervix is covered – it feels like a lump, a bit like the end of your nose
• If your cervix is not covered, take the diaphragm out by hooking your finger under the rim or loop (if there is one) and pulling downwards, then try again
• You must leave it in for at least six hours after the last time you had sex. You can leave it in longer but do not exceed 24 hours.

After use, you can wash your diaphragm with warm water and mild, unperfumed soap. Rinse it thoroughly, then leave to dry. You will be given a small container for it, which you should keep in a cool, dry place.

Never boil your diaphragm, never use disinfectant or detergent to clean it or use talcum powder with it.

You can get spermicide from a pharmacy or your local sexual health clinic.

The diaphragm can become less effective at preventing pregnancy if:

• It is damaged – for example, it is torn or has holes
• It is not the right size for you and doesn’t cover your cervix
• You use it without spermicide, or have sex three hours or more after you apply spermicide
• You do not use extra spermicide with your diaphragm every time you have more sex
• You remove it too soon (less than six hours after the last time you had sex)
• You use oil-based products, such as baby lotion, bath oils, moisturiser or some vaginal medicines (for example, pessaries).

If any of these things happen, or you have had sex without contraception, you may need emergency contraception.

If you think you may have been exposed to HIV, you can take preventative medication (PEP) to reduce the chance of becoming infected.

• A doctor or nurse will explain how to put in and take out the diaphragm and use spermicide
• They will ensure you can insert and remove your diaphragm independently before you leave the clinic
• You will only need to see a doctor or nurse to replace it or if you have any questions or concerns.