The diaphragm is a soft latex rubber cup that should be used with spermicidal jelly or cream. A woman inserts a diaphragm into her vagina, fitting it over the cervix, shortly before sexual intercourse and leaves it in place for at least 6 hours after intercourse.
How does a diaphragm work? (Mechanism of action)
The diaphragm blocks sperm from entering the uterine cavity
Spermicides provide additional protection by damaging the sperm
Who can use a diaphragm?
Women of any reproductive age and parity who:
Want to use this method of contraception
Have no contraindications
Who should not use a diaphragm?
(For more information see WHO eligibility criteria) Women who have the following conditions (contraindications):
Are less than 6 weeks postpartum
Allergy to latex
History of toxic shock syndrome
Certain anatomical abnormalities of the cervix and vagina
Advantages
Woman-controlled method
Possible to use without a male partner's knowledge
Offers contraception only when needed
Effective if used correctly with every act of sexual intercourse
Has no systemic side effects
No impact on lactation
Can be stopped any time
Can be inserted up to 6 hours before sex to avoid interrupting sex
Provides some protection from STIs
Reduces risk of cervical neoplasia
Contains menstrual flow when used during menses
Disadvantages
Requires fitting by a family planning provider, involving a pelvic examination
A woman may need a different size diaphragm after childbirth
Requires having the method on hand and taking correct action before each act of sexual intercourse
Less effective contraception than IUDs or systemic methods
Interrupts sex if not inserted beforehand
May be messy to use
Possible side effects (usually local irritation) or allergic reaction to latex (rare)
Should be washed with soap and clean water after each use
Needs careful storage to avoid developing holes
Requires a steady supply of spermicide
Possible side effects
Can cause local irritation, itching, vaginal wall lesions if ill-fitting
