Diaphragm

WHAT IS IT?

The only diaphragm currently available in Nova Scotia is the Milex Wide-Seal Diaphragm: Omniflex Style®. It is a hypoallergenic, silicone diaphragm with a unique wide seal that increases suction for extra protection. The Milex Wide-Seal diaphragm has been around for more than 40 years. In the past, there was also a latex diaphragm, but it is no longer being produced in Canada.

HOW DOES IT WORK?

The diaphragm is a barrier method. It is a flexible, dome-shaped cup that covers the cervix and prevents sperm from entering the uterus so that the sperm cannot fertilize an egg. It comes in eight different sizes, so women are required to be fitted by a doctor to find the size that works best for them.

It is very important that the diaphragm is always used with a spermicidal jelly or cream. The spermicide should kill any sperm that may slip over the rim. Unfortunately, spermicidal jelly is no longer being made in Canada, so it is difficult to find it in stores. We highly recommend that you do not use spermicidal foam, as the Nonoxynol-9 concentration is very high and may cause irritation.

The diaphragm does NOT protect you from sexually transmitted infections (STIs). You can use the diaphragm and a latex condom together to reduce the risk of both pregnancy and STIs.

HOW EFFECTIVE IS IT?

If used perfectly, the diaphragm is 92 - 96% effective in preventing pregnancy. Based on average use, it is estimated to be 68 – 84% effective. This means that if 100 women used the diaphragm last year, we could expect that approximately 15-30 of them may become pregnant.

It is recommended that you use a back-up method of birth control the first 8-10 times you use the diaphragm or until you feel confident with it.

HOW DO YOU USE THE DIAPHRAGM?

If you choose to use a diaphragm as your method of birth control, you will need to see a doctor to get fitted for the size you need. The doctor will show you how to put it in and take it out.

Each time you use the diaphragm, you should put in spermicidal jelly or cream. If you have sex more than once, don’t take the diaphragm out, but put more jelly or cream in your vagina with an applicator. If you have the diaphragm in more than two hours before you have sex, put an extra application of the cream or jelly into your vagina before having sex.

Always check that the diaphragm is covering your cervix before having sex. Your cervix feels like a bump or the tip of your nose under the middle of the diaphragm.

Only use water-based lubricants like K-Y Jelly for lubrication. Don’t use oil-based lubricants such as Vaseline, hand lotions, or body oils.

The diaphragm must be left in the vagina for 6-8 hours after intercourse. It can be left in for up to 24 hours. To reduce the risk of getting toxic shock syndrome, be sure not to leave the diaphragm in longer than 24 hours.

Do not douche, take a bath, or swim with the diaphragm inside you. Showers are okay.

Wash the diaphragm with warm water after you remove it, then dry it well. Check it for holes by holding it up to the light and always store it in a dry place.

You need to see your doctor to check the fit of your diaphragm if:

  • The diaphragm dislodges more than once
  • You have lost or gained 10 lbs (5 kg) or more
  • You have a baby, a miscarriage, or an abortion

Your diaphragm should be replaced every 1-2 years.

WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF USING THE DIAPHRAGM?

ADVANTAGES:

  • it does not contain any hormones
  • it can be used by women who are breastfeeding
  • it offers women privacy and control because they can insert it before intercourse

DISADVANTAGES:

  • must be used with spermicidal cream or jelly, which is no longer being made in Canada
  • must be available at the time of intercourse
  • requires proper insertion technique
  • does not protect against sexually transmitted infections
  • cannot be used by people who are allergic to spermIcides
  • may become dislodged during intercourse