A diaphragm is a shallow, dome-shaped cup made of a material called silicone. You insert the diaphragm into your vagina. It covers your cervix and keeps sperm out of your uterus. You need to use it with spermicide for it to work effectively.
- Effective immediately, can be put in hours before sex, and does not affect your hormones
- Effectiveness: the diaphragm is fairly effective – better with spermicide. With perfect use, 94 in every 100 women will prevent pregnancy. With typical use, or the way most people use it, the diaphragm prevents pregnancy in 88 out of 100 women who use it.
- Side effects: no problems for most, but irritation or urinary tract infections are possible
- Effort: high – you have to put it in place every time you have sex. But you can leave it in for up to 24 hours
- Doesn’t protect against sexually transmitted infections (STIs).
You are comfortable with your body. If you are not comfortable putting your fingers inside yourself, a diaphragm is not the best option for you. It is a little like putting in a tampon. If you can do that, you can probably manage a diaphragm.
It takes discipline. You have to remember to insert your diaphragm before you have sex. And you need to remember it every time you have sex. It takes a bit of self-discipline and planning. But you can carry it with you if you want.
Availability. There are two kinds of diaphragms commonly available.
Allergy issues. If you are allergic to silicone or spermicide, you should not use a diaphragm.
The pregnancy question. You will be able to get pregnant as soon as you stop using the diaphragm. If you do not want to be pregnant, use another contraceptive method as soon as you stop using the diaphragm.
How To Use
A diaphragm can be inserted just before sex. You can also insert it a few hours before. No matter when it goes in, you have to be sure to leave it in for at least 6 hours after you have sex. If you are going to have sex again that day, just leave the diaphragm in place and insert more spermicide way up in your vagina. Do not leave your diaphragm in for more than 24 hours.
Before you put it in. Add about 5 mL of spermicide to the inner part of the diaphragm. Spread a little of it around the rim, as well. (Not too much, or it will be too slippery to hang on to.) Some spermicide options are specifically designed for diaphragms and may come with an applicator you can use if you are going to have sex more than once within six hours (you will need to add additional spermicide). Any contraceptive gel or spermicide will do, except for the film or insert/suppository types. Do not forget to check the expiration date. If it is expired, then you need to buy new spermicide.
How to put it in. Inserting a diaphragm sounds more difficult than it is. Here are the steps:
- Wash your hands with soap and water. Let them air dry without touching anything.
- Check your diaphragm for holes and weak spots. Filling it with clean water is a good way to check – if it leaks, there is a hole. A hole in your diaphragm means that it is not working properly and you could get pregnant.
- Put about 5 mL or so of spermicide in the cup. Spread some around the rim too.
- Sitting or standing, spread your legs.
- Separate the outer lips of your vagina with one hand. Use the other hand to pinch the rim of the diaphragm and fold it in half.
- Put your index finger in the middle of the fold to get a good, firm grip. (You will be touching the spermicide.)
- Push the diaphragm as far up and back into your vagina as you can. Make sure to cover your cervix.
Having sex again? You need to leave the diaphragm in for 6 hours after sex. If you have sex a second time within those 6 hours, first insert more spermicide. The 6-hour clock starts again, counting from the last time you have sex.
How to take it out. Here is how:
- Wash your hands again. Use soap and water. Let your hands air dry, without touching anything.
- Put your index finger inside your vagina and hook it over the top of the rim of the diaphragm.
- Pull the diaphragm down and out.
Are you having trouble? Ask your doctor about getting an inserter, or consider switching to another method.
Finally, take good care of your diaphragm as it can last for several years.
- After you take it out, wash it with mild soap and warm water.
- Let it air dry.
- Do not use powders or oil-based lubricants (like Vaseline, lotion, or cold cream) on your diaphragm.
Tips and tricks
When you are inserting the diaphragm, make sure the vast portion of the spermicide stays inside the fold, where it will be most effective.
Everyone is different. What you experience may not be the same thing as another person.
The Positive: there are lots of things about the diaphragm that are good for your body as well as your sex life. 
- You can put a diaphragm in hours in advance
- You can have sex as many times as you like while it is in (as long as you add more spermicide each time)
- Neither you nor your partner should be able to feel it
- It is hormone-free
- Decreases the risk of pelvic inflammatory disease and tubal infertility
- Can be used while breastfeeding
- Some women have a hard time inserting the diaphragm
- It can cause vaginal irritation
- Some women wind up getting frequent urinary tract infections
- You have to use it every time you have sex, no matter what
- If you are allergic to spermicide or silicone, you should not use a diaphragm
- Can get pushed out of place by large penises, heavy thrusting, or certain sexual positions
- You need a prescription
- Hard to remember to use if you have had alcohol
 Cornell Health. (2019). Using a Diaphragm. Cornell University , New York . Retrieved from https://health.cornell.edu/sites/health/files/pdf-library/using-a-diaphragm.pdf
 CHIJIOKE, M. K. (2016). SPERMICIDES AND DIAPHRAGMS. UNIVERSITY OF BENIN CITY: DEPARTMENT OF HEALTH, SAFETY AND ENVIRONMENTAL EDUCATION. Retrieved fromhttps://www.academia.edu/24646826/SPERMICIDES_AND_DIAPHRAGMS
 FPA the sexual health charity. (2015). Your guide to diaphragms and caps. Retrieved from https://www.fpa.org.uk/sites/default/files/diaphragms-and-caps-your-guide.pdf
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 Society of Obstetricians and Gynaecologists of Canada. (2015). Canadian Contraception Consensus Chapter 5: Barrier Methods. JOGC Journal of Obstetrics and Gynaecology Canada , 37. Retrieved from https://www.jogc.com/article/S1701-2163(16)39376-8/pdf
 Schwartz, et al. (2015). Contraceptive Efficacy, Safety, Fit, and Acceptability of a Single-Size Diaphragm Developed With End-User Input. The American College of Obstetricians. Wolters Kluwer Health, Inc. Retrieved from https://www.essentialaccess.org/sites/default/files/Contraceptive_Efficacy_Safety_Fit.pdf
 Shoupe, D. (2016). Barrier Contraceptives: Male Condoms, Vaginal Spermicides, and Cervical Barrier Methods. En D. Shoupe, The Handbook of Contraception: A Guide for Practical Management. Retrieved from http://eknygos.lsmuni.lt/springer/677/147-177.pdf
 World Health Organization Department of Reproductive Health and Research and Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (2018) Family Planning: A Global Handbook for Providers. Baltimore and Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf?sequence=1
 World Health Organization. (2016). Selected practice recommendations for contraceptive use. Geneva. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/252267/9789241565400-eng.pdf?sequence=1