The contraceptive diaphragm is a small, dome-shaped cup made of rubber or silicone that covers the cervix (neck of the womb) to protect against pregnancy. To be effective, it has to be covered with a spermicide (jelly that kills sperm) so that it prevents sperm from entering in the uterus by blocking and/or killing it.
When used correctly, the diaphragm offers a 90-95% protection against pregnancy, but it won't fully protect you against sexually transmitted infections (STIs).
To obtain a diaphragm, you will need to visit a doctor, who can issue a prescription and show you how to use it (correct insertion, use of the spermicide). Your doctor will also establish the correct size.
The contraceptive diaphragm should be covered with spermicide and then inserted tightly against the cervix. You must leave it in place at for least 6 hours after sex. Although it is rare, there is a risk of toxic shock so you must also remove the diaphragm within 24 hours of putting it in place.
Remember to use spermicide each time you insert the contraceptive diaphragm. If you are having sex more than three hours after you've inserted it, you need to use more spermicide as well.
Don't have a bath when the diaphragm is in place - this can wash away the spermicide. You can put the diaphragm in anytime (including right before) having sex.
It is fairly easy to use and does not present too many risks or side effects. It can be put in place several hours before sex and you only use it when planning to have sex (unlike the pill for example).
Also, it offers partial protection against STIs.
You have to learn how to use the diaphragm and it may take you some time to get used to it. Usually, your healthcare provider will give you one to practice with the first time (but it's not a real one so don't use it when having sex).
Sometimes women report that the rubber causes irritation and say that they find applying the spermicide inconvenient.
If it is left in place for more than 24 hours, there is also the risk of irritation, an allergic reaction or toxic shock syndrome.
Finally, you'll probably need to readjust the contraceptive diaphragm or look for a different size if you gain or lose more than three kilos.
There is a risk that the contraceptive diaphragm can dislodge from its position, so you must be careful, especially: during sex, when you walk or when you cough.
Consult a doctor if you find the diaphragm painful during sex or if you find blood on the diaphragm after removing it (only if it's unrelated to your period), it might be a sign of irritation or infection.
The diaphragm is not recommended for people who have an allergy to rubber or silicone.
Likewise, women with a history of vaginal infection, cystitis or toxic shock syndrome are usually told to avoid using the diaphragm.
Finally it's also not recommended if you suffer from vaginal abnormalities that might pose a problem in placing the diaphragm or if you've recently given birth or had a miscarriage.