A diaphragm is a safe contraceptive for women who do not want to stress their bodies by taking hormones. However, correct use and the right size are crucial for reliability.
What is a diaphragm?
Schematic diagram for contraception using a diaphragm. Click to enlarge. The diaphragm, an elastic spiral or flat spring covered with a membrane of silicone, bears a close resemblance to a rolled-up condom. Before sexual intercourse, it is inserted into the vagina and placed over the cervix. In this way, it forms an impenetrable seal that prevents sperm from entering the uterus. Since the size and structure of the vagina varies from woman to woman, the diaphragm is available in nine different sizes with a diameter of six to nine centimeters. To ensure the best possible protection against pregnancy, fitting by a gynecologist is an absolute must.
Structure, function and mode of action
The reliability of this contraceptive method depends crucially on the diaphragm resting in the exact position on the cervix. To do this, the cervix is first measured. To determine the correct size of the diaphragm, different sizes must be tried in a second step. The largest diaphragm that cannot be felt after insertion is the right one. The correct fit can be easily checked by feeling the cervix with your finger. It must be completely covered by the diaphragm. The front end of the diaphragm should be inserted into the vagina 30 minutes before sexual intercourse. To do this, the edges are pressed together slightly and inserted deep into the vagina, similar to a tampon. The correct position is between the posterior vaginal vault and the pubic bone, as this completely closes the cervix. To increase safety, it is recommended to rub the diaphragm beforehand on the side facing the cervix and on the edges with a spermicide, a sperm-killing gel. If there is an allergy to spermicides, citric acid or lactic acid-based products can be used, which greatly restrict sperm motility. After insertion, woman should double check for proper fit. If the diaphragm can no longer be moved, it is in the correct position and forms a barrier that prevents fertilization of the egg by the sperm. After ejaculation, the diaphragm must remain in the vagina for at least eight hours until all sperm are incapable of fertilization. It should then be removed by grasping it with a finger under the front edge and pulling it out. It then requires thorough cleaning with water and a mild soap. Those who have multiple sexual intercourse while wearing it must also apply spermicides, which are inserted deep into the vagina using an applicator.
Medical and health benefits
A diaphragm is particularly suitable for women who have sex only occasionally and do not want to resort to permanent contraceptives, but do not want to leave control of contraception in men’s hands. A great advantage in its use is that the use of a diaphragm has no health side effects. Unlike the pill, through which hormones are absorbed, there are no effects on the menstrual cycle. In addition, women get to know their bodies better through insertion and feeling the correct position, which is appreciated by many as a valuable self-awareness. Other plus points are that a diaphragm only needs to be used when necessary and its size makes it easy to transport, as it fits comfortably in any handbag. Despite all the advantages, however, it must be remembered that the use of a diaphragm should be refrained from when frequently changing partners, as it does not protect against the transmission of STDs such as HIV. In addition, its use can increase susceptibility to bladder infections, and the use of spermicides can cause allergic reactions. If the diaphragm remains in the vagina for longer than 24 hours, the risk of contracting pathological vaginal discharge or vaginitis also increases.
