Diaphragm (vaginal pessary)

The diaphragm is made of silicone or rubber and has a bowl shape. They are available in different sizes. The gynecologist determines in an examination which size each individual woman needs.

Once the size has been determined, the diaphragm can be purchased over the counter in pharmacies or online. They are inserted like a tampon in front of the cervix (Portio uteri) a maximum of two hours before sexual intercourse and then checked for correct fit. After sexual intercourse, they must remain in the vagina for at least eight hours to ensure that no sperm reach the uterus.

After removing the diaphragm, it should be rinsed with lukewarm water. A diaphragm can be used again for up to a year. It should also be used with a spermicidal gel to increase the safety of contraception.

The spermicidal gel is simply applied to the diaphragm before inserting the diaphragm. The Pearl index of this contraceptive method is between 1 – 20. The copper spiral consists of a T-shaped plastic body.

The long part of the T is wrapped with a copper wire. The coil is inserted into the uterus by the gynaecologist during menstrual bleeding (intramenstrual). The procedure is hardly painful.

However, the uterus may be injured during the procedure, which is why the copper coil is not recommended for young women who want to have children later. Slight pain may occur a few hours after the procedure.After the procedure as well as in continuous intervals, the correct fit of the coil should be checked by a specialist in gynecology and gynecology. The copper coil can remain in the uterus for about two years and should then be replaced.

On the one hand, the copper coil acts as a mechanical barrier in the uterus and thus prevents sperm from reaching the fallopian tube, where fertilisation of the egg cell could occur. In addition, the copper wire permanently releases copper ions. On the one hand, these have a killing effect on the sperm (spermicidal) and on the other hand they disturb the structure of the endometrium.

Thus, if fertilisation of the egg should occur, the egg cannot implant in the uterus. The advantages of the copper coil are its long contraceptive effect. You do not have to worry about contraception for practically two years, nor do you have to think about taking tablets every day as with the contraceptive pill.

Disadvantages can occur in the form of a stronger and longer menstrual bleeding with abdominal pain. In addition, especially in the first few months after use, the coil may be rejected or infections may occur. Under contraception with the copper coil, an ectopic pregnancy occurs more often than without the use of contraceptives (ectopic pregnancy = EUG). The Pearl index is between 1 – 3, depending on the model of the copper coil.