- Birth control
What is the diaphragm?
A diaphragm is a shallow, dome-shaped cup made of silicone. (Honestly, it looks like Meg Griffin’s hat on The Family Guy. Except it’s only a few inches in diameter.) You insert the diaphragm into your vagina. Then it covers your cervix and keeps sperm out of your uterus. One super important thing to remember: For a diaphragm to work effectively, you need to use it with spermicide.
The diaphragm’s fairly effective—better with spermicide.
Perfect use: 84% effective
Typical use: 83% effective
What does perfect vs typical use mean?
No problems for most, but irritation or urinary tract infections are possible.
Have to put it in place every time you have sex, but can leave it in for up to 24 hours.
Easy to get
See a health care provider to get a prescription. For the Milex diaphragm you’ll need a fitting; the Caya diaphragm is one-size-fits-all.
Anywhere from $0-$90, but it all depends. Read more about costs.
It might be for you if…
You’re comfortable with your body
If you’re not okay with putting your fingers inside yourself, a diaphragm probably isn’t for you. It’s a little like putting in a tampon, though: If you can do that, you can probably manage a diaphragm.
It takes discipline
You’ve got to remember to insert your diaphragm every time you have sex, so it takes a bit of self-discipline and planning. But at least you can carry it with you if you want.
There are two kinds of diaphragm, Caya (a.k.a. SILCS) and Milex, currently available on the U.S. market. If you want to get one, it may be a good idea to call in advance to make sure your provider or pharmacy has diaphragms in stock.
If you’re allergic to silicone or spermicide, you shouldn’t use a diaphragm.
The pregnancy question
You’ll be able to get pregnant as soon as you stop using the diaphragm. So protect yourself with another method right away.
Don’t take our word for it. Check out the videos above to hear people talk about their experiences with the diaphragm.
How do you use it?
A diaphragm can be inserted just before sex, but it can also go in hours before you get to it so that it doesn’t get in the way of the moment. But no matter when it goes in, you have to be sure to leave it in for at least six hours after you have sex. If you’re going to have sex again that day, just leave the diaphragm in place and insert more spermicide way up in your vagina. Just don’t leave your diaphragm in for more than 24 hours.
Before you put it in
Add about a teaspoon of spermicide to the inner part of the diaphragm, and spread a little of it around the rim, as well. (Not too much, or it’ll be too slippery to hang on to.) Options Gynol II is specifically designed for diaphragms, and comes with an applicator you can use if you’re going to have sex more than once within six hours (you’ll need to add additional spermicide). Any kind of contraceptive gel or spermicide will do, however, except for the film or insert/suppository types. Don’t forget to check the expiration date.
How to put it in
Inserting a diaphragm may sound difficult, but with a bit of practice, it’s not so tough.
Here’s the deal:
- Wash your hands. Soap and water, no shortcuts.
- Check your diaphragm for holes and weak spots. Filling it with water is a good way to check—if it leaks, you’ve got a hole, which sorta defeats the whole purpose.
- Put a teaspoon or so of spermicide in the cup, and spread some around the rim, too.
- Get comfy, like you’re going to put in a tampon.
- Separate the outer lips of your vagina with one hand, and 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. (And yes, you’ll be touching the spermicide.)
- Push the diaphragm as far up and back into your vagina as you can, and make sure to cover your cervix.
Having another go at it?
You need to leave the diaphragm in for six hours after sex. If you have sex a second time within those six hours, first insert more spermicide. (Ortho Gynol II comes with an applicator that measures how much you’ll need, and gets it where it needs to go.) Then the six-hour clock starts again, counting from the last time you have sex.
How to take it out
Of course, what goes in must come out. Here’s how:
- Wash your hands again.
- 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.
- Still having trouble? Ask your doctor about getting an inserter, or consider switching to another method.
- Finally, take good care of your diaphragm and it can last up for several years.
- After you take it out, wash it with mild soap and warm water.
- Let it air dry.
Don’t use powders or oil-based lubricants (like Vaseline or cold cream) on your diaphragm.
How much does it cost?
Thanks to the Affordable Care Act, if you have health insurance, chances are good that you’ll be able to get this method with no out-of-pocket cost.
With proper care—and if you don’t gain or lose a lot of weight—you can keep your diaphragm for up to ten years, making it a great birth control value for your buck at the equivalent of 42 cents to $2.08 a month (plus the cost of spermicide).
- This method may be free or low-cost for you
- With Medicaid: Free
Without insurance: Depending on your income, you may be able to go to a low-cost clinic to get the diaphragm at reduced cost.
At full price, the diaphragm can cost as much as $90; some clinics may charge extra for a fitting fee. To see how this translates over a year, here’s what it would cost to pay for a diaphragm month-to-month at full price:
Cost per month over one year: $0 - $7.50
Cost per month over two years: $0 - $3.75
Payment assistance: Check with your local family planning clinics and find out if they offer free or low cost birth control (most do).
What are the side effects and benefits?
There are positive and negative things to say about each and every method. And everyone’s different—so what you experience may not be the same as what your friend experiences.
- You can put a diaphragm in hours in advance
- You can have sex as many times as you like while it’s in
- Neither you nor your partner should be able to feel it
- Doesn’t affect your hormones
- Decreases the risk of pelvic inflammatory disease and tubal infertility
- Can be used while breastfeeding
- Some women have a hard time inserting 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’re allergic to spermicide or silicone, you shouldn’t 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’re drunk