Written by the Healthline Editorial Team | Published on September 12, 2014
Medically Reviewed by Patricia Geraghty MSN, WHNP, FNP-BC on September 12, 2014

Birth Control: Diaphragm

The diaphragm is a physical barrier that blocks the cervix to prevent pregnancy. The device has been used as a birth control method in the United States since the early 1900s. It was very popular before the introduction of birth control pills.

A diaphragm is larger than a cervical cap, which is a small silicone cup that also works to prevent pregnancy by covering the opening to the uterus.

What Is a Diaphragm?

The diaphragm is a dome-shaped device. It is inserted into the vagina to prevent pregnancy. The diaphragm is made out of latex or silicone with a flexible rim.

How Does the Diaphragm Work?

The diaphragm is inserted before intercourse. It blocks sperm from traveling through the cervix during sex. Diaphragms are used in conjunction with spermicide. The spermicide helps to stop and kill sperm. If sperm cannot reach the uterus and fallopian tubes to fertilize the egg, pregnancy cannot occur. 

How Do I Use the Diaphragm?

You need a prescription to use a diaphragm. Your doctor will need to do a pelvic exam to determine what size provides the best fit. Make an appointment with your doctor to discuss if the diaphragm is the best birth control method for you.

You can insert the diaphragm up to six hours before intercourse. To insert the diaphragm:

1. Wash your hands with soap and water.

2. Put spermicide in the cup, and spread more around the rim.

3. With one hand, separate your vaginal lips.

4. With the other hand, fold the diaphragm in half with the spermicide on the inside pocket.

5. Push the diaphragm as far up and back as possible, then tuck the interior rim behind your pubic bone.

6.Let the diaphragm unfold, and make sure the cervix is covered.

Do not remove the diaphragm until at least six hours after sex. This gives the spermicide time to immobilize any remaining sperm. However, you should not leave the diaphragm in for longer than 24 hours.

If you have sex more than once in a 24-hour period, add more spermicide before intercourse You should also check to make certain the diaphragm is still in place.

To remove the diaphragm:

1. Wash your hands with soap and water.

2. Hook the rim with a finger to break the seal.

3. Pull the diaphragm down and out.

4. Wash the diaphragm with soap and water

5. Let it air dry.

Never use oil-based or silicone lubricants with a diaphragm, as these can damage silicone. It is also important to check your diaphragm for damage on a regular basis. Use a different method of birth control if it has any weak spots, wrinkles, or holes. It may be easier to see the damage if you hold the diaphragm up to a light.

How Effective is the Diaphragm?

The effectiveness of the diaphragm depends on how correctly it is used. According to Planned Parenthood, the failure rate is six percent for women who always use it as directed and 12 percent for women who don’t always use it as directed.

The effectiveness can be increased by checking the placement of the diaphragm before intercourse and always using spermicide with the device. It also helps if your partner pulls out before ejaculating.

A properly sized diaphragm is also important for effectiveness. You may need to get a new diaphragm if you:

  • have a baby
  • have a miscarriage
  • gain or lose 20 percent or more of your body weight

What Are the Benefits of the Diaphragm?

  • easier to insert than the cervical cap
  • unlikely to be felt by either partner during sex
  • can be inserted hours before sex, so as not to interrupt intimacy
  • can be carried around discretely in a purse
  • can be used during breastfeeding
  • does not interfere with natural hormones

The diaphragm is a convenient birth control choice. It has a number of advantages:

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