Birth control and you: The diaphragm

IT is a contraceptive method used by less than one per cent of women worldwide, and its popularity is diminishing.

The diaphragm is a round piece of flexible rubber (silicone) that fits over the opening to the cervix and prevents pregnancy.

According to gynaecologist Dr Charles Rockhead, it is one of several barrier methods that effectively blocks sperm from entering the uterus.

But in order for it to be effective, Dr Rockhead said when the diaphragm is used with a spermicide it is usually more effective than if used alone. He added that the diaphragm must not be left in place for more than 24 hours.

With regards to its popularity, Dr Rockhead explained that much is not heard about the diaphragm mainly because of the increase in access to other methods of contraception.

“It is a dying contraceptive with all the other technologies that are around now and the presence of STIs such as HIV and HPV (human papillomavirus),” he said.

Moreover, he said if you opt for this form of contraception you are guided as to how to insert it.

“You insert it way up in the vagina towards the back of the cervix to cover it, and then you apply the spermicide,” he said. “Be sure to wash your hands with soap and water before doing the insertion, and after withdrawing it, be sure to wash the diaphragm with soap and warm water.”

Additionally, caring for your diaphragm includes not using powders on it as this can cause infections; nor oil-based lubricants as they can damage the silicone, thus defeating the purpose.

Moreso, as with any contraception, there are pros and cons of using the diaphragm. These include:

Pros:

1. It has no effect on the hormonal levels of women.

2. It is safe to be used during breastfeeding.

3. It does not affect your ability to have intercourse.

4. Does not affect a man or a woman’s future fertility.

5. It can be carried in your pocket or purse.

6. It’s less expensive than a number of other birth control methods.

7. It is reversible.

Cons:

1. It does not protect against sexually transmitted diseases. In order to protect yourself from STIs, the man would need to wear a condom.

2. Many women might not feel comfortable inserting the diaphragm and some might find it difficult to insert. “You have to insert it so that it covers the upper part of the vagina to prevent the sperm from entering,” Dr Rockhead pointed out.

3. Failure rates for barrier methods such as the diaphragm are higher than most other methods of birth control.

4. It cannot be used by women who are sensitive to silicone or spermicide, or those with frequent urinary tract infections. “Some of the spermicides can cause vaginal inflammation and increase the chance of your getting STIs. It doesn’t cause STIs, but if someone has an STI and you are having sex with them, it may increase the possibility,” said the gynaecologist.

5. It lacks spontaneity. “You basically have to stop and insert it, which is a bit time-consuming,” said Dr Rockhead.

6. Some penis sizes and heavy thrusting may move it out of place.

7. Diaphragms and spermicides can occasionally cause physical discomfort due to poor fit or an allergic reaction.

8. You may need to be refitted.

— Kimberley Hibbert