Birth Control

What Is a Diaphragm? Everything You Need to Know About the Non-Hormonal Birth Control

It's old-school, but it works.
What is a diaphragm Contraception techniques against a pink background.
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Diaphragms are often overshadowed by other forms of birth control, like the pill or the IUD. So much so that you might even be wondering what is a diaphragm? The birth control method is old-school but it is still alive and well—many women rely on this long-established method of non-hormonal birth control. Curious? Here's everything you need to know about diaphragms.

What is a diaphragm?

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The first diaphragm was invented in 1941 (originally called the "womb veil") and was the main method of birth control used by women until the birth control pill was invented in 1960. Today, a diaphragm is a silicone dome that you insert into your vagina, which blocks sperm from reaching the eggs via a physical barrier—same idea as a condom. (Note: Diaphragms should always be used in conjunction with spermicide.) You can safely leave it inside your vagina for up 18 hours prior to intercourse and six hours after.

Diaphragms are easy to use and hormone-free

“Diaphragms are becoming more popular again,” says Jessica Shepherd, M.D., an assistant professor of clinical obstetrics and gynecology and director of minimally invasive gynecology at the University of Illinois College of Medicine at Chicago. Sure, the vast majority of her patients still explore other forms of birth control, but Shepherd says she’s seen an uptick in women asking about the diaphragm.

Women who opt for the barrier tend to like them because they’re environmentally safe and non-hormonal, Shepard says.

Diaphragms aren't as effective as the birth control pill or IUDs

There’s a reason diaphragms have been usurped by more popular birth control methods like the pill and IUD: they're not as effective at preventing an unintended pregnancy. Diaphragms used with spermicide are 88% effective. When used without spermicide, that number drops down to 80%. The pill and IUDs, on the other hand, are more than 99% effective (assuming you use the pill perfectly, which most people do not—typical use is closer to 91% effective).

In addition to being less effective, there are other considerations that have reduced the contraceptive's popularity. For example, women will need to get fitted for a new diaphragm if they gain or lose a significant amount of weight, have a baby, or undergo certain surgeries, explains Christine Greves, M.D., a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies. And then, of course, there’s the fact that you have to walk around with a diaphragm in your vagina for hours after you have sex.

Greves says she doesn’t think diaphragms are the best option for everyone due to their higher rates of failure, but says it’s a good choice for women who can’t use hormonal birth control and don’t want to get a copper IUD. “If combined with perfect condom usage, that can help reduce the failure, as well,” she says.

How to get a diaphragm

The process of getting a diaphragm is pretty simple, says Greves. You get fitted for one by your ob-gyn, learn how to place it in a follow-up visit, and then it’s good for the next two years. It’s also inexpensive, she points out—diaphragms cost anywhere from $0 to $75, per Planned Parenthood. Your health insurance might cover your diaphragms, as well.

If you’re interested in trying out a diaphragm, make sure talk to your doctor. He or she should be able to help you decide whether it’s the right method of birth control for you.

How to use a diaphragm

To use a diaphragm, you either sit down or elevate one leg to change the angle of your pelvis, squirt some spermicidal jelly or lube into the inside part, fold it up, and then slide it into your vaginal canal before sex (while you're at it, put some spermicide directly into your vagina for good measure). The back rim should fit into the posterior part of your vagina behind your cervix, and the front should fit nicely behind your pubic bone, Shepherd says. Six hours after you have sex, you can remove the diaphragm (it’s a good idea to wait because sperm can swim around the barrier if you remove it sooner). Then, Dr. Shepherd says, you wash it with soap and water, and you’re good to go. It sounds simple once you get the hang of it, and it is.

Other Facts About Diaphragms

Before you jump into using a diaphragm, here are a few additional things to know:

  • Diaphragms do not protect against sexually transmitted diseases.
  • They should never be worn while you are on your period.
  • Never apply petroleum jelly or oil-based creams, such as Monistat, while using a diaphragm—these will cause small holes to form in the diaphragm and reduce its effectiveness.
  • If you have intercourse repeatedly throughout one period of wearing the diaphragm, spermicide should be applied each time.
  • If you leave a diaphragm in for more than 24 hours, you are at risk for irritation, infection and even Toxic Shock Syndrome—so don't forget it's in there.

My Personal Experience Using Diaphragms

Before I had my son, I was a diaphragm user, so I kind of get it. I knew I wanted to try to get pregnant in six months or so, and wanted to explore a hormone-free birth control method that wasn’t condoms. So I tried out the little silicone cup. I have mixed thoughts about my experience—I loved not having to take a daily pill but wasn’t totally sure that I was putting in the diaphragm the right way. You also have to leave the diaphragm up there for hours after having sex, so, when my husband and I engaged in a little pre-work fun, I had remove the device at the office and wash it out in the bathroom sink while praying none of my coworkers caught me in the act.