Diaphragm & Cervical Cap

The diaphragm and cervical cap have been used for nearly a century in Europe, becoming widely popular in the United States by the 1920s. While offering no disease protection, women have enjoyed this dependable method of birth control which they can use at will. With no shot to get or pill to remember, this easily.

Diaphragms and cervical caps combine two contraceptive mechanisms by first serving as a physical barrier to shield the cervix against sperm and secondly, by enlisting spermicide to kill the sperm. Both the diaphragm and cervical cap may help hold spermicide in place against the cervix.

Diaphragms
are dome-shaped rubber cups with a flexible rim that, when inserted into the vagina, covers the cervix. Spermicidal cream or jelly applied to the inside of the dome before insertion is held in place near the surface of the cervix.

Cervical caps
are smaller than a diaphragm and is a soft, deep rubber cup that fits snugly around the base of the cervix. Spermicide, filling the dome a third full prior to insertion, is held in place against the cervix.

Both the diaphragm and cervical cap are obtained through a prescription. Both come in varying sizes so a physician must "fit" you for the size ideal for your body. Size will depend on weight, whether you've been pregnant, given birth, or had a miscarriage. If any of these have happened since your last fitting, your physician will need to re-size you.

Diaphragms
Inserted into the vagina by squeezing the spring rim, the diaphragm fits snugly behind the pubic bone against the cervix, providing protection for 6 hours. For every act of intercourse, an applicator of spermicide (without removing the diaphragm) is recommended. Following intercourse, the diaphragm must remain in place for at least 6 hours and no longer than 24 hours.

Cervical Caps
Like a diaphragm, this is inserted into the vagina by squeezing the rim. Significantly smaller than a diaphragm, the cervical cap is a soft, deep rubber cup that fits snugly around the base of the cervix. Spermicide, filling the dome a third full prior to insertion, is held in place against the cervix under the cap is removed. The cap provides continuous contraceptive protection for no more than 48 hours, regardless of the number of acts of intercourse. Additional spermicide is not needed.

Users must be careful to use their diaphragm or cervical cap every time they have intercourse and wash their hands with soap and water BEFORE inserting, checking, or removing their vaginal barrier method. Supplies should be stored in a cool, clean, dark place, and both the diaphragm and cap as well as the spermicidal applicator should be washed with plain soap after each use.

Efficacy of the diaphragm and cervical cap, like most other birth control methods, depends on the user. The typical diaphragm user will see a 18% failure rate while those who use it perfectly decrease that number to 6%. Of cervical cap users, your health history will play a factor in its efficacy. Of woman who have never given birth vaginally, typical use results in 18% failure while perfect use decreases that to 9%. However, in women who have given birth vaginally, the efficacy drops significantly. Typical users will see a failure rate as high as 36% while those who use it perfectly will have a failure rate of 26%.

Note:
Avoid oil-based lubricants and medications when using any barrier method of birth control. Such lubrications include mineral oil, baby oil, suntan oil, vegetable oil, some hand lotions, and butter; and vaginal medications such as Femstat cream, Monistat cream, estrogen cream, and Vagisil. All have a rapid deteriorating effect on latex.

Neither the diaphragm nor the cervical cap cause any systemic side effects or alter a woman's hormone patterns. Users of the diaphragm may have a lower risk for cervical dysplasia and canecer. For several reasons, woman who use the diaphragm may also be a decreased risk for the human papilloma virus (HPV), the virus that causes genital warts.

Some users of the diaphragm and cervical cap report cramps, bladder pain or rectal pain when wearing the devices. In some cases, partners report penile pain. Most pain is corrected with a better fitting device. Also, those with a latex allergy would not be candidates for the diaphragm or cap. Diaphragm users may also be at increased risk for vaginal and urinary tract infections.

Recently, spermicide has been under close scrutiny by the medical community, namely Nonoxynol-9 because it's been documented to cause irritation to the skin. Anytime there is irritation to the skin, that area is prone to infection and in this case, more susceptible to sexually transmitted infections. Spermicide gel used with the diaphragm and cervical cap contain Nonoxynol-9.

In addition to the spermicide risk, because diaphragms and cervical caps are foreign objects left inside the body for an extended period of time, Toxic Shock Syndrome is a concern. Often associated with tampons, TSS is rare, but if the following symptoms occur, contact your physician immediately:

Remember . . .
Diaphragms and cervical caps do not protect against sexually transmitted infections such as HIV/AIDS. Latex and polyurethane condoms provide some protection against such disease, but nothing is 100%. For more information on the diaphragm and cervical cap, see the following links:

By being frank with your healthcare provider, the two of you can work together to determine the birth control and disease prevention methods that best suits your health, your preferences and your lifestyle.

For more information, click on the hormonal and barrier click on the links below.

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