How are diaphragms used for contraception?

Updated: Dec 10, 2018
  • Author: Frances E Casey, MD, MPH; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Answer

The diaphragm is a shallow latex cup with a spring mechanism in its rim to hold it in place in the vagina (see the image below). Diaphragms are manufactured in various diameters. A pelvic examination and measurement of the diagonal length of the vaginal canal determines the correct diaphragm size. It is inserted before intercourse so that the posterior rim fits into the posterior fornix and the anterior rim is placed behind the pubic bone. Spermicidal cream or jelly is applied to the inside of the dome, which then covers the cervix.

Contraceptive diaphragm (Ortho-McNeil-Janssen Phar Contraceptive diaphragm (Ortho-McNeil-Janssen Pharmaceuticals, Inc.). Image courtesy of Wikimedia Commons.

It prevents pregnancy by acting as a barrier to the passage of semen into the cervix. Once in position, the diaphragm provides effective contraception for 6 hours. If a longer interval has elapsed without removal of the diaphragm, fresh spermicide is added with an applicator. After intercourse, the diaphragm must be left in place for at least 6 hours.


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