Nonhormonal contraceptive options, such as the diaphragm, can put the reigns back in your hands when it comes to managing your fertility and family planning. If you’re considering switching to a diaphragm as your primary form of birth control, there are a few things you should know.
Used alone, barrier methods tend to be less effective than hormonal birth control or sterilization. However, according to the American College of Obstetricians and Gynecologists (ACOG), diaphragms are in the middle tier, above other barrier methods, including condoms, cervical caps, or sponges, and just below to top tier of the most effective methods, which include implants, IUDs, and sterilization. That puts diaphragms on the same tier of effectiveness as hormonal injections, pills, patches, and rings, with less than 12 pregnancies per 100 women in a year with perfect use.
Effectiveness of contraceptive methods is usually measured in two ways, typical use vs. perfect use. Typical use means that you follow the product instructions most of the time. Perfect use means that you follow the instructions exactly. For diaphgrams, this means:
For the CAYA diaphragm, typical use has an effective rate of 18 pregnancies per 100 women, and perfect use has an effective rate of 14 in 100. These are based on using the diaphragm as directed and without any additional contraceptive methods. However, you can increase the effectiveness of your diaphragm further by combining it with other methods, such as the fertility awareness method (FAM or FAB), and by also using condoms.
If you’re using a diaphragm for your birth control, you can continue to use lubricants and condoms; however, you will need to verify that they are compatible with your particular diaphragm’s material. Many diaphragms are made of silicone or latex, which can be damaged by oil-based creams and oils.
Water-soluble lubricants and creams are the safest to use with most diaphragms. Avoid silicone-based or oil-based lubes because they can damage the chemical structure of your diaphragm.
Most condoms are compatible to use along with your diaphragm. Having your partner use a male condom together with your diaphragm can significantly increase the effectiveness in preventing pregnancy, not to mention STD prevention. Avoid condoms that have oil-based lubes and check your diaphragm’s package insert for any additional requirements in selecting compatible condoms.
It’s important to remember the above guidelines apply to medications as well. So if you’re being treated for a vaginal infection, keep in mind that oil-based medication creams can damage your diaphragm. For example, Clindamycin cream or ovules are often used for the treatment of bacterial vaginosis (BV). The CDC recommends avoiding using diaphragms within 72 hours following treatment to prevent damage to your diaphragm.
It’s not recommended to use your diaphragm dry, or in other words, without the use of a spermicide substance. Diaphragm manufacturers instruct users to apply a gel spermicide inside and around the rim of the device before insertion with additional applications if too much time has passed. The spermicide destroys sperm cells, preventing them from fertilizing an egg and increasing the effectiveness of the diaphragm alone.
You’ll need to purchase spermicide gel at your local pharmacy or drugstore in order to use your diaphragm properly. It is available for purchase without a prescription and usually comes in a large tube or individual pre-filled applicators. VCF vaginal contraceptive gel is a common brand of spermicide that is often used with diaphragms. Its active ingredient is nonoxynol-9 or N-9.
The CAYA diaphragm calls for 4 mL, or about a teaspoon, of spermicide gel for each use. Diaphragm users may also need to add additional gel with an applicator if it has been more than two hours since insertion. You can use FSA or HSA accounts to pay for spermicide at a variety of retailers.
Traditionally, contraceptive diaphragms required a woman to visit her gynecologist in person for an awkward appointment that was designated for fitting the correctly-sized diaphragm. Many diaphragms had a range of sizes, sometimes up to 8 different sizes, in order to provide a good seal around the cervical opening. As you can imagine, the process can be quite embarrassing, strenuous, and awkward.
Luckily, today there are new options available that do not require awkward diaphragm-fitting sessions. My Virtual Physician has partnered with one of these manufacturers to provide our patients with a one-size-fits-most diaphragm option: the CAYA diaphragm. To obtain your prescription, schedule an appointment online today. The process is very simple and only requires a virtual consultation with our online OBGYN in order to get your diaphragm prescription.
Contraceptive diaphragms put women back in control of their own bodies. This birth control method allows women to choose how effective their contraceptive method will be and to return to fertility immediately. In order to make your diaphragm the most effective for pregnancy prevention, it’s important to know and understand the considerations discussed above. If you’ve been using a diaphragm for a while, we’d love to hear your tips. Shoot us a message to let us know if you’ve got more to share about your diaphragm experience!