About the Diaphragm (page 2)

How Well Does a Diaphragm Work?

Over the course of a year, 16 out of 100 typical couples who rely on the diaphragm with spermicide to prevent pregnancy will have an accidental pregnancy. Of course, these are average figures and the chance of getting pregnant depends on whether it's used correctly every time.

In general, how well each type of birth control method works depends on many things. With a diaphragm, some of the most important things are that it fits correctly, that it is used every time a couple has sex, and that spermicide is used appropriately.

Protection Against STDs

The diaphragm does not protect against STDs. Couples having sex must always use condoms along with the diaphragm to protect against STDs.

Abstinence (not having sex) is the only method that always prevents pregnancy and STDs.

Possible Side Effects

Most young women who use a diaphragm have no problems with it, but possible side effects include:

• Spermicides may irritate the vagina and surrounding skin or cause an allergic reaction.
• Strong odors or vaginal discharge may appear if the diaphragm is left in too long.
• The rubber or latex in the diaphragm may cause an allergic reaction (this is rare).
• Diaphragms and spermicides may make urinary tract infections more likely.
• Toxic shock syndrome (TSS) is a rare complication if the diaphragm is left in too long.

Who Uses Diaphragms?

A young woman who can take responsibility for sex in advance can use a diaphragm. With a diaphragm, she must always have a supply of spermicide. The diaphragm isn't good for anyone who is uncomfortable or uneasy with the thought of reaching into her vagina. And it may not be a good choice if there are certain medical conditions present, such as frequent urinary tract infections. The diaphragm should not be used when a young woman has her period.

Where Are Diaphragms Available?

A diaphragm has to be fitted by a doctor. During a pelvic exam the doctor will measure the vagina to determine which diaphragm size is the right fit, then teach the patient how to insert and remove it. Some doctors may even have the woman insert the diaphragm at home, then come in while wearing it to check that it's positioned correctly. A diaphragm that's inserted incorrectly or doesn't fit properly can result in pregnancy.

During the annual exam, the doctor will make sure the diaphragm still fits correctly. It may not fit if a girl has gained or lost 10 pounds, had a baby, had an abortion, or was fitted when she was a virgin and she is now having sex. If any of these things have changed since her last exam, a young woman should see her doctor to have the fit of the diaphragm checked rather than waiting until her annual exam.

How Much Does a Diaphragm Cost?

A diaphragm usually costs about $15-$75. It should be replaced every 2 years. There is also the cost of the doctor's visit and a fitting fee. Many health insurance plans cover these costs and family planning clinics (such as Planned Parenthood) charge much less. In addition, the cost of spermicide is about $0.50 to $1.50 per use.

Reviewed by: Larissa Hirsch, MD
Date reviewed: April 2010