Using the contraceptive diaphragm as a method of birth control

Dr Kathryn Basford

Medically reviewed by

Dr Kathryn Basford

Last reviewed: 06 Dec 2021

The contraceptive diaphragm is a hormone free method of birth control that can be used by most people. To prevent pregnancy, you should insert a contraceptive diaphragm into your vagina and place it over your cervix before you have sex. Using a spermicide spray with a contraceptive diaphragm makes it more effective.

Contraceptive diaphragms do not contain hormones, making them useful if you do not want to use a hormonal method of birth control.

Diaphragms are not as effective as other types of birth control. If used perfectly, around 6 out 100 women will get pregnant while using the diaphragm. In reality the average is closer to 12 in 100.

If you want to use a contraceptive diaphragm, a doctor or nurse will need to give you one that is the right size for you. And you can use your contraceptive diaphragm for up to 1 year before you need to replace it, so it’s sustainable and environmentally friendly too.

Contents
Woman stood in front of a building checking her phone for information about the contraceptive diaphragm
 

What is a diaphragm?

The contraceptive diaphragm is a small, soft and squishy cover for your cervix that you can use to prevent pregnancy. It’s made out of silicone or latex and can fit in the palm of your hand. The shape of a contraceptive diaphragm is similar to the shape of an ice cream scoop. Contraceptive diaphragms have this scoop shape so they can hold onto the spermicide gel or spray that you put on it.

You should put spermicide onto your contraceptive diaphragm before you put it into your vagina to cover your cervix. It’s most effective if you do this just before you have sex. This way you can block sperm from getting into your womb (uterus) and kill any sperm that gets into the contraceptive diaphragm. You should keep the contraceptive diaphragm in for at least 6 hours after sex, so the spermicide has time to work. Then you can remove it, wash it in warm soapy water and leave it to dry.

You can get a contraceptive diaphragm from a doctor or nurse at a sexual health clinic. During your appointment, they will have a look at your cervix and give you a contraceptive diaphragm that should be the right size for you.

You can always go back to get a different size if:

  • you feel it’s not a good fit
  • it feels uncomfortable to use
  • your body weight goes up or down by more than 3kg (7lbs)
  • you give birth

How does the diaphragm work?

The contraceptive diaphragm works in 2 ways to prevent pregnancy:

  1. By covering your cervix, the contraceptive diaphragm acts as a barrier to stop sperm from entering your womb so an egg cannot get fertilised.
  2. The spermicide gel or spray you put on a contraceptive diaphragm kills the sperm if they manage to get under the edge of your contraceptive diaphragm.

When should I put my diaphragm in?

You should put your contraceptive diaphragm into your vagina just before having sex. If you want to have it in earlier, you can put it in with spermicide up to 3 hours before having sex.

But, if it’s been more than 3 hours, you should put more spermicide in your vagina before you have sex. You do not need to take out your contraceptive diaphragm to do this.

After you have sex, keep your contraceptive diaphragm in for at least 6 hours. If you want to have sex again during these 6 hours, put more spermicide in your vagina before you have sex. Then you’ll have to wait another 6 hours to take it out.

You should not leave your contraceptive diaphragm in your vagina for more than 24 hours. This is because it can increase your chances of getting toxic shock syndrome.

How do I take my diaphragm out?

You can take your diaphragm out between 6 to 24 hours after you’ve put it in or had sex. To take your diaphragm out you should:

  1. Put your finger into your vagina and find the edge of your contraceptive diaphragm
  2. Dig your finger under the edge of your contraceptive diaphragm until you feel it become loose
  3. With your finger hooked under the edge, gently pull the contraceptive diaphragm downwards and out
  4. Wash your hands and your contraceptive diaphragm with soap and warm water
  5. Once clean, leave your contraceptive diaphragm in a cool place to dry, away from direct sunlight
  6. Protect your contraceptive diaphragm by putting it into its case until the next time you want use it

If you take out your contraceptive diaphragm and notice it’s damaged or broken, speak to a healthcare professional straight away as you may need the morning after pill.

How do I take care of my diaphragm?

To take care of your contraceptive diaphragm, you should keep it clean by washing it straight after you use it. Use soap that is perfume-free and run it under warm water from a tap. Dry your contraceptive diaphragm with a clean towel, or leave it in a cool place. You should not put your diaphragm onto or next to a heater, or on a sunny windowsill. Once it’s dry, put your contraceptive diaphragm in its storage box or keep it safe in a clean drawer.

To avoid damaging your contraceptive diaphragm, do not let it come into contact with any of the following:

  • disinfectant chemicals, like alcohol or harsh cleaning products
  • oil based products, like baby oil or massage oil
  • detergents or powders, such as laundry detergent
  • boiling water

You may need to replace your contraceptive diaphragm if there are any tears, holes, or thin spots. You can check for these signs of damage by holding your contraceptive diaphragm up against a light and seeing if it shines through. Or you can pour cool water onto your dry contraceptive diaphragm and look out for any leaks.

If your contraceptive diaphragm feels like it’s smaller than usual, or has changed shape, you should replace it.

It’s easy to replace your contraceptive diaphragm by seeing a doctor or nurse for a new one, and you can use condoms until you get your replacement.

Looking after your contraceptive diaphragm will help keep it effective at preventing pregnancy, and you can use it for up to 1 year.

Is it safe to use the contraceptive diaphragm?

Yes, it is safe to use the contraceptive diaphragm.

However, you should not use a contraceptive diaphragm if you have:

  • a latex or silicone allergy
  • a spermicide allergy
  • ever experienced toxic shock syndrome
  • an infection in your vagina, such as thrush or bacterial vaginosis (BV)
  • a urinary tract infection or cystitis
  • weak vaginal muscles that cannot hold the contraceptive diaphragm in place, possibly due to giving birth

How effective is using the diaphragm as contraception?

A contraceptive diaphragm is around 88% effective during your first year of using it. So you should use condoms the first few times you use your contraceptive diaphragm as you get used to it. After this, a contraceptive diaphragm can be up to 94% effective as contraception.

Here are some tips to help you use the contraceptive diaphragm effectively:

  • apply spermicide before inserting your contraceptive diaphragm
  • reapply spermicide if it’s been more than 3 hours since you’ve put in your contraceptive diaphragm
  • put your contraceptive diaphragm in place before having sex, and check it is securely in place
  • keep your contraceptive diaphragm in place after sex for at least 6 hours, and then remove it

If your diaphragm falls out of place or tears during sex, speak to a doctor about getting emergency contraception.

A contraceptive diaphragm is not effective at preventing sexually transmitted infections (STIs), so you should use a condom to protect yourself.

How to use a diaphragm

To use a contraceptive diaphragm you should:

  1. Wash your hands with soap and water
  2. Get into a comfortable position, similar to one that you would use when putting in a tampon
  3. Put some spermicide inside and on the edge of your contraceptive diaphragm
  4. Squeeze your contraceptive diaphragm, so that it closes with no air bubbles
  5. Open your legs and gently push the contraceptive diaphragm into your vagina upwards
  6. Allow the contraceptive diaphragm to open over your cervix, and tuck the edges in and around it
  7. Check your cervix is completely covered by using your fingers to look for any gaps

You can practise how to use your contraceptive diaphragm at an appointment with a doctor or nurse at a sexual health clinic. They can help check that you’ve put it in correctly, so you’re ready for when you want to use it in future.

What are the benefits of using a diaphragm as contraception?

The benefits to using a contraceptive diaphragm as contraception include:

  • you only have to put it in before you want to have sex
  • you can use it more than once, and for up to 1 year
  • you are in control of your contraception
  • there are no hormones in a contraceptive diaphragm
  • it’s easy to look after
  • it’s up to 94% effective

What are the disadvantages of using a diaphragm as contraception?

Some disadvantages of using a contraceptive diaphragm as contraception include:

  • it takes practice to be able to use it as effective contraception
  • putting in your contraceptive diaphragm or reapplying spermicide can interrupt sex
  • it can take time for you to learn how to use it
  • it is not effective at preventing STIs
  • you or your partner can have an allergic reaction to the latex or spermicide in the contraceptive diaphragm
  • you can get a bladder infection when using the contraceptive diaphragm
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Medically reviewed by:
Dr Kathryn Basford

Dr Kathryn Basford is a qualified GP who works as a GP in London, as well as with ZAVA. She graduated from the University of Manchester and completed her GP training through Whipps Cross Hospital in London.

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Last reviewed: 06 Dec 2021

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