diaphragm contraceptive

Introduction

Molded natural rubber dome with a flexible rim that fits into the vagina & covers the opening of the cervix. It functions as a mechanical barrier to sperm & as a support for spermicide. Effective use of a diaphragm requires use in conjunction with a spermicidal agent & leaving in place for at least 6 hours. If intercourse occurs more than once in 6 hours, spermicidal agent should be reapplied leaving the diaphragm in place.

Effectiveness of a properly fitted & used diaphragm is 95%.

Sizes:

• range from 5.5-10.5 cm in 0.5 cm increments
• 7.0-7.5 cm most common
• check size every 2 years & after pregnancy, pelvic surgery or weight gain of > 25% of body weight

They differ in the type of spring mechanism used in the construction of the rim.

Types of springs

• arching spring diaphragm
  • most commonly used
  • easiest to use
• coil spring diaphragm
• flat spring diaphragm

The proper fit is the largest size diaphragm that covers the cervix & fits snuggly between the posterior vaginal fornix & the pubic symphysis without causing discomfort. It should be easy to remove by inserting the forefinger under the anterior rim.

Indications

• contraception

Contraindications

• immediate post-partum period
  • fit may change during postpartum period rendering contraception less effective

Adverse effects

• minimal
• allergy to rubber or spermicidal agent
• increased incidence of urinary tract infections
• pelvic discomfort
• inconvenience

More general terms

• contraceptive

Additional terms

• spermicidal agent