The Diaphragm
The
diaphragm is a flexible rubber dome which is placed at the top of the
vagina to cover the cervix. It comes in different sizes to ensure a good
fit, and it is available at any family planning clinic. A diaphragm is
used with spermicide to make it more effective.
How effective is the
diaphragm?
The
diaphragm is effective, but must be used correctly every time you have
sexual intercourse. For every 100 women who use it for a year, between 4
and 8 will become pregnant.
How does the diaphragm
work?
The
diaphragm acts as a barrier, preventing sperm from entering the woman’s
womb and so preventing fertilization. The spermicide increases the
effectiveness of the diaphragm by killing sperm.
What are the advantages
of the diaphragm?
·
You only have to use
it when you have sex
·
It has no serious
health risks
·
You are in control of
your contraceptive
·
You can put it in any
convenient time before you have sex
·
It may give you some
protection against cervical cancer and some sexually transmitted
infections
What are the
disadvantages of the diaphragm?
·
Putting
it in can interrupt sex
·
Some
people find the spermicide messy
·
It
can take time to learn how to put a diaphragm in correctly and easily
·
Some women who use the
diaphragm are more prone to infection of the
bladder
·
The rubber or
spermicide can cause an irritation in some women or their
partners. Using a different spemicide can help.
Can anyone use the diaphragm?
The
diaphragm is not suitable for everyone. It may be more suitable for
couples who:
·
Are well motivated to
avoid pregnancy
·
Have a stable
relationship
·
Where the woman is
over 35yrs
·
Have infrequent sexual
intercourse
It
is not suitable for women who:
·
Have vaginal muscles
which can’t hold a diaphragm
·
Have cervix of an
usual shape or awkward position
·
Are sensitive to
rubber or spermicide
·
Have repeated urinary
infections
·
Have a vaginal
infection
·
Have ever had toxic
shock syndrome
·
Do not feel
comfortable touching their vagina
How do I use the diaphragm?
Your
nurse or doctor will show you how to use your diaphragm. With clean hands,
put two strips of spermicide cream or jelly on each side of the diaphragm.
The strips need to be about 2cm long. Some women find putting a little
spermicide on the rim, makes the diaphragm easier to put in. Put your
index finger on top of the diaphragm and squeeze the diaphragm between
your thumb and other fingers. Slide the diaphragm into your vagina and
make sure that the diaphragm covers your cervix. You must check that you
feel your cervix covered by the rubber. The cervix feels like the end of
your nose.
If
it is not covered, take the diaphragm out by hooking your finger under the
rim and pulling downwards, and try putting in again.
You
might find it easier to insert the diaphragm lying down on your back. Some
women squat while they put in their diaphragm, or stand with one foot up
on a chair. You will need to find out which position is easiest for you.
If
the diaphragm is properly inserted, neither you nor your partner would
feel it’s presence. If you are going to have the intercourse 3 or more
hours after inserting the diaphragm, insert some more spermicide
in your vagina with an applicator or finger without removing the
diaphragm. The diaphragm should be left in place fro at least 6 hours
after sexual intercourse, to ensure that no live sperm remain in the
vagina. The diaphragm should not be left in the vagina more than 24-30
hours. Don’t wear your diaphragm for longer than 30hrs at a time because
of the risk of toxic shock syndrome.
How do I take my diaphragm out?
Take
it out by gently hooking your finger under the rim and
pulling downwards.
How do I look after the diaphragm?
When
you take the diaphragm out, wash it in warm water with a mild unperfumed
toilet or baby soap, then rinse it thoroughly. Dry
it carefully and keep it in it’s box in a dry cool place. Never
boil your diaphragm and never use talcum powder, disinfectant, detergent
or any oil-based product on it. Don’t scratch it with your nails or
jewellery. If your diaphragm goes out of shape, squeeze it gently back
into it’s circular shape. Your diaphragm may become discoloured with
time, but don’t worry as this will not make it less effective.
Can I
have a bath when I’ve got my diaphragm in?
Put
your diaphragm in after a bath rather than before. This is because water
may wash away the spermicide, or move the diaphragm. Have a shower rather
than a bath during the 6 hours that you need to keep your diaphragm in
after you have had sex.
Can I use my diaphragm during my period?
Yes.
If your period starts while your diaphragm is in place, it will collect
some blood in your vagina. Take your diaphragm out 6 hours after you had
sex and use a sanitary towel or tampon.
How often do I need to have my diaphragm checked?
You
should see a nurse or doctor every 6-12 months to check that your
diaphragm still fits. So unless you are going to have a smear test, put it
in before you go. They will give you a new diaphragm when you need one.
You nay need a different size diaphragm if you put or lose more than 3kg
in weight. You will probably also need a different size after you have a
baby, after you have a miscarriage or an abortion or after any
operation on your reproductive organs.
At your family planning clinic:
Feel
free to ask your nurse or doctor for further advice or information. It is
important that you attend your FP clinic regularly, keeping your
appointments as far as possible and asking for a new appointment if you
miss one.
Sexually Transmitted Diseases.
|
