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How
does it work?
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The
diaphragm is a small, dome-shaped rubber shield that sits over
the cervix and rests on the pubic bone. The diaphragm works
by keeping sperm from entering the cervix and going into the
uterus. It does this with the help of spermicidal jelly or cream.
It MUST be used with a spermicidal jelly or cream! Think of
it as a spermicide holder. |
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How
do I use it?
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Spermicide
is put inside the bowl of the diaphragm and around the edges.
A good tablespoon size works well. Spread it all over the diaphragm
and also around the rim. The diaphragm is folded in half and
inserted into the vagina, high enough so it is covering the
cervix. ALWAYS, check with your finger and feel that the latex
of the diaphragm is covering the cervix. The cervix will fell
like the tip of your nose.
The diaphragm must be
placed into the vagina before sex and left in place for 6
to 8 hours after sex. It can be inserted right before and
up to an hour before sex. More spermicide must be used for
any additional time you have sex while wearing the diaphragm.
Use the applicator to insert more spermicide, if you have
intercourse again.
DO NOT remove the diaphragm
to insert more. The diaphragm is removed by placing a finger
into the vagina to pull it out. The diaphragm must be washed,
rinsed, dried, then stored in its case after use. It should
never touch petroleum jelly or baby oil, since these substances
can cause the rubber to break down. Be sure your health care
provider shows you how to properly insert it and you show
him/her or the nurse that you can do it properly before you
leave their office.
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Pros
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Very
effective method when used correctly. Can be inserted up to
2 hours before intercourse, so it doesn't interrupt sex as much
as other barrier methods. Less expensive per month than the
pill. |
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Cons
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Condoms
should be used with a diaphragm & spermicide when you are
not with the same partner who has been tested for HIV. You must
be properly "fitted" by a health care professional.
A prescription to buy one is required. (Some clinics will have
them for sale after you are "sized"). A diaphragm
needs to be replaced about every two years. |
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Effectiveness
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Perfect-use
failure rate 2%
Typical failure rate 18% |
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Side
Effects
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Spermicides
may irritate or cause an allergic reaction in the vagina. Any
irritation should go away after you stop using it. Try another
brand of spermicide if you get a rash from one, you may be allergic
to the fragrance. If you have gained or lost 10 pounds have
the "size" checked by a health care provider. People
who are allergic to latex may have a reaction to the diaphragm,
but this is rare. |
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Examples
of Misconceptions
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A
diaphragm properly fitted by a doctor will not be painful to
insert. The rim is a flexible rubber-covered spring which will
not hurt the vagina or the penis during intercourse. It passes
easily through the vaginal opening. Once in place, it conforms
to the internal shape of the vagina and doesn't constrict the
urinary passage or the rectum. When properly fitted and placed,
the woman is unaware of it and can urinate normally.
"It is safe to
remove the diaphragm immediately after intercourse."
"It is not necessary
to use spermicidal jelly with the diaphragm." Way wrong!
It is not safe to remove the diaphragm immediately after intercourse.
For maximum effectiveness, it should be left in place for
at least six hours after the last ejaculation. If it is removed
before that time, viable sperm remaining in the vagina may
cause conception. Since the normal vaginal environment is
hostile to sperm, the longer the sperm remain in the vagina
and are unable to pass into the cervix, the greater the likelihood
that they will be destroyed. If spermicidal jelly is used
along with the diaphragm, the effectiveness of the diaphragm
is increased. During sexual excitement and intercourse, the
vagina changes shape. This may cause the diaphragm to slip
or to become dislodged allowing sperm to reach the cervix.
If spermicidal jelly has been used, any sperm reaching the
cervix will likely be destroyed. If intercourse is repeated
later, the diaphragm should be left in place and another applicator-full
of jelly (cream or foam) inserted prior to intercourse. With
the passage of time, the original jelly loses its effectiveness.
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