Diaphragms and caps

Inserting a rubbery cup into your vagina may be an age-old method of contraception, but how effective is it? And isn’t it a bit messy? We bring you up to speed on diaphragms and caps.

Is a diaphragm the right contraception for you?

What are they?

Diaphragms are circular domes (about the size of your palm) made of thin soft rubber or silicone with a springy, flexible rim. Caps are smaller (about the size of an egg-cup), are more rigid and made of latex or silicone. Both fit inside the vagina and cover the cervix, stopping sperm from getting inside the womb. It’s 92-96% effective in protecting against pregnancy (when used correctly, and with a spermicide).

Are they all the same size?

No. Because vaginas come in all shapes and sizes diaphragms and caps do too. Your GP or nurse at the family planning clinic will ‘assess your vagina’ before prescribing the perfect one for you.

How easy are diaphragms to fit?

The first time you use a diaphragm or cap you must get it fitted by a doctor or nurse at the family planning clinic. It will take a bit of practice to get the position right, but won’t take long before it becomes as familiar as inserting a tampon. Here’s what you have to do:

• Put a dollop of spermicide in the middle and around the rim – this is essential as effectiveness is reduced without it, and yes, it is a bit messy
• Get into a position – this can be squatting, lying down or one leg up
• Press the rim together and push into the vagina as far as it goes
• Using your fingers, feel that it has covered the cervix – it should feel like the tip of your nose
• If it feels uncomfortable, take it out and try again

Neither partner should be able to feel it during sex.

When should I put it in?

It can be inserted up to three hours before sex (if inserted more than three hours before you will need to use more spermicide) and should be kept in place at least six hours after having sex (but no longer than 30 hours).

You can also use it if you’re feeling horny during your period but your partner’s squeamish about the sight of blood, as there’s usually no sign of a period with a diaphragm in place.

How do I get a diaphragm back out again?

Simply hook your fingertip round it – your GP or nurse will show you how do this.

I hate the pill

If you don’t get on with the pill because it messes with your hormones, a diaphragm or cap is a good option. It won’t affect your the menstrual cycle, cause bloating, spots or mood swings. It may also protect against cervical cancer.

My boyfriend hates condoms

Unless both of you have been tested for STIs and have the all-clear he’ll still need to wear a condom. Even if you’re both clear of STIs, it’s best to stick with condoms until you become a pro at inserting your diaphragm or cap.

Are there any risks?

Cystitis can be a problem for some users, but not all.

Can I use a diaphragm or cap?

Most women can use a diaphragm or cap, however it’s not recommended if you:

• Have poor muscle tone in the vaginal area, (the diaphragm is partly held in place by the vaginal muscles)
• Are sensitive to rubber or spermicide – same for your partner
• Suffer from severe and frequent cystitis
• Have had toxic shock syndrome

Photo of a diaphragm by Heidi.