Diaphragms are not widely available in Canada. Buying the necessary spermicidal jelly to use with the diaphragm is difficult.
The diaphragm is a barrier method of birth control. It is a round, dome-shaped device made of rubber that has a firm, flexible rim. The only diaphragm currently available in Canada is made of non-latex silicone. It fits inside a woman's vagina and covers the cervix. It should always be used with a sperm-killing cream or jelly (spermicide).
A woman inserts her diaphragm no sooner than 6 hours before having sexual intercourse. To be effective, it must be used with a spermicide. The diaphragm must be left in place for 6 hours after intercourse and can be left in place up to 24 hours.
Diaphragms come in different sizes, so you must visit a health professional to be fitted and get a prescription for the right size and type of diaphragm. At this visit, you will be taught how to use and care for the diaphragm. A return visit with the diaphragm already in place is usually needed to be certain that you are using it correctly.
You will need to be refitted for the right size of diaphragm after:
Pregnancy. Pregnancy and childbirth can change the size of the cervix or vagina.
Major weight gain or loss.
A small weight gain or loss or a therapeutic abortion usually does not require a new diaphragm size.
Replace your diaphragm every 1 to 2 years to avoid an unintended pregnancy. With time and repeated use, small holes can form in the rubber or silicone. Rubber can also weaken over time and tear more easily.
Effectiveness in preventing pregnancy
On average, the diaphragm user failure rate is 12%. This means that 12 women in 100 become pregnant in the first year of typical use. Not using the diaphragm with every act of intercourse is the most common reason for failure. The "perfect use" failure rate is 6%, with a pregnancy in 6 of every 100 women who carefully use the diaphragm every time they have sex.footnote 1
Effectiveness in preventing sexually transmitted infections (STIs)
Women who use diaphragms may get more bladder infections (urinary tract infections, or UTIs). This is probably because the rim of the diaphragm presses on the urethra and may irritate it. A woman who gets frequent UTIs may need a smaller diaphragm or may prefer not to use the diaphragm.
Some people are embarrassed to use this method or feel the method interrupts foreplay or intercourse.
A couple must be comfortable with using the diaphragm and be prepared to use it every time they have sex.
A rubber diaphragm can't be used if either person is allergic to latex.
It is important to check your diaphragm for any cracks, holes, or other damage that would reduce its effectiveness. Do not use any petroleum-based vaginal creams, oils, or ointments, which can damage the rubber. But water-based personal lubricants, such as Astroglide and K-Y Jelly, are safe to use.
Trussell J, Guthrie KA (2011). Choosing a contraceptive: Efficacy, safety, and personal considerations. In RA Hatcher et al., eds., Contraceptive Technology, 20th ed., pp. 45–74. Atlanta: Ardent Media.
Current as of:
February 11, 2020
Author: Healthwise Staff Medical Review: Sarah Marshall MD - Family Medicine Anne C. Poinier MD - Internal Medicine Adam Husney MD - Family Medicine Kathleen Romito MD - Family Medicine Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology Rebecca Sue Uranga
Medical Review:Sarah Marshall MD - Family Medicine & Anne C. Poinier MD - Internal Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology & Rebecca Sue Uranga
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