Diaphragms & Cervical Caps

Nowadays, women have a lot of birth control options available that are user friendly and effective. Among these, the diaphragm and the cervical cap are methods that have gained the trust of many women and have been found to be as effective as birth control pills as well as other contraception.

Diaphragm

A diaphragm is a dome shaped disc made of rubber that has a flexible body and rim. It is inserted into the vagina and covers the cervix to prevent sperm from entering the uterus. A spermicide is also put on the device for added protection.

Cervical Cap

A cervical cap is a thimble shaped flexible device that is made of latex and comparatively smaller than the diaphragm. It is also inserted into the vagina and sits securely on the cervix, blocking the entry of sperm. A spermicide put on the cervical cap acts as an additional measure to kill sperm.

Who Can Use Them?

As a contraceptive, diaphragms and cervical caps are both very easy to use, provided you are comfortable with putting them inside your vagina. They come in different sizes and are best for those who prefer not to use hormonal methods of birth control, such as depo provera. However, not all women are suited to the diaphragm or cervical cap. Issues that may make these contraception methods unsuitable are:

• Recent abortion or childbirth
• Difficulty inserting device
• Uncomfortable touching the genitals
• Allergic to latex, rubber or spermicide
• Recent surgery of the cervix
• Sagging uterus
• Vaginal obstructions
• Poor vaginal muscles

A diaphragm may also not be used if you have frequent urinary tract infections. Women, who have complained of reproductive tract infections, have cancer of the uterus, vulva or vagina or breaks in the vaginal tissue should also avoid using cervical caps as a contraception method.

Other kinds of birth control, like condoms should be used if you experience any vaginal bleeding, including menstruation.

Insertion

For a Diaphragm
A diaphragm must be inserted up to 6 hours before having sex. However, it is necessary to place spermicide on the inside of the bowl, as well as the edges, each time you have sex. In general, spermicide is effective for 2 hours; therefore it is best to put in the diaphragm up to 2 hours before intercourse. To insert a diaphragm:

• Wash hands with water and soap.
• Put spermicide onto the diaphragm not forgetting the edges
• Take a comfortable position by lying down, squatting, or raising one leg on a chair.
• Hold the diaphragm from its edges in such a way that it gets folded in half.
• With the other hand, separate the labia and push the diaphragm inside the vagina as far as possible.
• Ensure that the cervix is covered completely
• Leave the diaphragm in place for about six hours after intercourse
• If you repeat intercourse within this time, another application of spermicide is required
• Do not keep the diaphragm inside for more than 24 hours.

For a Cervical Cap
Inserting a cervical cap is similar to inserting a diaphragm, only in this case you may locate the position of the cervix first by using your index and middle fingers. Also, the cervical cap should be inserted in such a way that the long side enters first and then the dome. Furthermore, a cervical cap should remain in place for about 8 hours after intercourse and more spermicide needs to be applied each time you have sex.

The cervical cap should not be kept inside the vagina for more than 48 hours.

Removal

To remove a diaphragm, place a finger on top of the edge to break the suction and then slowly pull the device out. Make sure you wash your hands before and after removal. Cervical caps usually come with a removal strap. Grip the strap and rotate the cap, then push the dome to remove.

Whether you’re using a diaphragm or a cap, every time you remove it, it will need to be washed, rinsed, dried and then stored carefully. Never use oil-based lubricants, like baby oil, with either of these contraceptions as that may make the rubber brittle. It is also better to check the rim and the rubber each time you use it.

Because both contraceptives are held in place by your vaginal muscles, it may be necessary to change the size of your cervical cap or diaphragm after giving birth, having a miscarriage or an abortion. In general, both devices can be used for a period of two years before you need to replace them.

Effectiveness

Both the diaphragm and cervical are considered to be effective birth control with similar failure rates. With typical use of either device, 14 to 16 women out of 100 will become pregnant after a year of use. With perfect use, the diaphragm and cervical cap are thought to be more than 90% effective. To ensure efficacy of a device, it will need to be placed correctly over the cervix. Additionally, women who have given birth vaginally are more likely to have this type of contraceptive fail for them.

It usually takes a little practice to perfect the placement of these contraceptive devices. It is therefore a good idea to use a natural birth control method or a condom during this time to avoid conception. Cervical caps and diaphragms are also not effective in preventing transmission of sexually transmitted diseases (STDs). Therefore, using a condom along with a diaphragm or cervical cap will help reduce your risk of getting an STD, like chlamydia or HIV.

Side Effects

Most women find the use of diaphragms or cervical caps very comfortable. Possible birth control side effects may be due to allergic reactions to the rubber or the spermicide. Other side effects may be:

• Vaginal and skin irritation caused by the spermicide.
• Frequent bladder infection
• If the devices are left for too long, vaginal discharge may appear with a strong odour.
• Allergy towards latex, silicon or spermicide
• Pain or discomfort

Toxic shock syndrome is a rare complication that may occur due to the use of the cervical cap or diaphragm. Possible signs of the syndrome are rashes, diarrhoea, weakness, fatigue, sudden fever and vomiting. If you get any of these signs remove the device immediately and consult your doctor. Use other birth control methods in the meantime.

You should also go to the doctor if you get any of the following sensations while using one of these contraceptions:

• Redness or swelling of the vulva or vagina
• Discharge from the vagina
• Burning sensation while passing urine
• Irritation and itching on the genital area
• Discomfort every time you use the device
• Irregular spotting or bleeding

Advantages

Some of the benefits woman have noted to using the diaphragm or cervical cap include:

• Comfortable and easy to use
• Can be worn hours before intercourse
• Does not affect future fertility
• Easy to carry around
• Does not disturb the menstrual cycle
• Can be used during breastfeeding
• Generally not felt by either partner during intercourse

Disadvantages

Some of the reasons women prefer not use these contraceptive devices include"

• Do not protect against STDs
• Possible allergies
• May increase risk of bladder infections
• May get messy
• Sometimes secretion of unpleasant vaginal discharge and odour
• May be difficult to insert
• May get out of place during intercourse thereby failing its purpose
• Requires a fitting to be done in a clinic
• Can not be used during menstrual cycles

How do You Get Them?

A diaphragm or a cervical cap is generally used after consultation with a doctor. The doctor will first examines the pelvic area and suggest a particular size of the contraceptive for you. The first fitting may be done in the clinic itself to check if it properly covers the cervix. You may also need to change the size after an abortion, miscarriage, vaginal birth, or if you have lost or gained weight.

Once you know the size and type of device that your require, you can buy them from a fertility clinic or a pharmacy.

Costs

While the intial cost of a diaphragm or a cervical cap is more than some other types of birth control, in the long run these devices are more cost effective. Depending on where you obtain your diaphragm or cervical cap, it may cost you between £30 and £50, although it is possible to get them for less at some health clinics. Additionally, some types of insurance may cover some or all of the cost. Both the diaphragm and cervical cap will need to be replaced approximately every two years.