Diaphragm: how to use the contraceptive method, what are its advantages and risks

The diaphragm is considered a barrier method of contraception. The gynecologist and obstetrician Vander Guimarães Silva, professor at the Faculty of Medicine of Petrópolis (RJ), explains that it is a device made of latex or silicone, in the shape of a hood, whose edge is a flexible ring.

Before each intercourse, it must be inserted by the woman herself, after a previous evaluation consultation with the gynecologist, who will use measuring rings to determine the ideal size for each patient – a measure that must be reassessed after each delivery or weight gain/loss.

In the vagina, the device rests on the posterior cul-de-sac of the vagina, obstructing the cervix and preventing pregnancy from happening.

The professional explains better how the method works, lists its positive and negative points, as well as other important details for women who use the diaphragm.

How it works and who it is for

When placed in the vagina, usually associated with spermicide (placed in its concave part), the diaphragm occludes the external orifice of the cervix, making it difficult for sperm that have been released in the vagina by intercourse to ascend and reach the egg, preventing so fertilization.

As it is not a hormonal method, the diaphragm does not interfere with the menstrual cycle and can be used by women who have some restriction on the use of hormones. “All women who want to use a contraceptive method, with or without restriction to the use of hormonal methods, can use the diaphragm, as long as they do not have contraindications”, explains the gynecologist.

Diaphragm advantages and disadvantages

As with any contraceptive method, the diaphragm has advantages and disadvantages, which must be analyzed by each woman, together with her doctor, in order to reach a conclusion regarding its use. The gynecologist lists some:

Benefits:

• It is a non-hormonal method;
• It has low cost;
• Its effectiveness is reasonable;
• It does not present risks;
• Combination with spermicide may protect against cervical cancer.

Disadvantages:

• It requires the ability of the woman for its insertion;
• It should be placed before and removed after coitus, which can cause discomfort during intercourse;
• It needs a longer stay in the vaginal cavity after sex, which can generate some discomfort for some women;
• Its use during the menstrual period is not recommended;
• It does not protect women against STIs (Sexually Transmitted Infections).

According to the doctor Vander Guimarães Silva, the possibility of diaphragm failure and the risk of an unwanted pregnancy are rare and are usually associated with inability to insert and incorrect use.

How to use the diaphragm?

The gynecologist explains that the diaphragm should be placed in the vagina up to 2 hours before sexual intercourse and remain in place for 6 to 8 hours after. In case of successive intercourse, the spermicide must be reapplied. It lists the step by step:

• Initially urinate and wash your hands well;
• Apply the spermicidal jelly to the concave part of the device;
• Fold the diaphragm and insert it deep into the vagina;
• With the index finger, adjust the diaphragm ring on the edge of the pubic bone, which is presented on the anterior wall, at the bottom of the vagina.

Diaphragm vs IUD: which is better?

Each of the two methods has its advantages and disadvantages, with a patient profile indicated for its use. “With regard to effectiveness, the IUD presents slightly more satisfactory numbers, with rates of unwanted pregnancy of approximately 0.2 to 2 pregnancies/women/year of use”, says the doctor.

But it is worth remembering that this is not a choice that is only up to women. It is necessary to consult a gynecologist, who will indicate the most suitable method for each patient, after an individual evaluation.

Where to buy

The diaphragm can be purchased in physical stores that sell medical products or even online, in companies that do this same type of trade. Prices can vary between 150 and 200 reais per unit.

To buy, you must have a medical indication. “The gynecologist is the one who will define if this is a suitable method for your case, in addition to indicating the ideal size and guiding you on how to use it correctly”, he says.

Diaphragm in SUS

The doctor also explains that there are few Family Planning clinics linked to the SUS that offer this device as a contraceptive method. “Women who opt for a diaphragm usually have to seek private or health insurance to obtain it,” she says.

Contraindications of the contraceptive diaphragm

Despite having many advantages, the diaphragm cannot be used by all women. There are some contraindications, which, according to the gynecologist, are:

• Virgin patients;
• Presence of vaginal infections;
• Pelvic inflammatory disease;
• Women with anatomical alterations of the vaginal canal and uterine cervix;
• Latex allergy.

The diaphragm is not disposable and can be used for up to three years. Durability will depend on careful handling, correct hygiene and proper packaging after use. When used correctly, its effectiveness can range between 90 and 98%.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.