Questions, answers and facts about the diaphragm.
The diaphragm is a dome made of silicone that you fill with a spermicidal jelly and put inside your vagina to prevent pregnancy.
Useful tip: Spermicidal jelly is not currently sold in Canada. You will need to order it from an online pharmacy or travel to the US to buy it.
How and where can I get a diaphragm?
- If you decide, along with your clinician, that the diaphragm is right for you, your clinician will refer you to a clinic that fits diaphragms.
- It can be difficult to find a clinician who is trained to fit diaphragms. It can also be difficult to find a pharmacy that carries or can order diaphragms. The Bay Centre for Birth Control both fits diaphragms and sells them for approximately $55. Call 416-351-3700.
- At the fitting, the clinician will do a pelvic exam, fit you for the proper size, and teach you how to insert a diaphragm properly. The clinician will write you a prescription for a diaphragm.
- Spermicidal jelly is not currently sold in Canada. You will need to order it from an online pharmacy or travel to the US to buy it. It costs approximately $15-18 per tube. One 3-4 ounce tube will last for 10-11 uses with a diaphragm.
If you are worried about inserting the diaphragm correctly, your health care provider will teach you how to properly insert it when you are fitted.
How does the diaphragm prevent pregnancy?
- The diaphragm blocks the entrance to the cervix so that sperm cannot enter the uterus and fertilize an egg.
- The diaphragm also contains a spermicide which kills sperm on contact.
Can I trust the diaphragm?
- When used perfectly, the diaphragm works 96% of the time. This means that if 100 people use a diaphragm for one year, only four people will get pregnant.
- Because the diaphragm may be used incorrectly, it is closer to 80% effective with typical use.
Before using your diaphragm, hold it up to the light and check for cracks or holes. You can also fill it with water to see if there are any leaks. If you discover any leaks, throw it away and use another form of birth control until you get a new diaphragm.
How do I use the diaphragm?
- You can insert the diaphragm up to 6 hours before you plan to have sex. After six hours you will need to add more spermicide into the vagina before having sex.
- Add about one tablespoon of spermicidal jelly to the hollow part of the diaphragm and along the rim. Use spermicidal jelly (spermicidal foam or film will not be as effective).
- Find a comfortable position. You may want to squat, put a foot up on a chair, or lie on your back.
- With the spermicide-filled dome facing down, fold two of the diaphragm’s sides together.
- Insert the diaphragm deep into your vagina and push it against your pubic bone. Then use one or two fingers to move it over your cervix. You should not feel the diaphragm once it has been inserted.
- The diaphragm works immediately after you insert it.
- For each additional act of vaginal sex, insert more spermicide into the vagina (without removing the diaphragm) using the applicator that comes with the spermicide.
- Leave the diaphragm in place for 6 hours after your last act of vaginal sex but not more than 30 hours in total.
- To remove the diaphragm, reach into your vagina with a finger and pull on the edge of the diaphragm.
- There is no risk of the diaphragm getting lost in your vagina. If you have trouble reaching it, try squatting to bring it closer to your vaginal opening or asking a partner to remove it.
- If you have a physical disability, you may need your support person or partner to help you insert the diaphragm.
- The diaphragm will last for up to 2 years. However, if you have given birth vaginally, had pelvic surgery (including abortion) or had a change in weight of 10 pounds (4kg) or more since you were last fitted, you will need to be refitted for a new diaphragm.
Practice finding your cervix before using the diaphragm. Your cervix is located at the top of your vagina and should feel a bit like the tip of your nose
What are the side effects of the diaphragm?
- The spermicide used in your diaphragm may cause irritation to your vagina or your partner’s penis, causing burning or itching.
- The diaphragm can also lead to vaginal infections like yeast or bacterial vaginosis (BV), especially if it’s left in for too long.
- The diaphragm can increase your risk of urinary tract infections (UTIs).
- In rare cases, the diaphragm can cause an allergic reaction and in extremely rare instances, it can cause Toxic Shock Syndrome (TSS).
What are the pros and cons of the diaphragm?
- You only have to use the diaphragm when you have sex.
- You are protected for multiple acts of vaginal sex within a 24 hour period if you add new spermicide for each act.
- There are no hormonal side effects. People who can’t or do not want to take hormonal birth control can use this method.
- It doesn’t affect your ability to get pregnant in the future.
- Your partner(s) doesn’t have to be involved and shouldn’t be able to feel it.
- You can easily carry it with you.
- Depending on how often you use it, the diaphragm may be cheaper than other forms of birth control.
- Spermicidal jelly is not available in Canada and you will have to order it online or buy it in the US.
- You will need to be comfortable inserting the diaphragm into your vagina.
- You will have to plan to insert the diaphragm before having sex.
- You have to remember to leave it in for 6 hours after the last act of vaginal sex before you can take it out. This may mean you have to wake up in the night to take the diaphragm out on time.
- You could forget to take it out.
- The diaphragm does not protect you from STIs.
- The spermicide used in your diaphragm may irritate your vagina, which can make getting some STIs more likely if you have sex with a partner who has an STI.
- You or your partner may experience side effects (see above).
- Practice finding your cervix before using the diaphragm. Your cervix is located at the top of your vagina and should feel a bit like the tip of your nose.
- There is no risk of the sponge diaphragm lost in your vagina. If you have trouble reaching it with your fingers, try squatting to bring it closer to your vaginal opening or asking your partner to remove it.
Download Planned Parenthood Toronto’s info pamphlet on this subject: Diaphragms