DIAPHRAGM How They Work

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DIAPHRAGM

How They Work

The diaphragm is a dome-shaped rubber cup with a flexible rim. It is
inserted into the vagina prior to intercourse and covers the cervix.
Spermicidal cream or jelly is placed on the dome before insertion.

Effectiveness

A failure rate for the diaphragm in actual use in the population is
seventeen pregnancies per one hundred women per year. Some studies
have indicated fewer failures than this. Most failures are due to
inconsistent and improper use of the diaphragm.

Contraindications

1. Allergy to rubber.
2. Repeated urinary tract infections.
3. Abnormalities such as uterine prolapse, cystocele, rectocele,
etc.
4. Inadequate vaginal muscle tone.
5. Inability to learn correct insertion technique.
6. History of toxic shock syndrome.

Side Effects

1. Toxic shock syndrome may occur.
2. Recurrent cystitis due to upward pressure of the rim of diaphragm
against the urethra.
3. Allergic reaction to rubber or spermicide.
4. Vaginal discharge may occur if diaphragm is left in the vagina
too long.
5. Pelvic discomfort, cramps or pressure on the bladder or rectum
can occur.

Use of Diaphragm

1. To apply contraceptive jelly or contraceptive cream: Hold the
diaphragm with the dome down (like a cup). Squeeze the jelly or
cream from the tube into the dome (use about one tablespoon);
spread a little bit around the rim of the diaphragm with your
finger.

2. To insert your diaphragm: With one hand, hold the diaphragm so
that the cup/dome full of spermicide is facing toward your palm.
Press the opposite sides of the rim together so that the
diaphragm folds. Spread the lips of your vagina with your other
hand and insert the folded diaphragm into your vagina. This can
be done standing with one foot propped up (on the edge of a
bathtub or toilet), squatting or lying on your back. Push the
diaphragm downward and back along the back wall of your vagina as
far as it will go. Then ^L

tuck the front rim up along the roof of your vagina behind your
pubic bone. Once it is in place properly, you should not be able
to feel the diaphragm except, of course, with your fingers. If
it is uncomfortable or otherwise noticeable, then it is probably
not in correct
position; take it out and re-insert it.

3. To check the placement of your diaphragm: When it is correctly
placed, the back rim of the diaphragm is below and behind the
cervix, and the front edge of the rim is tucked up behind the
pubic bone. Often it is not possible to feel the back rim. You
should check to be sure that you can feel your cervix covered by
the soft rubber dome of the diaphragm and that the front rim is
snugly in place behind your pubic bone. The spermicidal cream
(inside the dome of the diaphragm) should be next to your cervix.

4. Do not use Vaseline or other petroleum products when you are
using your diaphragm, as these may corrode the diaphragm. If you
need extra lubrication, use contraceptive jelly.

5. After intercourse, leave the diaphragm in place at least six
hours, then remove it as soon as it is convenient for you. If
you have intercourse more than once, add an additional
application of contraceptive cream or jelly each time.

6. To remove the diaphragm: Place your index finger behind the
front rim of the diaphragm and pull down and out. Be careful not
to puncture the diaphragm with a fingernail. If you find it hard
to hook your finger behind the diaphragm, try a squatting
position and push downward with your abdominal muscles. In other
words, bear down as though you were having a bowel movement.
Some women find it easier to remove the diaphragm by inserting a
finger between the diaphragm and the pubic bone to break the
suction created by the diaphragm in contact with the vaginal
wall. Practice inserting, checking the position of, and removing
the diaphragm frequently during the first weeks until you can do
so easily and confidently.

7. When you remove the diaphragm, wash it with mild soap and water,
rinse it and dry it with a towel. Store it in its plastic
container. Do not use talcum powder or perfumed powder--they may
damage the diaphragm or may be irritating to your vagina or
cervix.

8. Check your diaphragm for tears or holes each time you use it.
Hold it up to the light and stretch the dome slightly with your
fingers to check for defects in the rubber.

9. Your diaphragm should not interfere with normal activities.
Urination or a bowel movement should not affect its position, but
you can check its placement afterwards if you wish. It is fine
to shower or bathe with the diaphragm in place.

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DIAPHRAGM

How They Work

Effectiveness

Contraindications

1. Allergy to rubber.
2. Repeated urinary tract infections.
3. Abnormalities such as uterine prolapse, cystocele, rectocele,
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etc.
4. Inadequate vaginal muscle tone.
5. Inability to learn correct insertion technique.
6. History of toxic shock syndrome.
[K
Side Effects[K
[K
1. Toxic shock syndrome may occur.
2. Recurrent cystitis due to upward pressure of the rim of diaphragm
against the urethra.
3. Allergic reaction to rubber or spermicide.[K
4. Vaginal discharge may occur if diaphragm is left in the vagina
too long. [K
5. Pelvic discomfort, cramps or pressure on the bladder or rectum
can occur.
[K
Use of Diaphragm
[K
1. To apply contraceptive jelly or contraceptive cream: Hold the
diaphragm with the dome down (like a cup). Squeeze the jelly or[24;42H[PageUp: b][1;80H