Diaphragm

Overview

The diaphragm is a small, flexible cup made of silicone inserted into the vagina, along with spermicide, before penis-in-vagina sex. The diaphragm covers the cervix, preventing sperm from entering the uterus and fertilizing an egg. The spermicide used with it makes sperm less able to move.

The diaphragm is reusable for up to two years, no matter how many times it is used during those two years. There are two kinds of diaphragms, a one-size-fits-most version, called Caya, and a type with multiple sizes available that has to be fitted by a provider, called Milex. The Milex diaphragm is shaped like a little bowl, and the newer Caya diaphragm is shallower and slightly curved. Caya also has a smaller, inverted dome attached to make it easier to insert and take out.

One super important thing to know is that for a diaphragm to work correctly to prevent pregnancy, it needs to be used with spermicide, which kills any sperm that make it past the rim of the diaphragm. A woman can use either over-the-counter spermicide or prescription-only spermicide (Phexxi).

Quick Facts

Pretty effective when used perfectly, can be put in hours before sex, and doesn’t affect hormones.

Effectiveness

The diaphragm (used with spermicide) is pretty effective the way most people use it.
Perfect use: 84% effective
Typical use: 83% effective
What are perfect use and typical use?

Hormones

The diaphragm is hormone-free.

Side effects

Irritation or urinary tract infections are possible.

Cost

Anywhere from $0 (with insurance) to $250, but can be used for up to two years. Extra cost for spermicide of about $1 per dose.

STI protection

The diaphragm doesn’t protect against STIs.

Ongoing Effort

Has to be put in place every time a woman is going to have penis-in-vagina sex and leave it in for six hours after. It can be left in for up to 24 hours, but she has to apply a new dose of spermicide before having sex each time.