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Diaphragm birth control is a type of birth control where you place a diaphragm (a silicone or latex dome-shaped device) inside the vagina before sex to prevent pregnancy. Diaphragms are a type of barrier method of birth control, meaning they work by preventing sperm from reaching and fertilizing an egg. It’s often used in tandem with spermicide—a topical contraceptive that kills sperm.
Diaphragms appeal to many people for their convenience and lack of hormones. However, they are less effective at preventing pregnancy than other methods of birth control and don’t protect against sexually transmitted infections (STIs). The use of diaphragms with spermicide results in pregnancy about 17% of the time, making them about 83% effective at preventing pregnancy.
Diaphragms are dome-shaped devices constructed of either latex or silicone. Spermicide is added to the diaphragm before use. The rim of the diaphragm is flexible so that the diaphragm can be folded and inserted into the vagina. Once inside, the diaphragm unfolds and then creates a barrier over the cervix so that sperm can’t enter the cervix and cause a pregnancy.
Diaphragms aren’t the only type of birth control barrier method. Other examples of barrier methods include male condoms, female condoms, cervical caps, and sponges.
Each type of birth control has positives and negatives. What might work for one person might not work for another. Comparing the pros and cons of diaphragm birth control might help you decide if it’s right for you.
Pros
Oral birth control pills (“the pill”) and female sterilization are the most used birth control methods by women in the United States, but those methods are not best for everyone. Some people are drawn to the diaphragm when they want to avoid some of the side effects of hormonal birth control, like weight gain and mood changes. Others don’t want to use a method that causes infertility, like sterilization.
Many people also like diaphragms because you administer them yourself. Also, you can insert the diaphragm two hours before sex so it won’t break the mood of sexual encounters.
Cons
Diaphragms are not without drawbacks. The biggest one is that diaphragms have a lower effective rate than other popular birth control methods. For example, hormonal birth control pills are about 93% effective, whereas diaphragms are about 83% effective. Another significant drawback is that diaphragms don’t protect against sexually transmitted diseases (STDs).
Some people find aspects of using a diaphragm to be inconvenient. For instance, you have to remember to use one each time you have intercourse. Also, spermicide can get messy, and the diaphragm needs to be cleaned and stored correctly. There is an increased risk of urinary tract infections while using a diaphragm, which causes some people to stop using them.
| PROS | CONS |
| Avoids effects of hormonal birth control | Less effective at preventing pregnancy than hormonal methods |
| Provides temporary birth control (Doesn’t cause infertility like sterilization) | Doesn’t protect against STDs |
| Self-administered | Can be messy to use (with spermicide) |
| Can be inserted two hours before sex | Must be used each time you have intercourse |
| Easy to store and reusable | Increased risk of UTIs |
You need to visit your healthcare provider and get a prescription to get a diaphragm. Some diaphragms come in multiple sizes, so your provider must find the right fit for you. Other diaphragms are one-size-fits-all but still require a prescription. Diaphragms also need to be refitted if you lose or gain a significant amount of weight, have surgery, or give birth.
Your provider will discuss how to use your diaphragm and show you how to use it. Here are some general steps to follow to use your diaphragm:
- Apply spermicide inside the dome of the diaphragm and around the rim before insertion
- Insert the diaphragm by pinching the device between your fingers and gently guiding it into your vagina
- Let the diaphragm unfold: The concave side of the dome with spermicide in it will face your cervix, creating a barrier against the back of your vagina, and the front rim of the diaphragm should rest behind your pubic bone.
- Feel inside your vagina to make sure your cervix—which is a small nub that feels like the tip of your nose—is covered completely by the diaphragm
- Recheck the placement of the diaphragm after sex to make sure it didn’t move during intercourse
- Leave the diaphragm inside for at least six hours after sex, and don’t leave it in more than 24 hours
You can have sex more than once while the diaphragm is inserted. However, it’s recommended to apply more spermicide in the back of the vagina, without moving the diaphragm, before having sex again. If you have sex more than once, wait six more hours before removing the diaphragm.
When you are done using the diaphragm, keep these tips in mind:
- Remove the diaphragm from your vagina by using a finger to gently pull the rim toward you and then guide it out of your vagina
- Wash the diaphragm with soap and water after use, dry it completely, and then place it in its case
- Check your diaphragm frequently for wear and tear and holes
- Replace the diaphragm every two years
While diaphragms don’t typically cause serious side effects, there are some possible side effects. These include:
- Vaginal burning and irritation
- Allergic reaction, if you are allergic to latex
- Increased risk of urinary tract infections
- Vaginal pain or itching
- Vaginal infection
- Cervical infection or irritation
If a diaphragm is left in longer than the instructions recommend, you can experience toxic shock syndrome, which can be life-threatening. People with a history of toxic shock syndrome should not use diaphragms. If you or your partner may have STIs, do not use a diaphragm on its own, as it won’t protect you from STIs. You can combine a diaphragm with the use of a condom in this case.
The birth control method most similar to diaphragms is cervical caps. These are also inserted into the vagina and filled with spermicide to create a barrier against the entry of sperm.
Cervical caps are made of rubber, so they may be better for people with allergies to latex or who don’t want to use birth control made of silicone. The caps can also be left inside the vagina for 48 hours, as opposed to 24 hours for the diaphragm. However, diaphragms are slightly more effective than cervical caps, with a failure rate of 17% compared to 23% for cervical caps.
Condoms are another barrier method. They’re more effective at preventing pregnancy than diaphragms, with a 13% failure rate. They also protect against STIs, while diaphragms do not. However, many people like that they can insert a diaphragm two hours before intercourse rather than needing to put on a condom right before penetration. Diaphragms may also increase pleasure, as they allow more skin-on-skin contact than condoms.
Finally, many people consider whether to use diaphragms vs. hormonal birth control methods. Hormonal birth control methods are much more effective than diaphragms, with the pill ranging between 93-99% effective, as opposed to 83% efficacy for the diaphragm. However, hormonal methods can also cause more unpleasant physical symptoms, such as moodiness, weight gain, headaches, breast tenderness, menstrual changes, and nausea.
Diaphragms are a type of barrier birth control that prevents sperm from entering the body and fertilizing an egg.
While diaphragms can be a good choice for people who want to avoid some of the side effects of hormonal birth control or who don’t like the inconvenience of condoms, the device has some drawbacks. They have a lower effectiveness rate than other forms of birth control, can increase the risk of UTIs, and don’t protect against STIs.
If you are interested in using a diaphragm, you should contact your healthcare provider for more information and to help you decide if it’s the best choice for you.