A diaphragm is a reusable, non-hormonal birth control option - here's how it works

• A diaphragm is a silicone, cup-like object that you insert into your vagina to cover your cervix.
• Diaphragms must be used in conjunction with spermicide, which is a sperm-killing gel.
• A diaphragm has a failure rate of 17%, which is less effective than other forms of birth control.

Despite the fact that the diaphragm was invented in 1842, it's still a relevant birth control option for some people today.

Although modern options like the pill and IUDs are more effective, diaphragms can still be a good birth control option for people who want a non-hormonal option.

Here's what you need to know about how diaphragms work, as well as their advantages and disadvantages.

What is a diaphragm?

A diaphragm is a silicone device shaped like a shallow cup. It's about three inches in diameter and has a thick rim along the outside.

Note: Diaphragms are not one size fits all and must be fitted for you by a healthcare provider. See your gynecologist to discuss getting a diaphragm.

You insert the diaphragm into your vagina and it covers your cervix, which creates a physical barrier against sperm.

Diaphragms are typically 94% effective if you use them perfectly, but in reality they end up being about 88% effective- meaning that about 12 out of 100 people who use a diaphragm will get pregnant each year.

However, you can increase the effectiveness of a diaphragm by using spermicide. Spermicide is a gel that contains chemicals which are meant to kill sperm or stop it from moving up through the vagina toward a potential egg. Using spermicide along with the diaphragm makes it far more effective. It is not recommended to use a diaphragm without spermicide.

How to use a diaphragm

Diaphragms are hard to come by in drug stores, so your best bet of getting one is to schedule a visit with your healthcare provider. They can fit you with the right size as well as teach you how to insert it correctly.

Quick tip: You should plan to insert the diaphragm around two hours prior to sex. If you wait longer than two hours, the spermicide will not be as effective.

Here's how to insert a diaphragm according to Sarah Yamaguchi, MD, FACOG, Board-Certified Gynecologist at DTLA Gynecology:

1. Place spermicide in the diaphragm and along its rim.
2. Fold the diaphragm in half.
3. With one hand, spread open your vagina and with the other hand, insert the diaphragm with the side containing spermicide up.
4. Push the diaphragm as far up and back as it will go.
5. Push the front rim behind the pubic bone to ensure it stays in place.

After sex, it's important that you leave the diaphragm in place for at least six hours.

"This is because the sperm is in the vagina and so if you take it out early, then the sperm can get into the cervix," says Yamaguchi.

However, do not leave it in for more than 24 hours. If you have sex again within this time period, you will need to insert more spermicide into your vagina, but keep the diaphragm in.

When you're ready to remove your diaphragm, hook one finger under the front rim and pull it straight down and out.

Wash it with soap and water after each use and store it in its case in a cool and dry place.

Pros of diaphragms

• Diaphragms are non-hormonal: Some people choose to avoid introducing extra hormones into their bodies as a personal choice or because they experience side effects. .
• You only use a diaphragm when you need it: Unlike birth control pills which need to be taken every day or IUDs that are inserted and left in for a few years, you only use a diaphragm when you're planning to have penetrative sex.
• Your partner can't feel it: During sex, your partner shouldn't be able to feel the diaphragm.
• It's reusable: Unlike other barrier methods such as condoms which are single use, diaphragms are reusable. In fact, it can last up to two years.

Cons of diaphragms

• There's a relatively high failure rate: Compared to other types of more reliable birth control, diaphragms are more likely to fail at preventing pregnancy. Diaphragms have a failure rate of 17%, the pill has a failure rate of 7%, and an IUD has less than a 1% failure rate.
• It doesn't protect against STIs: For STI protection, you must use a condom along with the diaphragm.
• It increases your risk of infections and irritation: Since a diaphragm must be used with spermicide, you run the risk of infections since spermicides may disrupt your vagina's pH and cause UTIs, as well as overall vaginal irritation.

Insider's takeaway

Related Article Module: What everyone should know about birth control, from the types to effectiveness

When it comes to birth control, it's your body and your choice.

Ultimately, you should pick the type of birth control that works best for you after you're educated on all of the different options.

If you need help deciding which birth control is the right choice, don't hesitate to contact your OB-GYN.

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