DIAPHRAGM How They Work


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

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,
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     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[PageUp: b]