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Method Barrier Effectiveness Between 84-94% Return to Fertility No delay Availability Prescription and initial fitting by a health professional required li a Sexual & ste e Quick Facts W The diaphragm sits inside the vagina and is inserted prior to having sex to prevent pregnancy. Health ve Diaphragms product i Re r n A u str a What is it? The diaphragm is a soft dome with a flexible rim made of silicone or latex which is placed inside the vagina to cover the cervix (opening of the uterus). Silicone diaphragms are currently the only type available in Australia. Diaphragms come in a range of different sizes. How does it work? Inserted prior to having sex, the diaphragm is held in place by the pelvic muscles and prevents sperm from entering the cervix. The diaphragm must be left in place for at least 6 hours after intercourse to allow all sperm to become inactive. How effective is it? The effectiveness of the diaphragm can vary greatly, but is generally lower than other methods of contraception. Effectiveness increases with experience, consistent use and correct fitting of the diaphragm. It is recommended that women use spermicide in conjunction with a diaphragm to increase its effectiveness, however spermicide is not currently readily available in Australia. Who can use a diaphragm? A diaphragm may be suitable for women who: • prefer an alternative to hormonal contraception or intrauterine contraceptive devices • accept that there is a higher risk of pregnancy • want to use contraception only when required A diaphragm may not be suitable for women who: • need highly effective protection against pregnancy • suffer from recurrent urinary tract and/or vaginal infections • have poor muscle tone in the pelvic floor area • have vaginal or uterine abnormalities or problems • are unable to insert the diaphragm or feel their cervix A diaphragm is not suitable for women who have a history of toxic shock syndrome. Getting a diaphragm fitted You will need to visit FPWA Sexual Health Services or a doctor who has been properly trained in fitting diaphragms to have your diaphragm correctly fitted. During the visit you will receive instruction on how to insert the diaphragm, how to check its correct position and how to remove it. Insertion and removal To insert your diaphragm: 1. Wash your hands carefully with soap and water. 2. If using spermicide, place one teaspoon on the side of the diaphragm that is in contact with the cervix. 3. While standing, squatting or lying down, squeeze the diaphragm so it is long and thin. Separate the vaginal lips with the other hand and insert, downwards and along the back wall of your vagina as far as it will go. The front rim tucks up behind the pubic bone just inside the opening to the vagina. 4. Check that it’s in the correct position by placing two fingers in your vagina and feeling the cervix (feels like the tip of your nose in the shape of a cherry or plum) through the dome of the diaphragm. 5. If the diaphragm is not in position, remove and try again. srhwa.com.au If your diaphragm has been properly fitted and is in the right position in the vagina you should be unaware of it. However, if your diaphragm is uncomfortable (for you or your partner), you feel it move during intercourse, you feel sore after using it, or you have urinary discomfort, see a doctor or FPWA clinician. You may need a different size or type, or need to look at an alternative method of contraception. Usually a diaphragm will last for about 2 years depending on how often it is used and how you care for it. You should have your diaphragm checked for size if you have a pregnancy, pelvic surgery or if your weight changes by more than 3kg. You may like to bring your diaphragm along to have the size checked when you have your routine Pap smear. Remember that a diaphragm must fit well and be in good condition to help prevent pregnancy. Caring for and checking your diaphragm After taking your diaphragm out wash it in warm water with mild soap. Rinse and dry thoroughly and store it in the plastic box provided, away from light and heat. Check it regularly for holes or tears by holding the diaphragm up to the light and stretching it gently between your fingers. Only use water-based lubricants with your diaphragm. If you wish to wear your diaphragm almost continuously (only removing it each day for cleaning), it is a good idea to have two diaphragms so that they can be alternated. SRHWA 70 Roe St, Northbridge, WA 6003 Ph 08 9227 6177 [email protected] © Family Planning Association of WA (Inc) October 2010 li a Sexual & Health ve It is best not to use your diaphragm when you have your period due to the small chance of infection occurring. However, if you choose to use your diaphragm during this time you should remove it as soon as possible after the minimum 6 hours. ste e The diaphragm needs to be left in place for at least 6 hours after sexual intercourse. If you wish it may be left longer, but should be removed once every 24 hours for cleaning. Continuous wearing of a diaphragm for more than 24 hours is not recommended – check the packaging instructions for more information as this can vary between different types of diaphragms. W Practicing safe sex reduces the risk of contracting HIV and other sexually transmissible infections (STIs) product i Re r n A u str a What are some of the advantages of diaphragms? • • • • A diaphragm does not interfere with hormone levels or the menstrual cycle It can be inserted at any convenient time prior to intercourse and need not interfere with sexual spontaneity It can be safely used by women who are breastfeeding Silicone diaphragms can be used by people who are allergic to latex What are some of the disadvantages of diaphragms? • • • • • Use of the diaphragm requires learning correct insertion techniques and initial fitting by a health professional You need to have the diaphragm with you at any time you have intercourse and insert it beforehand Some people are allergic to rubber (used in latex diaphragms) and spermicide The risk of pregnancy is higher than with some other methods of contraception Some women don’t feel comfortable feeling inside their vagina to check the diaphragm is in place What if I forget to use it? If you forget to insert your diaphragm before having sex, or take it out less than 6 hours after having sex, you can use the Emergency Contraceptive Pill (ECP) to reduce the risk of unplanned pregnancy. The ECP is available over the counter at pharmacies, so you don’t need to see a doctor to get a prescription. It is most effective at preventing pregnancy when taken within 24 hours of having sex (the sooner it is taken the more effective it is). There is some effectiveness for up to 120 hours (5 days) after intercourse, however effectiveness decreases as time passes and is significantly reduced 72 hours (3 days) after sex. Diaphragms do not protect against sexually transmissible infections (STIs). Quarry Health Centre for under 25s 170 Aberdeen St, Northbridge, WA 6003 Ph 08 9430 4544 [email protected] Sexual Health Helpline Metro 08 9227 6178 Country 1800 198 205 [email protected] srhwa.com.au