Diaphragm and caps

These are barrier contraception methods, which get fitted inside the vagina and prevent sperm passage into the cervix or womb.
Made from latex or silicone, diaphragms are bigger soft domes, while caps are smaller. For improved effectiveness, these are combined with spermicide, a chemical which kills sperm. If used correctly in combination, success rate is 92-96% in preventing pregnancy.
Suitability of diaphragms and caps
Diaphragms and caps and spermicides (in gel or cream form) are available over-the-counter (OTC) at local pharmacies. However, first time users should consult their GP to assess the right size of diaphragm or cap to fit the individual size and shape of vagina. One can even go for a ‘practice’ diaphragm to ensure the right size and suitability.
These can be used by most women, with the below exceptions
Unusual shape or position of cervix
Weak vaginal muscles which fail to hold diaphragm or cap in place
Allergy or sensitivity to latex or the spermicidal chemicals
If women has had toxic shock syndrome – a rare, life threatening bacterial infection
Repeated UTI’s (urinary tract infections in urethra, bladder or kidneys).
Existing vaginal infection, so one should wait till infection disappears
Multiple sexual partners, which increases risk of sexually transmitted diseases.
How and when to use diaphragm and caps
Diaphragm
It is similar to a small sized, brimmed shower cap, flexible enough to fit the vagina. Before using, one should wash hands, apply small amount of spermicide to cover all sides of diaphragm and then place it high up into the vagina to completely cover the cervix.
Caps
This resembles the tip of a condom and has a thick rim which keeps it in place. Before use, it is filled one-third with spermicide avoiding the rim. Wash hands and place the cap over the cervix to fit and stay in with suction. Do ensure that cervix is fully covered.
If fitted correctly, both partners would not feel it during intercourse.
The diaphragm or cap should be inserted upto 3 hours before intercourse and reapply spermicide if used for any more time. It should be left inside for at least 6 hours after intercourse and surely not beyond 30hours to avoid infections. In case one needs to bathe, showers are preferred to prevent dislodging or washing away of spermicide.
Removal of diaphragm or cap
This is easily done by hooking finger under the rim and pulling it out. It should then be washed with luke warm water and mild soap, rinsed thoroughly and left to dry and then stored in the small container provided. It can be reused upto a year before replacement. Do not boil or use detergent, disinfectant or talc to avoid damage. The required size of diaphragm or cap may change with weight gain or loss beyond 3 kg or with childbirth, miscarriage or abortion. It should not be used during periods as it can cause a potentially fatal bacterial infection called toxic shock syndrome (TSS).
Advantages of using Diaphragms and caps
Need to be used only during intercourse
Can be used just before intercourse and only need to reapply spermicide in case it stays on beyond 3 hours
Self protection and non dependence on sexual partner.
Disadvantages of diaphragms and caps
Effectiveness is not as good as other contraceptives
Protection against STD’s is only limited
Messy to use
Possibility of bladder infections called cystitis
Allergies or irritation to latex or spermicide in either of sexual partners