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Choosing Your Contraceptive: The Modern Diaphragm Pros & Cons

October 13, 2022

Which contraceptive method are you using? Have you explored all of your options? According to the CDC, there are currently six categories of preventative birth control. They include:

  1. Intrauterine (IUD)
  2. Hormonal (Implant, injection, pill, patch, and ring)
  3. Barrier methods (condoms, diaphragm, cervical cap, and spermicides)
  4. Fertility awareness (calendar tracking)
  5. Lactational Amenorrhea (while breastfeeding)
  6. Permanent sterilization (tubal ligation or vasectomy)

Whether you’re shopping around for a new birth control method—or you’re just curious about what else is out there, it’s important to learn about the pros and cons of each type of contraception. One of the lesser-known barrier methods that’s making a recent comeback is the diaphragm. Here, we’ll give you the facts about using a diaphragm for birth control—the good and the bad, so that you can decide if it’s right for you.

Proponents for the Diaphragm Contraceptive Option

There are many benefits to choosing a barrier method for birth control. By checking out the pros listed here, you can see what your sex life would look like if you switch to a diaphragm.

#1 Diaphragms are Non-Hormonal

Diaphragms are a barrier method. Unlike hormonal birth control methods, diaphragms do not contain any hormone-altering chemicals. Diaphragms simply work by physically blocking sperm at the cervix (along with spermicide, which kills sperm at the cervix).

Why is non-hormonal a good thing in birth control? Because it doesn’t alter your body’s natural hormone levels. Hormonal birth control is known to cause unintended side effects for many women, including headaches, weight gain, irregular periods, changes in mood, decreased libido, acne, and nausea. With diaphragms, none of these side effects exist. The only side effects when using diaphragms are limited to an increased risk of urinary tract infections (UTI) or vaginal irritation in some women.

Because diaphragms are non-hormonal, it means they are safe to use while breastfeeding since there are no chemicals from the diaphragm to contaminate breast milk.

#2 Diaphragms are an On-Demand Contraceptive

Another perk of using a diaphragm is that there is no waiting period—they are immediately effective and immediately reversible. Therefore, there’s zero effect on your fertility once you stop using your diaphragm. Diaphragms, like all barrier methods, are an on-demand contraceptive—they only work when you use them during intercourse and cease immediately when you no longer use them.

#3 Diaphragms Don’t Dull Sexual Sensation

While condoms effectively reduce the spread of STDs and the risk of pregnancy, many people still balk at using them because they believe that sexual sensations are dulled. While diaphragms don’t help protect against STDs, they can provide a contraceptive option without affecting sexual sensation. Neither men nor women can feel the diaphragm during intercourse.

Setbacks to Using a Diaphragm for Birth Control

It wouldn’t be a fair assessment if we didn’t cover both sides of the coin. Using a diaphragm for birth control does have a few drawbacks. Let’s cover those now.

#1 Diaphragms Must be Used with Spermicide

The instructions for diaphragms require that spermicide is used together with the device. That means you’ll need to make periodic trips to the pharmacy to pick up more spermicide when you run out. The active ingredient in spermicide, nonoxynol-9, is also known to cause vaginal irritation and increase the risk of contracting HIV.

Another drawback of using spermicide (which is required with diaphragms) is that it is only activated during a window of about two hours. So, if you insert the diaphragm more than two hours before sex, you’ll need to insert more spermicide with an applicator. Spermicide also takes time to work—so you’ll need to wait six hours after sex to remove your diaphragm to ensure all sperm has been immobilized.

#2 Diaphragms have a Lower Effectiveness When Used Alone

Contraceptive diaphragms are around 82-88% effective at preventing pregnancy. This is a lower effectiveness rate than IUDs (99%), implants (99%), hormonal birth control (91-94%), and permanent sterilization methods (99%). On the other hand, diaphragms are more effective at pregnancy prevention than condoms alone (79%). There are ways to supercharge the effectiveness to get much closer to the 99%, such as using a condom along with your diaphragm.

Related: 5 Tips to Supercharge Your Contraceptive Diaphragm’s Effectiveness

#3 Diaphragms Require Some Preparation

Unlike condoms or spermicides, you can’t just run to the store and buy a diaphragm over the counter. First, you’ll need to schedule a doctor’s appointment to get a prescription. Fortunately, there’s now an option available that is one-size-fits-most (Caya Contoured Diaphragm), so you can get a diaphragm prescription during a virtual doctor visit and skip the fitting that traditional multi-sized diaphragms require. Once you’ve got your prescription, you can pick your diaphragm up from a pharmacy or have it shipped to you—and you’ll be good to go for about two years until it needs to  be replaced.

Related: Is it Time to Replace My Diaphragm? Here’s How to Know

Other than a two-year prescription renewal, there is some on-demand preparation required. You’ll need to insert the diaphragm each time you have sex for it to work. Inserting and removing a diaphragm takes some practice and can be messy at times, but after you get the hang of it, you’ll be a pro.

Ready to Try a Diaphragm for Yourself?

After weighing the pros and cons of using a diaphragm for contraception, you might find that you’re curious to try one for yourself. Whether that’s the case or you just want to cover your birth control options, My Virtual Physician is here to support you and provide the tools you need to take care of your reproductive health. Schedule your appointment below to connect with one of our board-certified gynecologists today.

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