How to use a diaphragm

The diaphragm is a flexible rubber or silicone cap that fits inside the vagina and covers the opening to the womb (the cervix). A doctor or nurse fits a diaphragm for you to check the size and to teach you how to use it properly. It should be used with a spermicide that kills sperm. Spermicides can come in the form of creams, foams or jellies.

The diaphragm is 92-98% effective with very careful use, higher failure rate with less careful use.

What are the benefits of the diaphragm?

• The diaphragm doesn’t affect how regular your periods are
• You only use it during sex and can put it in whenever you want before sex
• There are no long-term health risks associated with the diaphragm

Where to get a diaphragm

To get a diaphragm, you will need to speak to your GP.

• A diaphragm needs to be fitted by a trained nurse or doctor
• The nurse or doctor will select the right size diaphragm for you and show you how to put it in
• When you first receive your diaphragm, you will be instructed to take it home and practice positioning it in your vagina – you are not protected during this practice period and should use an alternative contraception
• You will then be asked to return to the clinic/doctor’s surgery after you have fitted it yourself, so that the doctor or nurse can check you know how to put it in properly
• You must always use spermicide with a diaphragm

How to use a diaphragm

• To use the diaphragm, you place it over your cervix and then run your finger around the rim to ensure that the cervix is fully covered. It may sound complicated at first, but you’ll soon get the hang of it
• You have to keep the diaphragm in for six hours after sex and use more spermicide if you have sex again during that time
• Do not have a bath within six hours after putting in the diaphragm, as the water could dislodge it or wash away the spermicide
• The diaphragm fitting should be checked by a doctor or nurse every year

Things to keep in mind when using the diaphragm

• The diaphragm does not protect against STIs, you will need to use a condom for full protection
• A consultation with a doctor is needed to select the right size and type
• Fittings should be checked every year
• Additional spermicide is needed each time you have sex
• Must stay in place for at least six hours after sex
• Some people get cystitis (an inflammation of the bladder) after using the diaphragm
• Some people find it difficult to fit in the vagina properly or feel uncomfortable touching their genital area
• Spermicide can cause irritation or allergy for some people
• Certain creams like those used to treat thrush can damage diaphragms

How can I protect my sexual health when using contraception?

There are many great options to help protect your sexual health, but none of them are 100% effective. Even if you use the diaphragm every time you have penetrative sex, you are still at risk of getting genital warts and herpes, as these can be passed through skin-to-skin contact. Going for an STI check or taking a home STI testing kit with a partner before having sex, can be a great way of protecting yourself and those you have sex with against STIs and HIV. However, not all STI checks check for all STIs, so it is important to speak to your healthcare provider and ask them what is being tested for as part of your screening.

Discussing with your sexual partners the type of contraception or protection options available to you, and agreeing on a type that works for everyone involved can help to reduce the risk of pregnancy, STIs and HIV. Looking out for sores or symptoms on a partner’s genitals before having sex with them, can help to identify STIs that they may not be aware of. If you do see any signs that someone may have an STI, do not have sex with them until you know for certain it is safe to do so. Asking someone about their sexual health history is the responsible thing to do before having sex, and it should not be taken as an insult if someone asks you about yours. 

Remember that the age of sexual consent in the Republic of Ireland is 17 and the age of sexual consent in Northern Ireland is 16.

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