What is a diaphragm?
A diaphragm is a soft silicone device which fits into the vagina so it covers the cervix. The single size diaphragm (Caya) is the brand available in Australia. It is one size only with this design estimated to fit 80% of women.
How does it work?
It’s a barrier method of contraception that stops sperm from entering the uterus and fertilising an egg. The diaphragm is inserted before having sexual intercourse and left in place for at least 6 hours after intercourse.
How effective are diaphragms?
Caya is a relatively new product with limited data that shows it is about 82–86% effective as a method of contraception. Diaphragms are less effective than other contraceptive methods.
What's good about using a diaphragm?
- It contains no hormones.
- It has no effect on your menstrual cycle or fertility.
- It has no effect on breastfeeding or breast milk.
What's not-so-good about a diaphragm?
- You need to have it with you at any time you have intercourse.
- You need to insert it before intercourse.
- You need to be comfortable about feeling inside your vagina with your fingers to check the diaphragm is in place.
What does it cost?
Diaphragms are not subsidised for Health Care Card holders and cost about $70–90. If the diaphragm is properly cared for it should last up to 2 years.
How to get a diaphragm
Diaphragms can be bought from SHine SA, online and most pharmacies. While the Caya diaphragm can be purchased without the need for a fitting, Family Planning Organisations recommend when possible that women are assessed by a health professional to discuss insertion and usage. Some women may wish to check the device is correctly inserted to cover the cervix.
Women should not use the Caya diaphragm if they are previous diaphragm users who are known to require a large (size 85 or larger) or small (size 60 or smaller) sized diaphragm. It is a good idea to practise inserting and removing the diaphragm several times before using it for contraception.
During this time:
- wear the diaphragm for at least 6–8 hours, during both night and day, to make sure it is comfortable
- the diaphragm should not interfere with passing urine or having a bowel action
- the diaphragm should not be felt at any time, including during intercourse
You can have a review one to two weeks after the initial assessment with your diaphragm in place so that its position can be checked. At this visit, you should discuss any problems you have noticed.
How to use a diaphragm
- Wash your hands carefully with soap and water.
- Use the dimpled grips and squeeze together the rim. Making sure that the arrow on the device is pointing towards the body, insert the diaphragm into the vagina and gently guide it backwards and upwards towards the small of the back as far as it will go.
- Tuck the diaphragm behind the pubic bone ridge at the front of the vagina.
- Check that the cervix is completely covered by the diaphragm by feeling with your fingers (the cervix usually feels quite firm like the tip of your nose).
- If not in the correct position, remove and try again (to remove the diaphragm, hook the index finger into the dome and pull out).
- The diaphragm needs to be left in place for at least 6 hours after sexual intercourse.
- It should not be left in place for longer than 24 hours without being removed for cleaning.
You do not need to use your diaphragm for contraception during the first 5 days of a normal period.
If lubrication is needed before or during intercourse use a water-based lubricant.
How to take care of your diaphragm
- Wash the diaphragm in warm water with a mild, unscented soap.
- Rinse thoroughly in clear water and dry carefully.
- Check the diaphragm for pinholes or tears by holding it up to the light and gently stretching the dome.
- If the diaphragm feels ‘tacky’ this may mean the silicone is damaged.
When to get the diaphragm checked
- When you have a sexual health check-up and/or smear test.
- If you lose or gain 3 kg or more in weight.
- After a pregnancy, miscarriage or abortion.
- If the diaphragm is uncomfortable for you or your partner.
- If the diaphragm slips or moves during sexual intercourse.
- If you have experienced an increase in constipation or urinary tract infections since starting to use the diaphragm.
You will need to replace your diaphragm immediately if it is damaged or no longer fits well. Remember, a diaphragm must fit well and be in good condition to prevent pregnancy.
Sometimes accidents happen
If you did not use your diaphragm, or if it slips out of place, and you are worried about getting pregnant, emergency contraception (EC) is available over-the-counter at pharmacies, SHine SA clinics, Clinic 275 and some public hospital Emergency Departments.
EC is most effective if it is taken within 24 hours of unprotected sex, but can be taken up to 5 days (120 hours) after unprotected intercourse.