Contraception - diaphragms

What is a diaphragm?

A diaphragm is a non-hormonal barrier method of contraception. It fits inside the vagina and covers the cervix (entrance to the uterus or womb) to stop sperm from meeting and fertilising an egg.

A diaphragm is a soft, shallow cup made of silicone. In Australia, the one-size diaphragm is sold as Caya®. It is used with a special gel (jelly-like material, sold as Caya Gel®).

Other barrier methods include external (male) and internal (female) condoms.

Diaphragm risks

Diaphragms:

• Do not protect you from STIs.
• Should be checked carefully for holes.
• Usually last around 2 years.
• Do not suit everyone.

Diaphragm effectiveness

If used correctly every time you have sex, diaphragms are 86% effective at preventing pregnancy.

If used incorrectly (for example, not inserting properly before sex or removing too soon after sex), they may only be 82% effective.

A diaphragm may not work if it is:

• not inserted correctly
• used without the gel
• taken out less than 6 hours after sex
• torn
• past its use-by date.

How to use a diaphragm

To use a diaphragm:

• Place a teaspoon of gel in the cup of the diaphragm.
• Put the diaphragm inside your vagina so it covers the cervix (opening to your uterus).
• Insert the diaphragm up to 2 hours before having sex.
• Leave it in place for at least 6 hours after sex.
• Do not leave the diaphragm in place for longer than 24 hours.

Before you use the diaphragm for the first time, you can ask a doctor or nurse to check that it fits well and you are inserting it correctly.

Diaphragms are the wrong shape for about one in 7 women.

Doctors and nurses can provide advice about how to insert the diaphragm comfortably. Caya® has a video with instructions on how to use the diaphragm.

How diaphragms work

The diaphragm and gel work as a barrier to prevent sperm from passing through the cervix into the uterus. The sperm die off quickly in the vagina.

Advantages of diaphragms

The advantages of using diaphragms include:

• You can insert them hours before having sex.
• They have little or no side effects.
• You can buy them without a script.
• They are a choice for those who do not want to use hormonal contraception.

Possible side effects from diaphragm use

Possible side effects for a small number of users can include:

• irritation of the vagina or penis
• increased risk of bladder infection (cystitis).

Rarely, use of a diaphragm might cause toxic shock syndrome.

When diaphragms are not recommended

A diaphragm might not be a good option if you:

• Are prone to bladder infections.
• Gave birth 6 weeks ago or less – this is because the size of diaphragm required may change as the uterus returns to normal size.
• Are unable to feel if your cervix is correctly covered by the diaphragm.

Speak to a doctor or nurse for advice.

Forgetting to use a diaphragm

You may need emergency contraception if you had sex without using your diaphragm and did not use other contraception (check with your doctor, nurse or pharmacist).

If you get pregnant while using a diaphragm, it is safe to continue the pregnancy (and stop using the diaphragm) or to have an abortion.

Diaphragm use after having a baby

You should usually wait 6 weeks after having a baby to start using a diaphragm.

Where to get diaphragms

You can buy a diaphragm from some pharmacies, sexual health clinics, family planning clinics and online.

Where to get help

• Your GP (doctor)
• Your school nurse or welfare coordinator. Some secondary schools provide access to an adolescent health trained GP on site
• Your local community health service
• Your pharmacist
• 1800 My Options – Victoria’s sexual and reproductive health information and phone line service Tel. 1800 My Options (1800 696 784)
• Sexual Health Victoria (SHV) – book an appointment online or call Melbourne CBD Clinic: (03) 9660 4700, Box Hill Clinic: (03) 9257 0100 or (free call): 1800 013 952 (Monday to Friday 9 am – 5 pm). These services are youth friendly.
• Women's sexual and reproductive health hubs (multiple locations in Victoria)
• Ballarat Community Health Sexual Health Clinic – book online or Tel. (03) 5338 4541
• Bendigo Community Health Services Sexual and Reproductive Health Hub - book online Tel. (03) 5406 1200 or (03) 5448 1600
• Gateway Health Sexual and Reproductive Health  – Clinic 35, Wodonga (Monday to Friday 9 am – 5 pm) Tel. (02) 6022 8888 and Wangaratta Tel. (03) 5723 2000 or email: info@gatewayhealth.org.au
• Sunraysia Community Health Services, Mildura (Monday to Friday 8:30 am – 5 pm) Tel. (03) 5022 5444 or email to: schs@schs.com.au
• Barwon Health Sexual Health Clinic (no GP referral, walk-in service Tuesdays 2 pm – 6:30 pm) Tel. (03) 5226 7489
• Victorian Aboriginal Health Service Fitzroy: Tel. (03) 9419 3000 and Preston Tel. (03) 9403 3300 (Monday to Friday 10 am – 4 pm) and after-hours locum service Tel. 132 660 or Epping: Tel. (03) 8592 3920 (Monday to Thursday 9 am-5 pm, Friday 9 am-4 pm)
• Sexual Assault Crisis Line Tel.1800 806 292