What is the contraceptive diaphragm?
The condom is not the only barrier method of contraception: in fact, in this category the contraceptive diaphragm also stands out, a small soft rubber dome mounted on a metal ring that is quite malleable and foldable, which the woman inserts near the neck of the uterus (transvaginal) a few moments before sexual intercourse.
It is right to point out a substantial and absolute difference between the contraceptive diaphragm and the condom: while the latter guarantees excellent protection from unwanted pregnancies (98-99.8%) and from sexually transmitted diseases, the diaphragm (improperly known also as a condom feminine) does not guarantee the same guarantee of protection from pregnancies or transmission of venereal diseases.
In Italy, the diaphragm is a method of contraception that is no longer used, above all because it is not entirely reliable; moreover, it is an almost difficult contraceptive to insert, especially for young women with little experience.
Features
The contraceptive diaphragm generally consists of medical silicone or latex, which forms the body of the cap; the base consists of a sort of flexible metal ring, useful for giving a certain support to the diaphragm.
When the woman wishes to use the contraceptive diaphragm, she must first undergo a gynecological examination: in fact, it will be the duty of the doctor to recommend the diaphragm to her most suitable, based on the internal genital anatomical characteristics of the patient.
According to Italian law, unlike many countries (eg USA), the diaphragm does not require a medical prescription.
The diaphragm, depending on the material with which it is made, can have a variable duration, generally from 6 months to two years.
Reliability of the method
Unfortunately, the diaphragm is not a valid contraceptive method, given the high Pearl index, estimated at around 2-3 (failure rate: 20%). Remember that "the Perl index" refers to a standard method to evaluate the effectiveness of contraceptive methods, therefore useful to give an idea about the reliability of the contraceptive method in question: the Pearl index is indirectly proportional to contraceptive efficacy (the greater the value, the lower its effectiveness). Considering that the Pearl index of contraceptive pills is estimated at around 0.1, it is clear that the value of 2 or 3 of the diaphragm announces a decidedly high risk of failure: some researches have estimated that the reliability of the diaphragm would still be lower, considering the high number of failures (unwanted pregnancies).
However, the risk coefficient of the diaphragm is almost variable, since it mainly depends on the correct application of the same.
The only contraceptive method that guarantees a guarantee of total success (Pearl index equal to zero) is surgical sterilization.
Mode of use
The doctor will have to communicate to the woman all the necessary indications for a correct use of the diaphragm: as already said, in fact, a diaphragm can be used for about two years. The integrity of the vehicle does not depend only on its structural characteristics, but also on the way in which it is used: in this regard, by carefully observing the correct conditions of use, a long duration of the diaphragm is ensured, and, above all, one benefits from of a certain guarantee against unwanted pregnancies.
- How should the contraceptive diaphragm be inserted?
The diaphragm must be inserted completely inside the vagina, positioning it near the neck of the uterus, which roughly corresponds to a distance of 2.5 cm from the pubic bone.
The diaphragm, being a sort of flexible dome, naturally adapts to the internal genital anatomy. To decrease the risk of a contraceptive failure, the diaphragm is used together with particular spermicidal substance: the best known spermicide, Nonoxilon-9, should be spread inside the rubber dome - from the part in contact with the opening of the cervix uterine - just before inserting the diaphragm. Ideally, the diaphragm-spermicidal association makes it possible to decrease the Pearl index, so it seems to be able to guarantee greater protection from a possible pregnancy. However, it is estimated that the Pearl index of the spermicide used alone is very high, and therefore very unreliable.
- When should the contraceptive diaphragm be inserted?
The contraceptive diaphragm, in general, is inserted some time before the report, to ensure the correct positioning of the same. It is not recommended to insert it immediately before the report, otherwise you could run the risk of inserting it too hastily, increasing the chances of incorrect application. However, theoretically, the diaphragm could be inserted even an instant before the relationship starts.
- When should the diaphragm be removed?
Given the poor reliability of the contraceptive method, it is advisable to remove the contraceptive diaphragm only after 6-8 hours from the complete report, to eventually give the spermicide a chance to act.
The diaphragm should not be kept in the vagina for more than 24 hours.
- How should the contraceptive diaphragm be kept?
Proper preservation of the diaphragm is essential for maintaining its perfect integrity: after removing it from the vagina gently, following the intercourse (preferably after 6/8 hours, when used together with the spermicide) the diaphragm should be washed thoroughly in warm water and soap, rinsed again and dried, to be placed inside the container. It is recommended to keep it in a dry environment, away from excessive heat and humidity, and to check its integrity whenever a complete report is consumed.
Furthermore, it is advisable to consult the gynecologist once or twice a year for a possible replacement of the diaphragm.
If a hole or tear is found in the diaphragm, prevention from pregnancy is almost nothing: consequently it is advisable to consult a doctor for a possible post-coital contraceptive method (IUD spiral, morning-after pill) since a pregnancy may be in progress.
Diaphragm and Contraception: advantages and disadvantages »
