Diaphragms seem a little old fashioned now with all the other options available to us, but they provide a pretty stable barrier between cervix and sperm.
A diaphragm is a flexible silicone ‘cap’ that sits over the cervix and is held in position by the natural shape of the vagina, cervix and pelvis. They come in different sizes, because we are all different on the inside.
After sex the diaphragm must be left in for a further six hours, so any lingering semen has dripped out, away from the cervix, or die. You just squeeze it together, and pop it up. Taking it out needs to be done within 30 hours (less preferably, and six hours if you have your period) because otherwise there is a greater risk of infection. Stuff should not be hanging around in the vagina for too long, which is why it is affected by gravity: things must come out. A diaphragm lasts for up to two years, but you must take good care of it by cleaning it thoroughly and drying it properly.
If it happens to come out during sex, or tears, you should use the emergency contraceptive pill to prevent pregnancy.
If you have any issues with size, going to the toilet, pain or any other symptoms that don’t seem normal, you should call the person who gave it to you and ask.
The diaphragm is, despite its physical barrier being so obvious, only about 90-95 per cent effective, so if you definitely don’t want a baby, don’t use it. There are better methods, though if it’s your only option, just be extra careful. Between six and 12 women out of every 100 using this method for a year get pregnant.
Good things about diaphragms are that side-effects are rare, there is no delay in return to fertility, and it can be used on the occasions you need it only. If you know you are going to have sex in advance, you can prepare earlier. If you are breastfeeding you can use it safely, and if you find hormones unbearable for any reason, it can work. Manufacturers suggest using spermicide with the diaphragm, but if you value your vaginal flora, this can be a bad idea.
There are a few drawbacks to this method, including its unreliability. If you have trouble getting it in or out, you probably won’t like it. Allergies are rare, but can happen. Risks include increased frequency of urinary tract infections and toxic shock syndrome (rare, but can happen if you use a diaphragm during menstruation).
If you want a diaphragm, you need to be fitted for one at your local family planning clinic.