Birth control 101: What is the diaphragm, and how does it work?

If you’re looking for non-hormonal birth control, the diaphragm could be a great option. We’re not talking about the muscle that helps you breathe—but rather, the barrier method that has been helping people prevent pregnancy for decades. This small, flexible, dome-shaped cup made of silicone is inserted into the vagina to sit over your cervix before sex and blocks sperm from reaching an egg. To be effective, it must be used with spermicide, and it can be reused for 1-2 years depending on the brand. Keep reading to learn how diaphragms work, how to use one, and whether this birth control method is right for you.

If you’re interested in diaphragms like Caya, Hey Jane offers birth control consultations from the comfort and convenience of your phone. To get started, see if you’re eligible here.

How effective is the diaphragm?

How well any birth control method works really depends on how you use it. Typical use—meaning occasional mistakes or inconsistencies—makes the diaphragm about 87 percent effective at preventing pregnancy. If you use it consistently and correctly (known as perfect use), that rate rises to 94 percent.

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A few factors can impact how well your diaphragm works, such as:

• Making sure it’s inserted correctly and fully covering your cervix (we’ll explain this in more detail later)
• Using spermicide every single time
• Leaving it in for at least six hours after sex (but no more than 24 hours)
• Being consistent with use

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Compared to other birth control methods, the diaphragm isn’t quite as effective as the pill, IUD, the patch, the ring, or implant, but it can be a great choice for those looking for a non-hormonal, on-demand option. The best birth control is the one you can use consistently and correctly, and what works best for one person isn’t always what will work best for you!

Pros and cons of using a diaphragm

Here’s a look into the benefits and downsides of this contraceptive:

Do you need a prescription?

Yes, diaphragms require a prescription, but the good news is that you no longer always need an in-person appointment. While an in-person fitting could help ensure the best size and comfort, some newer diaphragms offer a one-size-fits-all option, so you don’t have to schedule an appointment. 

If you want a diagram without the hassle of scheduling an in-person appointment, Hey Jane has you covered. We offer convenient access to diaphragms via our telehealth services. Here’s how it works:

1. Intake form: Answer a few health questions to make sure you’re medically eligible for our services. You can start your intake here.
2. Virtual consultation: Chat with one of our expert clinicians who will be responsible for prescribing the diaphragm.
3. Prescription and delivery: Get your prescription sent to your local pharmacy or have it delivered right to your doorstep depending on how you pay.

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You can get a prescription diaphragm from Hey Jane if:

• You’re at least 18 years old.
• You’re deemed medically eligible to receive our care.
• You’re in a state we operate in (residency not required)

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How to use and care for your diaphragm

Using a diaphragm may take a little practice, but it's pretty simple once you get the hang of it. Here’s a step-by-step guide:

1. Wash your hands with a mild (unscented) soap and water.
2. Apply spermicide to the inside of the diaphragm before inserting it.
3. Find a comfortable position, such as lying down, squatting, or standing with one leg propped on a chair or counter.
4. With one hand, part your labia (or lips) to get to your vaginal opening. 
5. Fold the diaphragm in half and insert it into your vagina, pushing it up so it covers your cervix.
6. Apply spermicide inside your vagina once the diaphragm has been inserted.
7. Leave it in for at least six hours after sex to ensure sperm doesn’t sneak through.
8. Remove by hooking your finger under the rim and gently pulling it out.
9. Wash with mild soap and warm water, then air dry before storing it in its case.

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With proper care, a diaphragm can last up to two years. You should replace it sooner if you:

• Notice tears, holes, or weakening of the material
• Become pregnant
• Have pelvic surgery 
• Experience significant weight changes

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Is the diaphragm right for you?

The diaphragm is a solid option for people who:

• Want a non-hormonal birth control method
• Prefer on-demand contraception (only using when needed)
• Are comfortable with inserting a barrier method before sex
• Don’t mind using spermicide

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However, it might not be the best choice if you:

• Dislike the idea of planning ahead before sex
• Have a history of frequent UTIs (spermicide can increase the risk)

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Where to learn more and get started

If the diaphragm seems like the right birth control method for you, Hey Jane makes it easy to get started. Check out our services to learn more about getting a diaphragm prescription and explore other birth control options that may fit your needs.