Diaphragm (contraceptive)

Diaphragm
An arcing spring diaphragm in its case, with a quarter added for scale.
Background
Type	Barrier
First use	1880s
Failure rates (first year with spermicide)
Perfect use	6%
Typical use	12%
Usage
Reversibility	Immediate
User reminders	Inserted before sex with spermicide. Left in place for 6–8 hours afterwards
Advantages and disadvantages
STI protection	Possible
Periods	Catches menstrual flow
Benefits	May be reused 1 to 3 years
Risks	Urinary tract infection, toxic shock syndrome (rare)

The diaphragm is a barrier method of birth control. It is moderately effective, with a one-year failure rate of around 12% with typical use. It is placed over the cervix with spermicide before sex and left in place for at least six hours after sex. Fitting by a healthcare provider is generally required.

Side effects are usually very few. Use may increase the risk of bacterial vaginosis and urinary tract infections. If left in the vagina for more than 24 hours toxic shock syndrome may occur. While use may decrease the risk of sexually transmitted infections, it is not very effective at doing so. There are a number of types of diaphragms with different rim and spring designs. They may be made from latex, silicone, or natural rubber. They work by blocking access to and holding spermicide near the cervix.

The diaphragm came into use around 1882. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. In the United Kingdom they cost the NHS less than 10 pounds each. In the United States they cost about 15 to 75 USD and are the birth control method of 0.3% of people. These costs do not include that of spermicide.

Before inserting or removing a diaphragm, one should first wash one's hands to avoid introducing harmful bacteria into the vaginal canal.

The rim of a diaphragm is squeezed into an oval or arc shape for insertion. A water-based lubricant (usually spermicide) may be applied to the rim of the diaphragm to aid insertion. One teaspoon (5 mL) of spermicide may be placed in the dome of the diaphragm before insertion, or with an applicator after insertion.