Diaphragms and caps


Find out from this factsheet by fpa how contraceptive diaphragms and caps work, how effective they are at preventing pregnancy and their advantages and disadvantages.

What are they and how do they work?
Diaphragms and caps fit inside the vagina and cover the cervix (entrance to the womb). They are barrier methods of contraception and stop sperm meeting an egg.
Both methods are made from rubber or silicone and come in different shapes and sizes. Caps are smaller than diaphragms and both need to be used with spermicide, a special gel or cream that kills sperm.
Their effectiveness depends on how carefully they're used. Diaphragms and caps are 92 to 96 per cent effective if used according to instructions. This means that using either method, between four and eight women in 100 will get pregnant in a year. The silicone cap, Femicap has a higher failure rate.
Diaphragms and caps must be used every time you have sex. Spermicide is applied to the diaphragm or cap, which is inserted into the vagina to cover the cervix. If this is done more than three hours before sex, more spermicide must be used when you have sex. Spermicide needs to be put into the vagina every time you have more sex. The diaphragm or cap must be left in the vagina for at least six hours after sex. It's then removed, washed and stored away.
Advantages
• They're only used when you want to have sex and can be put in at any time.
• They have no serious health risks.
• They may help protect against cancer of the cervix.


Disadvantages
• Inserting a diaphragm or cap in can interrupt sex if you don't do it beforehand.
• Some people find spermicide messy.
• It takes time and practice to use either method easily and correctly.
• Some diaphragm users find they get cystitis (changing to a smaller cap or diaphragm can help).
• Some women or their partners find that rubber or spermicide can cause an irritation.


Can anyone use them?
Diaphragms and caps don't suit everyone. Reasons not to use them include:
• you're not comfortable touching your vagina
• your cervix is an unusual shape or you can't reach it
• you're sensitive to rubber or spermicide
• you have frequent urinary infections


General comments
Once you have a diaphragm or cap you are happy with, you only normally need to see a doctor or nurse once a year to replace it. You may need a different size if you gain or lose more than 3kg (7lb) in weight, have a baby, abortion or miscarriage.
Where to get them
Contraception is free on the NHS. You can get diaphragms and caps from family planning clinics and some GPs. You'll be fitted with the correct size of practice diaphragm or cap to see if the method's right for you. To start with you'll be give a practice diaphragm or cap to make sure you like the method and it's suitable for you.