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Posted Jun 13 2009 12:12am

Diaphragms are a popular type of contraception that consist of a sheath of silicone or latex around a
circle-molded spring that is placed in the vagina prior to intercourse to prevent sperm from entering the uterus.  Having discussed with many women my age various types of contraception, the diaphragm is probably one of the least discussed among us.  I have always had the impression that only “older” women use diaphragm.  (I use “older” lightly, meaning simply women who are about 35 or older.  There is nothing old about these women, of course, they are simply more sophisticated.)  So what’s the deal with diaphragms?

Forerunners of the diaphragm have been around since time immemorial.  Ancient peoples used various implements to function as a proto-diaphragm such as lemon slices and paper leafs stuck to the cervix using honey (a natural anti-bacterial and antiseptic).  The modern diaphragm began to take shape in the nineteenth century when vulcanization processes allowed for rubber contraceptive devices to be used.  Margaret Sanger promoted the use of such rubber devices as early as 1916 and helped introduce them en masse to the United States.  By the 1940s nearly one-third of all married couples in the United States used diaphragms as a primary method of contraception.  However, the introduction of intrauterine devices (IUDs) in 1960s and the popularity of oral contraceptives (the pill) greatly reduced the use of the diaphragm.  By 1965, fewer than 10% married couples were using diaphragms.  Following safe sex campaigns of the 1980s and 1990s, condom use increased greatly and now less than 2% of married couples in the United States use diaphragms.

Diaphragms have several advantages.  Many women prefer diaphragms to oral contraceptives because pills generally require daily use and it can be difficult to always remember to take it.  One advantage for women is that they can be inserted hours before sexual intercourse allowing it to progress without having to stop to put on a condom.  Because diaphragms are meant for somewhat longterm reuse, they oftentimes end up costing less than other forms of contraception.  Also, some types of diaphragms are designed to collect menstrual blood though they are not usually used primarily for this reason (i. e., they are used to allow sexual intercourse without having to worry about blood).  Diaphragms, when properly used, are 94-95% effective in preventing pregnancy.  However, with “typical” use this rate drops to about 85%.

One drawback to diaphragms is that they do not fully protect against sexually transmitted diseases (STDs).  Used in conjunction with spermicides, diaphragms do offer some protection against these diseases but are not 100% effective.  (The effectiveness of diaphragms in preventing STDS is debated by scientists.  The cervix is especially prone to contracting STDs, so protecting it with a diaphragm may impede the transmission of some STDs but certainly not all.)  Another drawback is toxic shock syndrome, though this is more likely to occur with use of tampons.  There is also an associated risk of urinary tract infections, though if properly used diaphragms usually do not cause this.  And of course, women who are allergic to latex should not use latex-based ones and should warn partners ahead of time in case they are allergic to latex.

Having never used a diaphragm myself, I cannot deliver a personal opinion though they seem like something worth trying if you are interested in different methods of birth control.  Of course, I recommend using them in a monogamous relationship because of their decreased ability to prevent STDs.  If you are having sex outside of a monogamous relationship, you should always use a condom–still the most effective means of preventing the transmission of STDs.  So, do you have something to say about diaphragms or maybe have a question?  I’m all ears.


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