Diaphragm anyone??HELP

iVillage Member
Registered: 05-04-2004
Diaphragm anyone??HELP
9
Sun, 05-16-2004 - 5:25pm
So. . .I decided that I did not want to be on a hormonal method of birth control. . .I went to my doctor to discuss some barrier options. . .I asked him about diaphragms and cervical caps. . .he said he didn't fit people for cervical caps and that I'd have to go to planned parenthood for that. He then proceeded to give me a thousand reasons why diaphragms are bad (hard to insert, loss of spontaneity, 18% failure rate etc.) and then reluctantly gave me a prescription for an ortho wide-seal diaphragm. Does anyone know what the failure rate of using a diaphragm in conjunction with pulling out? I really do not like the idea of being on hormones (too many risks). . .when I told my doctor that. ..he said I should be worried about getting pregnant. . .not taking a little pill. I guess I'm just frustrated right now! Does anyone use the diaphragm? Is it really THAT bad? Can your partner feel it? Maybe I should order some sponges from one of those canadian websites? HELP!
iVillage Member
Registered: 12-30-2003
Sun, 05-16-2004 - 9:23pm
Hi tootsie718,

No, a diaphragm is not that bad, at all!

I wear a cervical cap as my primary method and a Milex wide-seal diaphragm for flow control and contraception during menses and that combination works extremely well for me. Diaphragms and caps aren’t quite as effective as hormonal contraceptives but they have their own set of advantages. Contraceptive Technology, 18th Ed. (2002) says that a diaphragm in typical use is 84% effective and in perfect use is 94% effective. Typical use includes such things as running out of spermicide, forgetting to insert before IC, leaving it at home while on vacation and not having the fit checked for a weight change of +/-7 lbs. Perfect use is defined as using a properly fitting diaphragm correctly and consistently for every act of IC. I wouldn’t count on the effectiveness being much different using withdrawal with a diaphragm. It may be slightly more effective but there are no figures on it. Theoretically, if withdrawal is practiced correctly, using a diaphragm and withdrawal should be extremely effective, but there are so many variables in effectively using withdrawal that it is impossible to predict actual effectiveness.

Doctors want their patients to have the most effective form of contraception and technically hormonal methods are a bit more effective than barriers if taken correctly. Some women can’t take hormones or would rather not and some doctors have difficulty in working with their patients when the patient selects a barrier as method of choice. If you are still interested in a cap you can check the provider listings on the Prentif site http://www.cervcap.com/locate.cfm to see if there is a fitter in your area.

Using a vaginal barrier requires discipline. Anyone who doesn’t have the discipline to use a diaphragm correctly should use another method of contraception. If you use your diaphragm correctly and every time you can expect effectiveness in the mid 90% range. Diaphragms and caps lend themselves far more to spontaneity than do condoms as they can be inserted well ahead of being needed. One of the first things a new barrier wearer needs to do is decide on a wearing regimen that fits her lifestyle and make it a habit so that she isn’t caught unprotected.

Like any other skill, learning to insert and remove your Diaphragm correctly will take a bit of practice, but it isn’t difficult. The only thing you really need is to be able to feel your cervix with your fingers. That’s because you need to make sure that the diaphragm is inserted correctly. That is done by feeling with your fingers that your cervix is beneath the dome. A little practice will allow you to develop an insertion technique that works well for you.

Usually a diaphragm wearer’s partner won’t be able to feel it. Depending on the anatomies of you and your partner, if you are small and he is large, he might be able to feel the rim in deep penetration positions.

When you doctor fit your diaphragm was it comfortable when inserted? After it’s inserted you shouldn’t be able to feel it. I haven’t heard of an Ortho wide-seal diaphragm nor can I find a wide seal listed in the Ortho-McNeil product listing. Did your doc. give you an Rx for a Milex wide-seal? Milex is an excellent silicone diaphragm.

I’ve used the sponge and it wasn’t for me. It is a one-size-fits-all device and is less effective than a diaphragm or cap. I didn’t like how in moves around inside me during IC and if you have much need it can be rather pricy.

If you have more questions, please ask.

Good luck

      Jill

    

iVillage Member
Registered: 05-04-2004
Mon, 05-17-2004 - 9:24am
Thanks for all that info. Jill it was definitely helpful!!! I think my dr. probably didn't want to be bothered fitting me for a diaphragm as well (he was really busy when I went in). . .It's much easier for him to just write out a prescription for BCP. You're right about the ortho. . .I just checked the script. . .it's an ortho all-flex #70. I actually wanted a milex, but my doctor said this is the only one he's equipped to fit for. I'm getting the vibe that diaphragms aren't the most popular choice! I didn't feel it at all once he placed it inside of me. But. . .when he asked me to put it in myself. . .he said I didn't place it in quite far enough. ..any tips? Thanks again! :)
iVillage Member
Registered: 12-30-2003
Mon, 05-17-2004 - 11:11am
I think less that 2% of women using contraception in the U.S. wear diaphragms and less than 1% wear cervical caps so we are definitely in the minority.

An All-Flex (arching spring rim style) is a good diaphragm and the easiest of the rim styles to insert correctly as the bowed rim slips beneath the cervix easily. For insertion I stand with one foot on the toilet or the bathtub. When you are ready for insertion hold the diaphragm dome down, with a tsp of spermicide in the dome and the rim compressed into a long bowed oval between your thumb and middle finger. Spread your labia with the other hand and place the end of the oval facing you against the entrance to your vagina with your index finger hooked over the outside of the rim at the other end of the oval. The index finger is used to push the compressed rim into your vagina. A dab of spermicide on the outside of the end of the rim against the entrance of the vagina helps lube the insertion. Push the rim as far into your vagina as it will go. The far end should slip under your cervix and fit against the back wall. The front of the rim should tuck comfortably in the notch behind your pubic bone. Once your D is in place then you should feel for your cervix to make sure it is behind the dome of your diaphragm to make certain that you are protected. Does this help? More questions?

Good luck

      Jill

    

iVillage Member
Registered: 05-04-2004
Tue, 05-18-2004 - 2:38pm
Thanks again for all of your advice. .. I just picked up my Ortho at the pharmacy. . .I will be "practicing" when I get home. . .hopefully it will be ok! I'll definitely let you know!
iVillage Member
Registered: 05-04-2004
Wed, 05-19-2004 - 9:33am
Well. . .I picked up my diaphragm from the pharmacy and tried putting it in last night (without the spermicide). . .It seemed to go in fine. . .I just have a few more questions. . .sorry for being a pest about this. . .Do diaphragms effect vaginal lubrication since my cervix will be covered? Won't my boyfriend kind of feel almost like he's wearing half of a condom since it seems to cover one side of my vaginal wall? and. . .What type (brand) of spermicide should I purchase after using up the small tube that came with the diaphragm? Thanks again!
iVillage Member
Registered: 03-15-2004
Wed, 05-19-2004 - 10:29am
I wanted to stop by and offer . Believe me I know what your going through with unsupportive doctors. I finally have a fitting appointment today after going in circles. I have also received a number of lectures on the less effectiveness of barrier methods. Then I was told they ran out of fitting kits to fit me with. I called my PCM and they don't do any kind of barrier fitting. I was about ready to go to Planned Parenthood and pay out of pocket when I was able to get an appointment recently to the GYN I was referred to. On the Planned Parenthood website they didn't show barrier methods as a service they provide but most do you just have to ask. Jill has been a big help to me and knows her stuff when it comes to diaphragms and caps. There are other nonhormonal methods you can use along with the diaphragm until your comfortable with using it such as: condoms, spermicide applicators, and charting using the fertility awareness method. Good-luck!
iVillage Member
Registered: 12-30-2003
Wed, 05-19-2004 - 10:36am
Hi tootsie718,

A diaphragm will reduce your lube to some extent. The vaginal walls weep lubricating mucus when you are aroused so the dome will collect the lube from the wall beneath the dome. I once asked DF what he felt when I’m wearing my diaphragm and he said the dome feels nearly natural to him. The only time there is anything significantly different is if he hits the back rim which rarely happens. I think he feels the dome as almost ‘natural’ because there is movement and lubricated friction between his shaft and the dome, unlike when he is in a condom where there is no movement between him and the latex. With his lube and yours from the portion of the wall not covered you should be fine. If not, a little spermicide will add lube or, if for some reason you are really dry then a water based lubricant like Astroglide works great. Remember with a latex barrier you should NOT use Oil based lubes and medicines while wearing your diaphragm. Oil based products will deteriorate the rubber and drastically reduce the life of your diaphragm.

There are several brands of spermicides to choose from. A gel or cream works best with a diaphragm. You only need one with 2% Nonoxynol-9 for it to be effective. The greater the amount of N9 the more likely you or your partner are to have an allergic reaction to it. Also, occasionally someone might have a reaction to the gelling agent so if you have problems, switching brands might work. Look on the box to be sure the spermicide is formulated for use with a diaphragm or cap and that that the expiration date is some time off so it doesn’t go out of date on you. I use Ortho Options Gynol II gel which works well for me. I’m glad you have already developed an insertion technique good for you! See, insertion isn't hard at all is it?

Good luck

      Jill

    

iVillage Member
Registered: 05-16-2004
Thu, 05-20-2004 - 4:00pm
I have used a diaphragm in the past. I didn't get pregnant, my partner couldn't feel it.

Had no problems but you do have to do a little more planning ahead.

Hope that helps.

iVillage Member
Registered: 04-02-2004
Thu, 05-20-2004 - 4:38pm
Hello,

Reading this makes me angry at your doctor. I understand being concerned with pregnancy, but he/she should not disregard your concerns.

I am also asking tomorrow to get fitted for a diaphragm because I want to get off BCPs. Planned Parenthood does offer cervical caps. Make sure to read the pros and cons of both caps and diaphrams, it almost seems the diaphragms have a higher success rate and come dislodged less often-- but that it just my observation of what I have read.

Good luck,

Jennifer

PS-- Always consider a doctor's suggestions, but don't ever let anyone dictate your care-- that is my philosophy.