diaphram vs cervical cap
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diaphram vs cervical cap
| Fri, 10-15-2004 - 12:55am |
So, I am temporarily giving up on getting an IUD, and my next option is a diaphram or cervical cap. You never hear a lot about them, and I was wondering why? Perhaps they are not as fashionable as the Pill, or maybe I am not the only one that associates a diaphram with my mothers generation. I have done some research and they both seem to be effective, if you use them properly. I am a fanatic about organization and being prepared, so I think that I would police myself pretty well about using them properly. Any users here that would give me some insight, or advice would be greatly appreciated. Thanks.

If you've previously had a child though, do not get a cervical cap. The failure rate rises dramatically if the woman has given birth, the site below says the failure rate is 9% with perfect use for a woman who hasn't given birth, and 26% if she has.
http://www.wprc.org/sexuality/birthcontrol.html
"...my next option is a diaphram or cervical cap. You never hear a lot about them, and I was wondering why?"
You mean aside from the pharmaceutical lobby that is pushing pills? Well, a diaphragm or cervical cap is a higher maintenance method than hormonal contraceptives or an IUD and user failure (failure to use the method correctly and consistently) is the single largest reason for unintended pregnancies so I think it's mainly because hormonal methods are easier to use correctly.
You have read the post in the FAQs about diaphragms and caps, right? That gives some pros and cons of both barrier types. Anyone wanting to use a cervical barrier should find the most experienced and supportive fitter she can. Usually Planned Parenthood and women's clinics, Midwives and Nurse Practitioners are more likely to have or be experienced and supportive. It’s a real downer for your fitter to be telling you what a bad idea using a barrier is while s/he is fitting you. Once you have a good fit it is very important that you develop a wearing regimen that fits your needs and lifestyle. Then make that regimen a habit.
The thing that scared me away from a cap 7 or 8 years ago was that I hadn’t made my wearing regimen a habit and so during my fertile times, when my hormones were in full cry and raging, I would find myself thinking "I won't bother with my Prentif (cervical cap)... just this once." I nearly did that once and when I thought about it later it scared me so badly that I decided to switch to hormones. After 3 years on OTC my libido had disappeared and I decided to give barriers another try. I was fortunate to find a Gyn who helped me develop an effective wearing regimen and I have made it a habit so now I'm always protected when I'm around DF as we are very spontaneous. I’ve been using an Oves for 30 cycles now and haven’t had a problem or scare. If you have a good fit and are motivated and disciplined enough to use your barrier correctly and for every act of IC then you should be fine.
Most Diaphragms and caps are still made of latex. If you decide on a barrier you might want to consider getting one made of silicone rubber. Silicone is more inert than latex. It is less likely to contribute to yeast infections and is impervious to medicines and lubricants made with a petroleum base which will destroy latex barriers. Silicone is also easier to clean. The Milex diaphragm is the only silicone one available in the U.S. The Prentif cavity rim cervical cap, made of latex, is still the most widely prescribed in the U.S. There are several other cervical cap barriers which are made of silicone (FemCap and Lea Barrier) approved by the FDA and available in the U.S. but they are relatively new on the market and not many practitioners are familiar with them. I wear an Oves which is a very small disposable silicone cap but it hasn’t been approved yet by the FDA. However, Oves is available on the Internet. The only problem with Oves is that it does not come in enough sizes, only 26, 28 and 30mm while Prentif comes in 22, 25, 28 and 31mm. The 22mm size is important in fitting petite or very young women (a 19mm is also needed if you ask me but no one makes a cap that small) so overall more women can be fit with Prentif than Oves. Other things that can prevent a proper fit of a cap are the cervix being too long or short, not symmetrical, not having smooth sides and a cervix that has been damaged while giving birth. Those are the sorts of things that cause problems retaining the vacuum in the dome which is what holds a Prentif or Oves correctly in place. Sorry, I seem to be rambling here… If you want more information just ask. Let us know what you decide, ok?
Good luck,
Jill
Contraceptive choices: http://www.plannedparenthood.org/bc/cchoices.html
Method effectiveness: http://www.plannedparenthood.org/bc/bcfacts2.html
Jill
It should not affect the fit of a diaphragm or caps such as FemCap and Lea Barrier that develop suction against the walls of the vagina. It could, in some cases, affect the fit of Prentif or Oves caps that suck directly on the cervix. An experienced fitter should be able to answer your question specifically. I hope you have a doctor who will listen to you. However, unless you have already discussed the subject of barriers with your doctor, you might want to be prepared to be under whelmed by his or her enthusiasm or even for outright hostility to their use. Let us know how you’re doing, ok?
Good luck and hugs,
Jill
The failure rate figures on the Planned Parenthood site: http://www.plannedparenthood.org/bc/bcfacts2.html taken from the forthcoming 18th edition of Contraceptive Technology are:
Diaphragm: 6.0% perfect use, 16.0% typical use
Cervical Cap: Women who have not given birth, 9.0% perfect use, 16.0 typical use.
Cervical Cap: Women who have given birth, 26.0% perfect, 32.0% typical use.
There is nothing wrong with those figures. Barriers are definitely not for everyone. However, there have been cervical cap studies of self selected, highly motivated, educated women for whom the average effectiveness has been much higher. Two factors that may account for some of the differences are: 1) The experience of the fitter and fit of the barrier. There can be poor, good, very good and excellent fits. And the correctness of the fit will change with weight gain/loss. A weight change of 7 lbs. for a diaphragm or 14 lbs for a cap requires a recheck of the fit. 2) Whether other contraceptive options were available and how dire the consequences would be of an untended pregnancy. There was a definite increase in effectiveness for studies using women for whom the cap was a ‘last chance’ method and who saw an unintended pregnancy as something to be avoided at all costs. That seems to indicate that discipline and motivation can make a big difference in effectiveness. That is why I continually stress the need to find the most experienced fitter possible and to develop a wearing regimen that fits your lifestyle and to make it a habit. A barrier will not protect you when it’s in your dresser drawer or is too large or too small.
Jill
Sorry, I didn't answer all your questions the first time...
>>I also read on one brand's website that it should be left in for 8 hours after intercourse, is that correct? <<
Yes, any cervical barrier should remain inserted for at least 6, preferably for 8 hours after IC.
>>what routine do you have for wearing your cervical cap? Do you keep it in all the time? Is that safe? It seems like that might cause an infection, or be a problem with CM discharge. <<
My wearing regimen is to wear Oves continuously. I insert after my bath in the morning. Oves can be worn for 72 hours at a time so I remove it before my bath on the 4th morning. Afterward I wash it, reapply spermicide and reinsert. That way I'm protected continuously. While Oves is meant to be a single wearing device I think they are rugged enough for a single one to be used for an entire intermenses period. A Gyn friend in the UK allows his patients to wear Oves that way and they have had no problems. Cervical caps can't be worn during menses as the flow will fill and dislodge them. So, when I begin to spot I switch to my Milex diaphragm. My 80mm will hold about as much flow as a Keeper/Diva cup and on my heavy days it needs emptying in about 4 ½ hours. As long as you keep the dome emptied there is little likelihood of infection. If you were to forget and leave it inserted with flow in the dome for several days that could be a problem. At the end of my period I switch back to Oves again.
As far as CM discharge is concerned, I haven't heard of any problems with wearing a Prentif as the dome is larger than Oves and the continuous wearing interval is shorter, only 48 hours. An Oves dome is very small. For some women whose FCM is very heavy that can limit the continuous wearing interval. One Oves user I know can wear hers continuously for only 48 hours when she is fertile. I can go longer than 72 hours with no problem (if we have IC at the end of the 72 hour interval) if I need to keep it in longer. One common problem is that new cap users will sometimes apply too much spermicide in the dome, it should be no more than a third full or it could fill the cavity and lead to a dislodgment.
Take care,
Jill