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Diaphragms and Cervical Caps Overview

Diaphragms and cervical caps belong to the barrier method of birth control. They were most often used before the invention of hormonal contraceptives and intrauterine devices. Diaphragms have a longer history of use than cervical caps. However, both of them became significantly less popular with the development of hormonal contraception. Nowadays, women use this barrier method for a number of reasons – cultural, religious, and health-related.


A diaphragm is a soft, thin, and flexible dome-shaped disc with a rim and a spring attached to the latter. It covers the cervix and part of the uterus to prevent sperm from entering it. Diaphragms are made either of latex or silicone. Their springs also differ in types. There are coil springs, flat metal, and arching springs.

Diaphragms come in different sizes: from 50 to 105 mm in diameter. The most commonly used ones are the devices measuring 65 to 80 mm. The variety of diaphragms types and sizes allows every woman to choose the most comfortable device, which would suit her vaginal anatomy best.

Actually, not a woman herself, but a physician is responsible for choosing the appropriate device for every woman (the size and the type). Therefore, a diaphragm is prescribed and fitted by the doctor. It is at the doctor’s office that a woman is trained to insert and remove the diaphragm, as well as instructed how to take care of it.

In general, a woman has to know that the given birth control tool should be inserted into the vagina and placed properly over the cervix up to 6 hours before the sexual intercourse. A diaphragm can also serve as a spermicide delivering means. It must be left inside for not less than 6 hours after sexual relations. If more than one intercourse occurs, additional spermicide should be placed into the vagina, and 6 hours should pass before the device extraction. However, this contraceptive should not be left inside for more than 24 hours.

After the diaphragm is removed from the vagina, it should be examined for breaks, washed with soap and warm water, and stored in the dark cool place. This contraceptive can be used for two years; then it needs to be refitted by a doctor. Pregnancy and child bearing, abortion, or gaining weight can change the size of the cervix; therefore, diaphragms should also be refitted in such cases.

Barrier method of contraception is known to be quite safe, producing few side effects. Diaphragms use is sometimes associated with the higher risk of urinary tract infections and allergic reactions to latex. There also were some associations with toxic shock syndrome and diaphragms; however, there is no reliable official data on this issue for the time being.

Low incidence of adverse reactions is definitely a great advantage of the diaphragms. On the other hand, their effectiveness could have been better. Perfect use is said to be 97% effective, average use gives pregnancy protection only in 82% of cases. Using spermicide or male condom significantly lowers diaphragms failure rates.

Cervical Caps

Cervical caps have very much in common with diaphragms: they also represent a barrier method of contraception; they work the same; they are often used with spermicide; they need to be chosen in the clinic by the doctor and they also require some efforts for a woman to learn how to use them right. Besides, cervical caps and diaphragms have practically the same rates of effectiveness and few side effects (allergic reactions and rarely bladder infections).

However, there are also differences between diaphragms and cervical caps. The latter are thimble-shaped and are placed only over the cervix without covering uterus. They are held in place with the help of suction.

Cervical caps come in different sizes depending on the brand. There are only three of them officially approved in the USA: Prentif, FemCap, and the Lea's shield. Prentif is made of latex; it is available in sizes 22, 25, 28, and 31 mm. Femcap is made of silicone; it comes in sizes 22, 26, and 30 mm. The Lea’s shield is also made of silicone. The latter device is designed to fit all the sizes.

Cervical caps can be inserted some time before the intercourse and should stay inside for 8 hours after the last sex. They are, however, not recommended to be left on the cervix for more than 48 hours, since this is supposed to increase the risk of toxic shock syndrome, vaginal irritation, unpleasant vaginal odor and discharge.

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These days very few women choose cervical caps for pregnancy protection. They say that one of the reasons why they are reluctant to use this birth control method is that it is quite difficult to learn how to correctly insert and remove caps.

The final note should be done about the anatomic peculiarities and the use of cervical caps and diaphragms. The matter is that women with abnormal vaginal anatomy are bad candidates for the use of these contraceptive, since it will increase their risks of getting pregnant or may cause difficulties even with placing the devices inside.


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