Always use a spermicidal cream or jelly with your diaphragm. The two are equally effective. Jelly has a bit more lubricating effect than cream. If you buy cream or jelly in a drugstore, make sure the word "contraceptive" is on the label or ask the pharmacist. Not all vaginal creams and jellies will kill sperm.
Apply cream or jelly to the entire rim and put about a teaspoon inside the dome.
Insert the diaphragm not more than 30 minutes before intercourse (you should urinate before inserting the diaphragm).
You can insert your diaphragm while you are lying down, squatting, or standing with one foot propped up (see diagram). Hold the folded diaphragm with one hand and spread your vaginal lips apart with the other (Diagram A). Guide the diaphragm down and back along the back wall of your vagina (the wall closer to your rectum) as far as it will go (diagram B). Tuck the near rim up behind the bulge in the lip wall of your vagina (the wall closer to your bladder - see Diagram C). The inside of the dome with the cream or jelly should be next to your cervix. Then check with your finger if you can feel your cervix through the dome of the diaphragm (Diagram D). Your cervix is a smooth, firm, round structure, about the diameter of a quarter. It feels something like the tip of your nose.
Leave the diaphragm in place for at least six hours after intercourse. It will take that long for the cream or jelly to "kill the sperm" If you choose to douche, you must wait until at least six hours after intercourse.
If you expect to have intercourse again, add more cream or jelly with applicator. Be sure to remove and wash your diaphragm at least once every 24 hours to prevent infection and unpleasant odor. Always observe the six-hour minimum after intercourse before you remove your diaphragm.
To remove your diaphragm, reach in with your index finger, hook your finger over the nearest rim (Diagram E) and pull down and out (Diagram F). Be careful not to tear the latex with your fingernail.
To care for your diaphragm, wash it is plain soap (such as Ivory) and water each time you remove it, dry it, dust it with cornstarch if you wish, and store it AWAY FROM HEAT in its container. (Don't dust the diaphragm with other types of powders. They can weaken latex). Check your diaphragm for holes or tears each time you use it by holding it up to a light. Discoloration of the latex is normal. With proper care, a diaphragm will last at least two years, often longer.
If you need extra lubrication for intercourse, use extra contraceptive cream or jelly. DO NOT use petroleum jelly such as Vaseline because it can weaken latex.
Make sure you always store your diaphragm, cream or jelly, and applicator for extra cream in the same place.
See your doctor any time you think your diaphragm does not fit properly, or any time you are not sure you are inserting it properly. Also, see your doctor if:
- at any time you have discomfort, pain or bladder infections;
- after any surgery involving your reproductive organs, or
- after pregnancy.
All of these conditions could mean you need a different size or type of diaphragm. Diaphragms come in different sizes and must be fitted to the size of the vagina by a physician.