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Washington and Lee University

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Diaphragm, Cervical Cap, & Spermicides


Diaphragm

Background

The diaphragm is a dome shaped latex or silicone cup that fits securely in the vagina and covers the cervix. It should always be used with a spermicidal gel formulated for diaphragm use. It works by 1) blocking the opening to the uterus and 2) holding spermicide that may destroy sperms' cell membranes.

How to use

The diaphragm can be inserted into the vagina at the time of intercourse or up to 2 hours before intercourse. After intercourse, the diaphragm must be left in place for at least 6 hours. Using it longer than 24 hours is not recommended because of the very rare but possible risk of toxic shock syndrome.

The diaphragm is fitted by a healthcare provider. Insertion and removal instructions are given at the time of fitting. With proper care, diaphragms can ideally last up to two years.

Advantages

  • Non hormonal method of contraception
  • Reusable
  • Immediately effective
  • Used only when needed

Disadvantages

  • Requires fitting
  • Spermicidal cream or jelly may cause irritation
  • Some individuals are allergic to latex or silicone
  • Can interrupt sex
  • No protection from STIs
  • More bladder infections for some women
  • Less effective than other types of contraception

Efficacy

Failure rate for typical use is 16%, while failure rate for perfect use is 6%.

Availability

  • Contact the Student Health Center to be fitted, or a health care provider (Primary Care physician, OB/GYN, or sexual health clinic)
  • Cost ranges from $15-$75 plus additional fees for fitting and spermicide

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Cervical Cap

Background

The cervical cap is placed over the cervix and should be used in conjunction with spermicides. There are two types of cervical caps available in the United States. Lea's Shield is oval shaped and comes in one size. The FemCap comes in three sizes and is shaped like a bowl. They can be inserted any time prior to intercourse, but must be left in place for at least 8 hours after sex and no more than 48 hours. It is not to be used during menstruation.

How to Use

Push the cap into the vagina and make sure that the cap directly covers the cervix.

Advantages

  • Is non-hormonal 
  • Effective immediately
  • Can be used only when needed

Disadvantages

  • Spermicide causes issues such as rash or allergies for some
  • Not as effective as other kinds of contraception
  • Doesn't protect against STIs

Efficacy

If a woman has never given birth, the typical failure rate is 14%. In women who have given birth, the typical failure rate is 29%.

Availability

Both of these cervical caps are available by prescription only and costs between $60-$75 (plus fees for exam and fitting)

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Spermicides

Background

Vaginal spermicides are creams, foams, gels, or suppositories containing chemicals that prevent sperm motility. They can be used alone, but for highest protection against pregnancy spermicide should always be used alongside the cervical cap and diaphragm.

How to use

  • Lie down or squat and insert the spermicide deep into your vagina with either your fingers or an applicator
  • Many require that you wait at least 10 minutes before having intercourse
  • Spermicides usually remain effective for one hour
  • Do not douche after intercourse

Advantages

  • Portable and convenient
  • Avoids the negative effects of steroid hormones
  • Easy to get/does not require a prescription

Disadvantages

  • Harder to use correctly
  • Messier, may leak from the vagina
  • May irritate the vagina or penis
  • May irritate cervical tissue if used many times a day, increases susceptibility to HIV

Efficacy

Failure rate: 15% - 29%

Availability

  • No prescription required
  • Local pharmacy or community health center
  • Price: about $8 per kit ($4 - $8 for refills)