Julianne M. Dunne, MD

Taking care of women...mothers and their daughters

Home

Patient Forms

Administration

Julianne Dunne, MD

Lisa Luehman, NP

Weight Management

Meal Replacements

Top 10 reasons

What is BMI?

BMI calculator

What does my BMI mean?

I am done with dieting

Nutrition Basics

Which diet is best?

Tools for Weight Loss

Structured Eating

Build a Meal

Weight Loss Medication

Fresh Steps

Vitamins and Supplements

Weight Management Visits

1: ordering out

2: sugar is not so sweet

3: your microbiome

4: IF and keto

5: sweet dreams

6: good mood

7: thyroid balance

8: just breathe

9: cortisol connection

10: hormone imbalance

11: obesity and cancer

12: staying motivated

Lifestyle Modifications

Exercise

Sleep Hygiene

Manage Your Stress

Breathing Techniques

Mindful eating

Sustainable Kitchen

Self-monitoring

Your Wellness Journey

Fasting Mimicking Diet

What is ProLon FMD?

TheFasting Mimicking Diet

What's in the box?

At Home Workouts

Total Body Workouts

Core Workouts

Lower Body Workouts

15 Minute Workouts

Pilates, Yoga & Stretches

How to Choose Your Diet

Ketogenic Diet

Mediterranean Diet

Paleo Diet

Vegan Diet

Whole30 Meal Plan

Food Plans

Core Food Plans

Cardiometabolic Food Plan

Elimination Diet

Detox Food Plan

GI Specific Plans

Mito Food Plan

Recipes

Keto Morning Joe

Breakfast Ideas

Lunch Ideas

Dinner Ideas

Side dishes

Snacks

Dessert

HealthTrac App

How to Use HealthTrac

The HealthTrac Program

Getting Started

Never Done Shopping

Purity Coffee

Body Togs

Livliga

My birth control options

how effective are these?

nexplanon

intrauterine devices

depo-provera

birth control pills

diaphragm

Common GYN problems

Abnormal Bleeding

PMS

Vaginal infections

Interstitial Cystitis

Explaining my Pap results

What my results mean

Normal Pap

Normal Pap, HPV negative

Normal Pap, HPV DETECTED

ASCUS Pap, HPV negative

ASCUS Pap, HPV DETECTED

Low grade SIL

High grade SIL

When my Pap is abnormal

Cervical dysplasia

The next step: Colposcopy

Your colposcopy results

LEEP vs. Cone biopsy

High risk HPV

Cervical cancer

Menopause

How is my bone health?

What is osteoporosis?

Preventing osteoporosis

Bone Density Test Results

How much calcium in food?

Contact Us

Driving Directions

Message Board

Guestbook

Is the diaphragm right for me?
(vaginal barrier contraception)



Document
Is the diaphragm right for me? Download our handout

What is “the Diaphragm”?


The diaphragm is a round rubber dome that fits inside a woman’s vagina and covers her cervix.  It must be used with spermicide (a sperm-killing cream or jelly).


 

How does the Diaphragm work?


The diaphragm is a barrier method of birth control that prevents pregnancy by placing a physical and chemical “wall” between the sperm and the cervix.  It must always be used with a spermicidal cream or jelly.  Be sure that the jelly or cream you purchase is a spermicide containing nonoxynol-9.

How effective is the Diaphragm?


The diaphragm is NOT the most effective form of birth control.  Effectiveness includes the use of spermicide.  Among perfect users (women who use the diaphragm perfectly), about 6 in 100 women (6%) is expected to become pregnant over the first year of use.  Among typical users, 18 in 100 women will become pregnant over one year of use.   However, using a condom along with the diaphragm will increase the effectiveness AND provide protection from sexually transmitted disease. 

 


Am I a good candidate for the Diaphragm?


The diaphragm is worth considering if you cannot or prefer not to use hormonal birth control. You must be able to use it every time you have sex.

 


Are there any reasons why I shouldn’t use the Diaphragm?


The diaphragm may not be a good choice for you if you are unlikely to use it correctly every time you have sex.  You may not be able to use it if you or your partner is sensitive to the chemicals used in spermicides or has a latex allergy.  You may have a higher failure rate if you are under 25 years of age and have intercourse three or more times per week.

 


What are the most common side effects of the Diaphragm?


·
increased risk of urinary tract infections, yeast infections and bacterial vaginosi
·sensitivity due to latex allergy


 

What are the benefits of the Diaphragm?


·
almost no side effects and does not affect your hormonal pattern
·lower risk of cervical cancer and pre-cancerous conditions of the cervix


 

How do I get a Diaphragm?

The diaphragm itself requires a prescription although the spermicide used along with it may be purchased over the counter.  Diaphragms come in many sizes and you need to be examined to find out which size fits you best.  After a type and size of diaphragm are determined for you, you will be shown how to insert and remove it.  You will also learn how to check that the diaphragm is properly placed.  The first time you do this should be during the office visit to ensure you are inserting it correctly.


How do I use a Diaphragm?

Here are the basic instructions for inserting a diaphragm:

1.       Wash your hands carefully with soap and water before inserting the diaphragm.  Apply spermicidal cream or jelly around the rim and inside the dome of the diaphragm.  The spermicide must be on the side of the diaphragm facing or in contact with the cervix.  It also can be placed on both sides.

2.       Squeeze the rim of the diaphragm between your fingers and insert it into your vagina.  When the diaphragm is pushed up as far as it will go, the front part of the rim should be up behind a bone you can feel in front of your pelvis (the pubic bone).  Tuck the front rim of the diaphragm up as far as it will comfortably go.

3.     Check to see if your cervix is covered.  To do this, reach inside and touch your cervix.  The cervix feels something like the tip of your nose.  After the diaphragm is in place, the cervix should be completely covered by the rubber dome.

When do I insert the Diaphragm?

The diaphragm may be placed up to 6 hours before you have sex.  No matter when you insert the diaphragm, always be sure to use a spermicide.  Diaphragms should not be used without this added protection.  If you have put in the diaphragm more than 2 hours before having sex, you must insert a fresh supply of spermicide into your vagina just before intercourse. To do this, insert the spermicide with an applicator while the diaphragm is in place.  An applicator usually comes with the spermicide.  You must also check the position of the diaphragm and add more spermicide before each act of intercourse, no matter how closely together they occur.  Do not use oil-based lubricants such as petroleum jelly; they can damage the diaphragm.  Water-based lubricants such as KY jelly or Astroglide are fine.

 

When should I remove the Diaphragm?

The diaphragm must be left in place for 6 hours after you have sex, but should NOT be worn for more than 24 hours.  To remove the diaphragm, pull gently on the front rim.  Wash it with mild soap and water, rinse the soap off well (soap can harm the rubber), dry it, and put it back in its case.

 

When do I need to replace the Diaphragm?

The diaphragm may become discolored over time, but it can still be used unless you notice any holes in the rubber.  To check for holes, hold the diaphragm up to the light and stretch the rubber gently between your fingers.  Filling the diaphragm with water is another way to check for holes.  You should get a new diaphragm about every 2 years.  Your diaphragm should be rechecked at your yearly exam and should be refitted if you have:

 

                ·had pelvic surgery

                ·been recently pregnant

                ·gained or lost a lot of weight

                ·trouble with the diaphragm slipping out of place

                ·pain or pressure during sex

 

What should I do if I forgot to use the Diaphragm or placed in incorrectly?

Emergency contraception is available if you are concerned that may be pregnant.  This can only be used within 72 hours of unprotected or inadequately protected intercourse.  Call the office to find out more about this back-up method of birth control.


Are there any warning signs I should look out for when using a Diaphragm?

There is a slight increased risk of toxic shock syndrome in diaphragm users if it is worn for more than twenty-four hours. 

Call your doctor if you have any of the following warning signs
-Sudden high temperature
-Vomiting or diarrhea
-Dizziness, faintness, weakness
-Sore throat, aching muscles and joints
-Rash-like sunburn


Julianne M. Dunne, MD
westmed medical group
3030 Westchester Avenue
Suite 202
Purchase, NY  10577
tel. (914) 848-8668
fax. (914) 948-1019