This handout will tell you about diaphragms and how to use one. If you have questions or concerns, please call the number listed at the end of this handout.  

What is a diaphragm?

It is a form of birth control used by women. It is made out of a thin silicone or latex dome and has a flexible ring around the outer edge. You must add in spermicidal (sperm-killing) cream or jelly to the diaphragm every time you use it. It acts as a block to keep sperm out of your uterus. It holds spermicidal (sperm-killing) cream or jelly close to your cervix. If you are unsure what spermicide to use, please ask your health care provider or pharmacist.

Getting Your Diaphragm

Diaphragms come in many sizes. Your health care provider must fit you for your diaphragm. We will find the right size for you. You will be asked to practice putting one in and taking it out. You need to know how to correctly put in and take out the diaphragm before you go home.

How do I put it in? 

The diaphragm must be used each time you have sex. You will want to hold it up to a light and look for tiny cracks, holes, or breaks. Apply spermicide to the diaphragm before inserting it in the vagina. Use about 1 tablespoon or the size of a quarter. Apply it to the inside center of your diaphragm. Use your finger to spread more spermicide around the rim. This will help form a seal against the cervix when it is in place. Put the diaphragm in the vagina as directed.

The diaphragm covers your cervix. It tucks behind your pubic bone (see picture). You should be able to feel your cervix through the diaphragm. A poor fit can cause the diaphragm to slip out of place. This can cause discomfort and increase the risk of getting pregnant.  


Using Your Diaphragm

If over 6 hours passes before you have sex, insert more spermicide in the vagina by using an applicator full of spermicidal cream or jelly. You should leave your diaphragm in to do this.

After you have had sex, you need to keep your diaphragm in place for at least 6 hours. This is done so that the diaphragm keeps blocking the sperm from entering the uterus. It also allows for the spermicide to work on stopping or killing all of the sperm. Do not douche during this time, as it will wash away the spermicide.  

If you want to have sex more than one time, leave your diaphragm in place. You will need to add another dose of spermicide before each time you have sex. Wait 6 more hours before you take it out. Always start counting the 6 hours from the last time you have had sex before taking out your diaphragm.  

Before each time you have sex, it is also vital to check to make sure your diaphragm is still in the correct place. If you find that it has slipped out of place and you have had sex, call our office right away. You may be able to take emergency contraception. It needs to be given as soon as possible after unprotected sex to decrease your chance of getting pregnant.  

You can leave your diaphragm in place for up to 24 hours. It should not get in the way of your normal routines.

How often does it need to be replaced? 

  • It will need to be re-fitted if you gain or lose over 10 pounds.

  • If you have a baby. 

  • If it becomes torn or damaged.

  • Every 2 years.

A diaphragm may or may not be covered by your insurance. Spermicidal cream or jelly must be used with the diaphragm. These can be purchased over-the-counter without a prescription. 

How effective is the diaphragm?

  • With perfect use, if women use the diaphragm every time they have sex and use as instructed every time, the failure rate is 6%. 

  • This means that with perfect use 6 out of 100 women will get pregnant in the first year of use. 

  • The diaphragm works best to prevent pregnancy when it is always used correctly and used every time you have sex.  

  • The typical woman though may not use the diaphragm every time she has sex or may not always use it correctly. 

  • Because of this, the actual failure rate is about 20%. This means that 20 out of 100 women will become pregnant in the first year.  

Care of Your Diaphragm

After use, your diaphragm needs to be washed with mild soap and water. Pat it dry. You may dust it with cornstarch to absorb any extra moisture or leave it to air dry in your open case. This will keep the silicone or latex from breaking down. Do not use talcum powder or perfume. Those may be harmful to the silicone or latex. You will want to hold it up to a light and look for tiny cracks, holes, or breaks. Always store it in its case to protect it. Be aware that contact with oil-based products can cause the diaphragm to fall apart.  

Do not Use

  • Over-the-counter and prescription vaginal creams such as Monistat®, Vagisil®, Gyne-Lotrimin®, Terazol®, Metro-Gel®, Premarin® or Estrace®

  • Petroleum jelly

  • Mineral Oil

  • Cocoa Butter

  • Cold cream

  • Hand lotion

  • Vegetable oil

You may use water-soluble lubricants if needed.  

When to Call Your Clinic

  • Fever

  • Unusual vaginal discharge

  • Odor

  • Itching

  • Urgent, frequent, or burning urination

UW Health- Managed OB Clinics

UW Health West OB/GYN Clinic 

451 Junction Rd

Madison WI 53717

(608) 265-7601

UW Health Gynecology/Oncology Clinic

600 Highland Ave

Madison WI 53792

(608) 263-1548

UWMF- Managed OB Clinics

OB/GYN Clinic

20 S. Park, Suite 307

Madison, WI 53715

(608) 287-2830

UW Arboretum OB/GYN Clinic

1102 S. Park Street

Madison, WI 53715

(608) 287-5898