Since there are various types and sizes of diaphragms, you will need to have a gynecological examination to make sure your pelvic organs are normal and that you do not have any infections. At that time you will be measured and taught how to use the diaphragm during your clinic visit. You will then be given the fitting diaphragm to take with you, insert at bedtime, and return with it in place to clinic in the morning for a recheck to be sure the size is correct and that it remained in place overnight. You will then be given a prescription for a diaphragm which you can buy at the pharmacy of your choice.

During actual use, squeeze approximately one tablespoon of spermicidal cream or jelly into the dome of the diaphragm and spread it around the dome. Fold it in half and insert it into the vagina like a tampon. With your index finger check the rim at the pubic arch and make sure the cervix is covered. It may be inserted immediately before intercourse or some time ahead to promote spontanaeity, and is left in place 6-8 hours after intercourse to ensure inactivation of sperm. It is effective immediately upon insertion and up to four hours without adding more cream or jelly, or for one intercourse. Should you have intercourse a second time, use an additional applicator of jelly in the vagina without removing the diaphragm and extend the removal time another 6-8 hours. It should not be left in place longer than 24 hours.

After removing the diaphragm, wash it with warm water and mild soap. Dry it thoroughly, inspect it for possible tears or holes, and store it in a dry place. This regular inspection will allow you to replace the diaphragm before you need it again should you find any defects. Allowing it to air dry or dry thoroughly in a drawer before putting it in its case keeps the rubber in better condition longer and prevents odor. You may also powder it lightly with cornstarch. Soak it in rubbing alcohol (70%) for 30 minutes after use following treatment for vaginal infection.

Following the diaphragm fitting and recheck, you should have a yearly gynecological examination including Pap smear and tests for infection if indicated. However, the diaphragm does not need to be checked for size every year unless you have a pregnancy, a marked change in weight (either gain or loss), or think for some reason the diaphragm is no longer fitting properly. The diaphragm will usually remain suitable for use for several years.

SCHS: CN/Rev/2/01