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Fact Sheet
The diaphragm
What is a diaphragm?
Advantages as a contraceptive method
A diaphragm is a barrier method of contraception used
by women.
• Side effects are rare
• There is no delay in return to fertility as it does not
interfere with the menstrual cycle
• It can be used on an intermittent basis when sexual
activity occurs
• It does not inhibit spontaneity with sexual activity (it
can be inserted well before the time of sexual activity
if preferred)
• It can be used by breastfeeding women
• It is a safe alternative for women who are unable to use
hormonal methods of contraception
A diaphragm is a shallow dome of silicone with a firm,
flexible rim. It is placed in the vagina so that it covers the
cervix (entrance to the uterus) and tucks in behind the
pubic bone. It is held in position by the pelvic muscles.
Diaphragms are available in different sizes.
Disadvantages as a contraceptive method
Disadvantages include:
• The relatively low effectiveness rate may be
unacceptable to some women
• It has not been found to protect against STIs (sexually
transmissible infections)
• It may be unacceptable to some women who do not
feel comfortable inserting the device into the vagina
How does a diaphragm work?
When the male partner ejaculates inside the vagina
during intercourse, the diaphragm prevents the sperm
getting into the uterus. After intercourse the diaphragm
must be left in place for a further six hours during which
time any sperm in the vagina die (sperm in the vagina
don’t survive as long as sperm in the uterus or fallopian
tubes due to the difference in the vaginal environment
compared to the uterus or fallopian tubes).
How effective is the diaphragm?
The diaphragm is 88-94% effective. This means that
between 6 and 12 out of every 100 women who use
this method for a year may become pregnant. The
effectiveness increases with experience, consistent use
and correct fitting of the diaphragm.
Possible side effects or complications of
using a diaphragm
Side effects are rare but may include:
• An increase in urinary tract infections, particularly in
women with a history of urinary tract infections in the past
• Toxic shock syndrome – which has been reported
in women using barrier methods of contraception
including diaphragms. These cases are extremely rare
but appear to be more likely if a woman is using a
diaphragm during menstruation. Women with a history
of toxic shock syndrome should not use a diaphragm
What do I need to know about starting to
use a diaphragm?
Diaphragms come in different sizes. It is important to be
fitted for one that suits you, at a Family Planning clinic
or by other trained health professionals. Complete
instructions on how to insert and remove the diaphragm
will be provided at the time of fitting.
www.fpnsw.org.au | talkline 1300 658 886 | bookshop
clinical services & information | education & training | research | international development
Family Planning NSW is a not-for-profit organisation funded by the NSW Ministry of Health
The information in this Fact Sheet has been provided for educational purposes only. FNPNSW has taken every care to ensure that
the information is accurate and up-to-date at the time of publication. Individuals concerned about any personal reproductive or
sexual health issue are encouraged to seek advice and assistance from their health care provider or visit a Family Planning Clinic.
Reviewed May 2013/FPNSW 05/13
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Figure A: The
diaphragm is
inserted into the
vagina anytime
before intercourse,
by squeezing the
opposite sides of
the rim together
so it is narrow
enough to slide
into the vagina. Some women find it easiest to insert the
diaphragm when standing with a foot on a chair whilst
others prefer to squat or lie down. It needs to be inserted
so that it covers the cervix with the front rim tucking
behind the pubic bone. You should check that the
diaphragm is covering the cervix, with your index finger.
Figure B: To remove
the diaphragm, put
your finger behind
the front rim and
pull it down and
out. It must not be
removed until at
least six hours after
sexual intercourse,
as sperm can survive in the vagina for a number of hours. It
should not be left in the vagina for more than 30 hours as
this may lead to vaginal irritation and discharge.
Although use of a spermicide with the diaphragm is
recommended by the manufacturer, spermicide is
not currently available in Australia. Studies have not
clearly established whether spermicide improves the
effectiveness of the diaphragm.
If spermicide is used, a teaspoon sized amount should
be applied on the (upper) side, which will be in contact
with the cervix, prior to sexual intercourse. If sex takes
place again within the six hour time frame, additional
spermicide should be applied into the vagina, but
without removing or dislodging the diaphragm.
checked regularly for any holes or signs of wear or feeling
“tacky” as this may indicate the silicone is perished.
Avoid contact with disinfectants, detergents, powders
or perfumed soaps which may weaken and damage the
diaphragm.
Check with a pharmacist when using any vaginal product,
to find out if it is suitable to use with a diaphragm.
You are advised to check that the size is still suitable in
the following circumstances:
• six weeks after giving birth
• if there has been a weight gain or loss of around 3 kg or more
• if it is uncomfortable for you or your partner when it is
in place
• if the diaphragm is easily dislodged or moves during
intercourse
• if you have any difficulties inserting or removing the
diaphragm
• if you have discomfort passing urine or opening your
bowels
What if the diaphragm is dislodged or
breaks during sex?
If the diaphragm moves out of place, tears or is not used
properly, emergency contraception should be considered.
The Emergency Contraceptive Pill (ECP) can be used
to help prevent pregnancy. It is available without a
prescription from pharmacies. It should be taken as soon
as possible after unprotected intercourse. Contact your
Family Planning clinic or GP if you are unsure whether you
need to take the ECP.
Where are diaphragms available?
Diaphragms may be bought from Family Planning clinics and
most pharmacies once the correct size and type are known.
For further information
• Contact the Family Planning NSW Talkline on
1300 658 886 or go to www.fpnsw.org.au/talkline
If the diaphragm is used during menstruation, it should
not be left in place for longer than six hours because of
the small risk of toxic shock syndrome.
• NRS (for deaf) 133 677
Ongoing use of the diaphragm
purposes only. Family Planning NSW has taken every care to ensure that
If the diaphragm is properly cared for it should last for up
to two years.
the information is accurate and up-to-date at the time of publication.
After use, the diaphragm should be cleaned, rinsed,
dried thoroughly and stored in a cool place. It should be
• Visit your nearest Family Planning clinic
The information in this Factsheet has been provided for educational
Individuals concerned about any personal reproductive or sexual
health issue are encouraged to seek advice and assistance from their
health care provider or visit a Family Planning clinic.
www.fpnsw.org.au | talkline 1300 658 886 | bookshop
clinical services & information | education & training | research | international development
Family Planning NSW is a not-for-profit organisation funded by the NSW Ministry of Health
Family Planning QLD 07 3250 0240 | Family Planning TAS 03 6273 9117 | Family Planning VIC 03 9257 0121
Family Planning WA 08 9227 6177 | Family Planning Welfare Association of NT 08 8948 0144
Sexual Health and Family Planning ACT 02 6247 3077 | SHine SA 08 8300 5300