The diaphragm requires you to use your fingers to insert and remove the diaphragm. To protect you from pregnancy, the diaphragm and spermicidal cream or gel must be used every time intercourse occurs.
Step 1: Check your diaphragm
Inspect your diaphragm carefully each time before you use it to make certain there are no holes or tears. The best way to do this is to hold the diaphragm up to a light. Pull the diaphragm at the rim on all sides to make sure there are no holes. Look closely at your diaphragm. If there are puckers, especially near the rim, this could mean a thin spot in the rubber. You can also conduct a test by filling the diaphragm with water. If there is a puncture in the diaphragm, you will be able to see a leak.
Step 2: Inserting your diaphragm
Place about one tablespoon of spermicidal cream or gel in the cup of the diaphragm and spread it on the inner cup up to the rim. Insert the diaphragm by squeezing it closed and inserting it into the vagina. Guide the back rim past the cervix and then press the front rim up behind the bony arch that guards the front wall. Make sure you can feel that the cervix is covered by the diaphragm. At first, it may be easier to lie on your back to insert it. The diaphragm can also be inserted from a standing or sitting position.
You can insert the diaphragm and spermicide up to 6 hours before intercourse. But if 6 hours or more pass before you have intercourse, you should leave the diaphragm in place and insert more spermicide deep into the vagina.
During sex, it is possible that the diaphragm may become dislodged when using some positions, but this is not likely to occur if the diaphragm is properly inserted and the fit is tight.
You must leave the diaphragm in place for 6 to 8 hours after intercourse to ensure that all the sperm have been killed. If you have intercourse again in that period of time, you will need to insert more spermicide each additional time. Do not remove the diaphragm to insert more spermicide because you will lose your contraceptive protection.
Step 3: Removing your diaphragm
To remove the diaphragm, wait until at least 6-8 and no more than 24 hours after interourse, then insert your finger into your vagina and up and over the top side of the diaphragm rim and slightly to one side. Hook your finger firmly on the rim of the diaphragm and break the suction. Pull the diaphragm down and out.
Step 4: The ongoing care of your diaphragm
After removing your diaphragm, wash it with warm water and a mild soap such as Ivory. Avoid perfumed soaps--the ingredients may weaken the rubber.
Contact with oil-based products can deteriorate a diaphragm, so you should avoid using oil-based vaginal medications or lubricants (eg petroleum jelly, hand lotion or vaginal yeast creams) when you are using a diaphragm. You should also avoid using any powders on the diaphragm as they can cause infections.
Store the diaphragm in its plastic case and keep it away from heat sources. With time and use, the rubber of the diaphragm may darken, but as long as you take good care of it, it will stay elastic. We suggest getting a new diaphragm approximately every two years.
You should have your diaphragm checked once a year by a medical provider. You may need a new diaphragm if you have a 20% or more change in your weight, have a pregnancy, an abortion or abdominal surgery.