What is the contraceptive diaphragm?
The condom is not the only barrier method of contraception: in fact, the contraceptive diaphragm also stands out in this category, a small soft rubber dome mounted on a fairly malleable and foldable metal ring, which the woman inserts near the neck of the " uterus (transvaginally) a few moments before sexual intercourse.
It is necessary to point out a substantial and absolutely important difference between the contraceptive diaphragm and the condom: while the latter guarantees excellent protection from unwanted pregnancies (98-99.8%) and from sexually transmitted diseases, the diaphragm (improperly also known as condom female) does not provide the same guarantee of protection from pregnancy or from the transmission of venereal diseases.
In Italy, the diaphragm is a contraceptive method that is no longer in use, above all because it is not entirely reliable; moreover, it is an almost difficult contraceptive to insert, especially for young women inexperienced.
Features
The contraceptive diaphragm is generally made of medical silicone or latex, which forms the body of the cap; the base is made up of a sort of flexible metal ring, useful for giving some support to the diaphragm.
When the woman wishes to use the contraceptive diaphragm, she must first undergo a gynecological examination: in fact, it will be the doctor's task to recommend the most suitable diaphragm for her, based on the patient's internal genital anatomical characteristics.
According to Italian law, unlike many countries (eg USA), the diaphragm does not require a medical prescription.
The diaphragm, depending on the material with which it is made, can have a variable duration, generally from 6 months to two years.
Reliability of the method
Unfortunately, the diaphragm does not represent a valid method of contraception, given the high Pearl index, estimated at around 2-3 (failure rate: 20%). Please note that "the" Perl index "refers to a standard method suitable for evaluating the effectiveness of contraceptive methods, therefore useful to give an "idea about the reliability of the contraceptive method in question: the" Pearl index is indirectly proportional to the contraceptive efficacy (the higher the value, the lower its effectiveness) . Considering that the Pearl index of birth control pills is estimated at around 0.1, it is clear that the diaphragm value of 2 or 3 heralds a very high risk of failure: some research has estimated that the reliability of the diaphragm would be even lower, considering the high number of failures (unwanted pregnancies).
In any case, the risk coefficient of the diaphragm is almost variable, since it mainly depends on the correct application of the same.
The only contraceptive method that ensures a guarantee of total success (Pearl index equal to zero) is surgical sterilization.
How to use
The doctor must communicate to the woman all the information necessary for a correct use of the diaphragm: as already mentioned, in fact, a diaphragm can be used for approximately two years. The integrity of the medium does not depend only on the structural characteristics of the same, but also by the way it is used: in this regard, by carefully observing the correct conditions of use, a long life of the diaphragm is ensured and, above all, it benefits from a certain protective guarantee against unwanted pregnancies.
- How should the contraceptive diaphragm be inserted?
The diaphragm must be inserted completely inside the vagina, positioning it near the cervix, which corresponds approximately to a distance of 2.5 cm from the pubic bone.
The diaphragm, being a kind of flexible dome, naturally adapts to the internal genital anatomy.To decrease the risk of contraceptive failure, the diaphragm is used together with particular spermicidal substances: the best known spermicide, Nonoxilon-9, is spread inside the rubber dome - on the part in contact with the opening of the cervix. uterine - just before inserting the diaphragm. Ideally, the diaphragm-spermicide association allows to decrease the Pearl index, therefore it seems to be able to guarantee greater protection from a possible pregnancy. However, it is estimated that the Pearl index of the spermicide used alone is very high, consequently very unreliable.
- When should the contraceptive diaphragm be inserted?
The contraceptive diaphragm is usually inserted some time before intercourse to ensure correct positioning of the same. It is not recommended to insert it immediately before intercourse, otherwise you could run the risk of inserting it too hastily, increasing the probability of an incorrect application. In any case, theoretically, the diaphragm could be inserted even a moment before the beginning of the relationship.
- When should the diaphragm be removed?
Given the low reliability of the contraceptive method, it is advisable to remove the contraceptive diaphragm only after 6-8 hours from full intercourse, to allow the spermicide to act if necessary.
The diaphragm should not be kept in the vagina for more than 24 hours.
- How should the contraceptive diaphragm be stored?
Correct conservation of the diaphragm is essential for maintaining its perfect integrity: after having removed it from the vagina gently, following intercourse (preferably after 6/8 hours, when used together with the spermicide) the diaphragm should be washed thoroughly in warm water and soap, rinsed again and dried, to be placed inside the containing case. It is recommended to store it in a dry environment, away from excessive heat and humidity, and to check its integrity every time a complete report is consumed.
In addition, it is advisable to go to the gynecologist once or twice a year for a possible replacement of the diaphragm.
If there is a hole or a tear in the diaphragm, the prevention of pregnancy is almost nil: consequently it is advisable to consult a doctor for a possible post-coital contraceptive method (IUD spiral, morning after pill) since a pregnancy could be in progress.
Diaphragm and Contraception: advantages and disadvantages "
