You only have to use a diaphragm or cap when you have sex, but you must leave it in for at least 6 hours after the last time you had sex. You can leave it in for longer than this, but don’t take it out before.
You need to apply more spermicide if:
- you have sex again with the diaphragm or cap in place
the diaphragm or cap has been in place for three hours or more before you have sex
- Don’t take the diaphragm or cap out to reapply spermicide.
You shouldn’t use a diaphragm or cap during your period as there is a possible link with toxic shock syndrome (TSS), a rare condition that can be life threatening.
Most women are able to use a diaphragm or cap, but it may not be suitable for you if you:
- have an unusually shaped or positioned cervix (entrance to the womb), or if you can’t reach your cervix
- have weakened vaginal muscles (possibly as a result of giving birth) that can’t hold a diaphragm in place
- have a sensitivity or an allergy to latex or the chemicals in spermicide
- have ever had toxic shock syndrome
- have repeated urinary tract infections
- currently have a vaginal infection (wait until your infection clears before using a diaphragm or cap)
aren’t comfortable touching your vagina
- have a high risk of getting an STI – for example, if you have multiple sexual partners
Research shows spermicides that contain the chemical nonoxynol-9 don’t protect against STIs, and may even increase your risk of getting an infection.
A diaphragm or cap may be less effective if:
- it’s damaged – for example, it’s torn or has holes
- it’s not the right size for you
- you use it without spermicide
- you don’t use extra spermicide with your diaphragm or cap every time you have more sex
- you remove it too soon (less than 6 hours after the last time you had sex)
- you use oil-based products, such as baby lotion, bath oils, moisturiser or some vaginal medicines (for example, pessaries) with latex diaphragms – these can damage the latex
If any of these things happen or you’ve had sex without contraception, you may need to use emergency contraception.
Depo-Provera is most commonly given in the UK and lasts for 13 weeks. Occasionally, Noristerat may be given, which lasts for 8 weeks. Sayana Press also lasts for 13 weeks, but it’s a newer type of injection so is not available at all clinics or GP surgeries. You usually have the Depo-Provera and Noristerat injections in your bottom, but you can have them in your upper arm. You can have the Sayana Press injection in your tummy (abdomen) or thigh and would normally learn to do this yourself.
If you’re 40 or over when you have an IUD fitted, it can be left in until you reach the menopause or you no longer need contraception. Check your IUD is in place a few times in the first month and then after each period, or at regular intervals. An IUD has 2 thin threads that hang down a little way from your womb into the top of your vagina. The GP or nurse that fits your IUD will teach you how to feel for these threads and check that it’s still in place. It’s very unlikely that your IUD will come out, but if you cannot feel the threads or think it’s moved, you may not be protected against pregnancy. See a GP or nurse straight away and use additional contraception, such as condoms, until your IUD has been checked.
Advantages and disadvantages of condoms
Some advantages of using condoms:
- When used correctly and consistently, they are a reliable method of preventing pregnancy.
- They help to protect both partners from STIs, including chlamydia, gonorrhoea and HIV.
- You only need to use them when you have sex – they do not need advance preparation and are suitable for unplanned sex.
- In most cases, there are no medical side effects from using condoms.
- They are easy to get hold of and come in a variety of shapes, sizes and flavours.
Some disadvantages include:
- Some couples find that using condoms interrupts sex – to get around this, try to make using a condom part of foreplay.
- Condoms are very strong but may split or tear if not used properly. If this happens to you, practise putting them on so you get used to using them.
- Some people may be allergic to latex, plastic or spermicides, but you can get condoms that are less likely to cause an allergic reaction.
- When using a condom, the man has to pull out after he has ejaculated and before his penis goes soft, holding the condom firmly in place.
Condoms come lubricated to make them easier to use, but you may also like to use additional lubricant (lube). You can use any type of lubricant with polyurethane condoms that aren’t made of latex. However, if you’re using latex or polyisoprene condoms, don’t use oil-based lubricants – such as lotion, body oil or petroleum jelly (Vaseline) – because they can damage the condom and make it more likely to split. Water-based lubricants are safe to use with all condoms. If you are using medication for conditions like thrush, such as creams, pessaries or suppositories – this can damage latex and polyisoprene condoms, and stop them working properlySome condoms come with spermicide on them. You should avoid using this type, or using spermicide as a lubricant, as it doesn’t protect against STIs and may increase your risk of infection.
Advantages of a diaphragm or cap:
- you only need to use a diaphragm or cap when you want to have sex
- you can put it in at a convenient time before having sex (use extra spermicide if you have it in for more than 3 hours)
- there are usually no serious associated health risks or side effects
- you’re in control of your contraception
Disadvantages of a diaphragm or cap:
- it’s not as effective as other types of contraception, and it depends on you remembering to use it and using it correctly
- it doesn’t provide reliable protection against STIs
- it can take time to learn how to use it
- putting it in can interrupt sex
- latex and spermicide can cause irritation in some women and their sexual partners