Diaphragm: Do you know this contraceptive method?


Interest in diaphragm seems to be growing. In social networks, women discuss and exchange information to start a new life, free of hormones

You are Brazilian, you are of childbearing age and you protect yourself from pregnancy with the use of a condom or birth control pill . Right? It’s easy to know that. After all, these are the most popular contraceptive methods in the country. In Brazil, 79% of women use some type of contraceptive, and the vast majority opt for hormones (such as the pill and the injection) or choose a condom, which is a barrier method. But few couples remember an old option, which seems to be coming back slowly: the diaphragm – you must have heard of it in one of those old school sexuality classes.

Now, women are rediscovering this alternative and they come together in online groups to exchange information. They are usually people who want to get rid of the use of hormones (and the side effects that come with them) or want to associate the diaphragm with other methods (such as a condom or table) for extra protection. On Facebook, the closed group Diaphragm – Contraceptive Method was created in August of last year specifically for those interested in the topic. There are already more than 5,000 participants who talk without taboos and help each other by exchanging personal experiences. Another group that only grows is the Goodbye Hormones: Non-Hormonal Contraception, with 123 thousand members. There, they all have one common goal: figuring out the best way to avoid pregnancy without bombarding the body with hormones. For this, they discuss several methods – among them,

“We have recommended the associated use. Some women and professionals may ask, but does it make sense? Well, it makes sense to many women. The diversity of methods is important, “explains gynecologist Halana Faria of the Feminist Sexuality and Health Collective, who became a reference for the method in São Paulo (SP). “The diaphragm enables the woman to get in touch with her body and understand its anatomy and physiology. It generates autonomy, because it places and takes away when it wants. It does not depend on a professional, as it does on implants and the IUD, “he says. CRESCER talked to several experts to understand everything about the diaphragm. Check it out next.


It is a non-hormonal contraceptive method, but a barrier. That is, it prevents pregnancy because it prevents the sperm from coming into contact with the egg. The diaphragm is nothing more than a circular shaped silicone mold. Before intercourse, it should be introduced through the vaginal canal and positioned to cover the cervix.

When did it happen and why did it fall into disuse?

The diaphragm was born in Germany in the 19th century, according to medical literature. In Brazil, it came in the late 1980s. Many schools explained about the method in sex education classes, but today few know it. In social networks, women complain about the difficulty of finding doctors who can guide them about their use. According to professionals interviewed by CRESCER, the fall in popularity is due, in large part, to the growing medication of women’s health. From the 1990s onwards, the pill gained space and the diaphragm came to be seen as outdated. Another reason would be that the effectiveness of it (94%) is not as high as that of the pill (99%), the IUD (97%) or the subcutaneous implant (99%). It is also necessary to consider that the doctor has to know well the method to prescribe it, besides being willing to guide the woman. A query in which the diaphragm is presented is usually longer, since the specialist needs to pass a series of information and guidance. A survey of Febrasgo with 600 physicians showed that 34% of them had no training to teach the patient to use the diaphragm, and even those who knew it rarely did.


First of all, know that the diaphragm lasts for three years, according to the manufacturer. After this period, it must be changed so that there is no risk of unwanted pregnancy. It is also necessary to acquire a new case if there is any hole or scratch on the surface. The hygienization of the object can happen in the bath itself and does not need anything other than soap and water. When not in use, it should be stored in the enclosure that came with the product to prevent damage to the material. It is important to emphasize that as the woman gains or loses a lot of weight, it is fundamental to re-measure with the gynecologist, since the previous diameter may change. It is worth remembering that during the menstrual period it should not be used because it holds the blood inside the uterus and this can lead to severe inflammation or infection.


Seek out a gynecologist who is familiar with the diaphragm. This can be done in the SUS Basic Health Units or in private consultations or agreements. In them, the patient undergoes a measurement, since there are several sizes available (from 60 mm to 85 mm). The woman lies in a gynecological examination position and the doctor inserts two fingers into the vaginal canal. As measured, it tests two or three different diameters of the product. Then the patient should move to make sure she feels some discomfort. The ideal size does not cause any discomfort. Then the gynecologist will teach you to put it on and take it off alone and also make a prescription to be able to buy it.


In Brazil, it can only be bought with a prescription, since it depends on a previous measurement. It is possible to find in pharmacies or stores of hospital products, and the easiest way is in the virtual stores, which deliver throughout the country. Another option is to contact the manufacturer. Currently, there is only one company that produces in Latin America, Semina – and it is Brazilian! It costs about $ 120.


Daily (so-called “continuous use”) or just prior to intercourse. If you find it difficult to insert it, use water-based lubricant. After sex, you must wait at least eight hours to remove the diaphragm (this is the maximum time the sperm survives in the vaginal canal). But be careful: never stay more than 24 hours straight with him. It is important to remove and leave the channel free, even for a short time.


The Ministry of Health offers several contraceptives for free – and the diaphragm is one of them! In a statement, the agency said that the method should be available at all UBS. According to official data, from 2011 to 2015, 63,266 units of the product were distributed by the SUS – a tiny number compared to 27 million women of childbearing age in the country. If you can not find a qualified SUS professional for the measurement, call 136 (Dial Health) and register the complaint.


The subject is controversial in the medical literature because it involves a number of factors (from mode of use to association with other methods). For maximum protection, it is recommended to use the product in all sexual relations, even if you are not on fertile days – this is called “perfect use.” In these cases, the chance of getting pregnant using only it is 4% to 6%. However, when the woman does not follow the recommendation, this rate can reach 16%. That is why physicians have suggested the combined use of the diaphragm with one or more forms of protection, such as a condom, table or sintothermal method (temperature and cervical fluid gauging).


With her own hand, the woman pushes the diaphragm (2) through the vaginal canal (1) until she feels it is covering the cervix (3). To remove, simply insert your finger and pull it out.


Almost every woman can use the method. It is not only recommended for those who have prolapse, rupture, retroversion or severe anteflexion of the uterus (which are rare situations), as well as poor vaginal muscle tone. Those with a psychological aversion to touching their own genitalia or who show great difficulty in learning how to place and remove the diaphragm should also avoid it.


The biggest of these is the fact that it is hormone-free and consequently can be used by the vast majority of women without side effects. Otherwise, it is a non-invasive method, which is not felt by the couple during the relationship and can be stopped immediately (if you decide to become pregnant). If you currently only use a condom as a contraceptive method, the diaphragm can also be helpful because it acts as an extra barrier in case it pops or leaks. And, to complete, for those who have allergy to latex condoms, the diaphragm is a great option, because it is made of silicone.


If used alone and not very carefully, there is a higher failure rate than methods such as the pill or the IUD, for example. It also does not protect against sexually transmitted diseases – unlike condoms.


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