One super important thing to remember: For a diaphragm to work effectively, you need to use it with spermicide. A diaphragm is a shallow, dome-shaped cup made of silicone; made to hold the spermicide in place. (A diaphragm looks like Meg Griffin’s hat on The Family Guy. Except it’s only a few inches in diameter.) You insert the diaphragm into your vagina. Then it covers your cervix and keeps sperm out of your uterus. 

There are two kinds of diaphragms, Caya (a.k.a. SILCS) and Milex. Your doctor needs to teach you about insertion/removal and do an exam to be certain the diaphragm is a good fit.  If you’re not okay with putting your fingers inside yourself, a diaphragm probably isn’t for you. It’s a little like putting in a tampon, though: If you can do that, you can probably manage a diaphragm. You must use spermicide with the diaphragm for it to be effective.

The most common brand of spermicidal gel in the U.S. is Gynol II, with the active ingredient nonoxynol 9. A new alternative called Cayagel is sold with the Caya diaphragm in Canada and Europe, but it’s not approved in the U.S. yet. Cayagel’s active ingredient is lactic acid and you may be able to purchase online.
A diaphragm can be inserted just before sex, but it can also go in hours before you get to it so that it doesn’t get in the way of the moment. But no matter when it goes in, you have to be sure to leave it in for at least six hours after you have sex. If you’re going to have sex again that day, just leave the diaphragm in place and insert more spermicide way up in your vagina with the applicator. Just don’t leave your diaphragm in for more than 24 hours.

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