How you prepare

The traditional dome-shaped diaphragm comes in different sizes, and you need to be fitted for one by your health care provider. A newer diaphragm option — the Caya diaphragm — comes in one size. To get either type of diaphragm, you need a prescription from your health care provider.

During an office visit, your health care provider will demonstrate how to insert and remove the diaphragm — and may have you practice doing so, too. To confirm that the diaphragm is in the correct position, your health care provider may perform a pelvic exam.

Before you use the diaphragm for the first time, practice inserting the diaphragm until you're comfortable with it. You may want to use a backup method of contraception, such as a male condom, the first few times you use the diaphragm.

Always use the diaphragm with spermicidal cream, foam or gel. Avoid use of body lotions near your vagina and vaginal medications when using the diaphragm. If you're using a diaphragm and douche, wait until at least six hours after sex to avoid washing away spermicide.

Make sure you regularly check your diaphragm for puncture marks or cracks. To search for holes, hold your diaphragm up to the light and gently stretch the rubber between your fingers or fill the diaphragm with water. Replace your diaphragm at least every two years. You may need to have your diaphragm checked and possibly refitted if:

• Your diaphragm no longer fits snugly or comfortably
• You've given birth or had an abortion
• You've had pelvic surgery
• You've gained or lost more than 10 pounds (4.5 kilograms)
• You have repeated urinary tract infections
• You or your partner feels pain or pressure during sex