Editing Diaphragm (birth control) (section)

{{Short description|Cervical barrier type of birth control}}
{{Infobox Birth control
|name                 = Diaphragm
|image                = contraceptive diaphragm.jpg
|width                = 300
|caption              = An arcing spring diaphragm in its case, with a [[Quarter (United States coin)|quarter]] added for scale.
|bc_type              = Barrier
|date_first_use       = 1880s<ref name=Su2014/>
|rate_type            = Failure
|failure_measure      = first year with [[spermicide]]
|perfect_failure% = 6
|perfect_failure_ref =<ref name=Trus2011>{{cite book|last=Trussell|first=James|year=2011|chapter=Contraceptive efficacy|editor1-last=Hatcher|editor1-first=Robert A.|editor2-last=Trussell|editor2-first=James|editor3-last=Nelson|editor3-first=Anita L.|editor4-last=Cates|editor4-first=Willard Jr.|editor5-last=Kowal|editor5-first=Deborah|editor6-last=Policar|editor6-first=Michael S. |title=Contraceptive technology|edition=20th revised|location=New York|publisher=Ardent Media|isbn=978-1-59708-004-0|issn=0091-9721|oclc=781956734|pages=779–863|chapter-url=http://www.contraceptivetechnology.org/wp-content/uploads/2013/09/CTFailureTable.pdf|url-status=live|archive-url=https://web.archive.org/web/20131112130150/http://www.contraceptivetechnology.org/wp-content/uploads/2013/09/CTFailureTable.pdf|archive-date=2013-11-12}}</ref>
|typical_failure% = 12
|typical_failure_ref =<ref name=Trus2011/>
|duration_effect      =
|reversibility        = Immediate
|user_reminders       = Inserted before sex with spermicide.<br>Left in place for 6–8 hours afterwards
|clinic_interval      = For size fitting and prescribing in some countries
|STD_protection_YesNo = Possible
|periods              = Catches menstrual flow
|benefits             = May be reused 1 to 3 years
|weight_gain_loss     =
|risks                = Urinary tract infection, toxic shock syndrome (rare)
|medical_notes        =
}}
{{distinguish|female condom}}
<!-- Definition and medical uses -->
The '''diaphragm''' is a [[barrier contraception|barrier method]] of [[birth control]].<ref name=Hil2008>{{cite book|last1=Hillard|first1=Paula J. Adams|last2=Hillard|first2=Paula Adams|title=The 5-minute Obstetrics and Gynecology Consult|date=2008|publisher=Lippincott Williams & Wilkins|isbn=9780781769426|page=240|url=https://books.google.com/books?id=fOoFIQOdIhkC&pg=PA240|language=en|url-status=live|archive-url=https://web.archive.org/web/20170924000728/https://books.google.com/books?id=fOoFIQOdIhkC&lpg=PA240|archive-date=2017-09-24}}</ref> It is moderately effective, with a one-year failure rate of around 12% with typical use.<ref>{{cite book|last1=Wipf|first1=Joyce|title=Women's Health, An Issue of Medical Clinics of North America|date=2015|publisher=Elsevier Health Sciences|isbn=9780323376082|page=508|url=https://books.google.com/books?id=fJzuCQAAQBAJ&pg=PA508|language=en|url-status=live|archive-url=https://web.archive.org/web/20170924000728/https://books.google.com/books?id=fJzuCQAAQBAJ&pg=PA508|archive-date=2017-09-24}}</ref> It is placed over the [[cervix]] with [[spermicide]] before sex and left in place for at least six hours after sex.<ref name=CDC2016/><ref name=Helm2006>{{cite book|last1=Helms|first1=Richard A.|last2=Quan|first2=David J.|title=Textbook of Therapeutics: Drug and Disease Management|date=2006|publisher=Lippincott Williams & Wilkins|isbn=9780781757348|page=419|url=https://books.google.com/books?id=aVmRWrknaWgC&pg=PA429|language=en|url-status=live|archive-url=https://web.archive.org/web/20170924000728/https://books.google.com/books?id=aVmRWrknaWgC&lpg=PA429|archive-date=2017-09-24}}</ref> Fitting by a healthcare provider is generally required.<ref name=CDC2016>{{cite web|title=Contraception {{!}} Reproductive Health {{!}} CDC|url=https://www.cdc.gov/reproductivehealth/contraception/|website=www.cdc.gov|access-date=1 January 2017|date=21 June 2016|url-status=live|archive-url=https://web.archive.org/web/20170102081052/https://www.cdc.gov/reproductivehealth/contraception/|archive-date=2 January 2017}}</ref>

<!-- Side effects and mechanism -->
Side effects are usually very few.<ref name=Helm2006/> Use may increase the risk of [[bacterial vaginosis]] and [[urinary tract infections]].<ref name=Hil2008/> If left in the [[vagina]] for more than 24 hours [[toxic shock syndrome]] may occur.<ref name=Helm2006/> While use may decrease the risk of [[sexually transmitted infections]], it is not very effective at doing so.<ref name=Hil2008/> There are a number of types of diaphragms with different rim and spring designs.<ref name=Cor1995/> They may be made from [[latex]], [[silicone]], or [[natural rubber]].<ref name=Cor1995/> They work by blocking access to and holding spermicide near the cervix.<ref name=Cor1995>{{cite book|last1=Corson|first1=S. L.|last2=Derman|first2=R. J.|title=Fertility Control|date=1995|publisher=CRC Press|isbn=9780969797807|pages=211–212|url=https://books.google.com/books?id=30EzZPp1ypYC&q=Diaphragm%20latex%20silicone&pg=PA211|language=en|url-status=live|archive-url=https://web.archive.org/web/20170924000728/https://books.google.com/books?id=30EzZPp1ypYC&lpg=PA213&dq=Diaphragm%20latex%20silicone&pg=PA211|archive-date=2017-09-24}}</ref>

<!-- History, society and culture -->
The diaphragm came into use around 1882.<ref name=Su2014>{{cite book|last1=Everett|first1=Suzanne|title=Handbook of Contraception and Sexual Health|date=2014|publisher=Routledge|isbn=9781135114114|page=62|url=https://books.google.com/books?id=8j9FAwAAQBAJ&q=Diaphragm%20contraception%20history&pg=PA62|language=en|url-status=live|archive-url=https://web.archive.org/web/20170924000728/https://books.google.com/books?id=8j9FAwAAQBAJ&lpg=PA61&dq=Diaphragm%20contraception%20history&pg=PA62|archive-date=2017-09-24}}</ref> It is on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref><ref name="WHO22nd">{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 22nd list (2021) | year = 2021 | hdl = 10665/345533 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2021.02 | hdl-access=free }}</ref>