To wonder why so few women use the diaphragm nowadays

[Jemima232]

I am forever reading posts about contraception and wonder why so few women use the diaphragm or cervical cap nowadays.

I used both for years and found them very reliable.

No hormones, no coils leading to heavy bleeding/pain and no condoms.

Why have they gone out of fashion?

I use it as I don’t like the pill and have fallen pregnant on it twice and don’t want the added hormones

And I prefer sex without condoms

Can put in before you have sex and have found it’s fine to use early on in a relationship as you know you are going to anyway (so will have it in place most of the time) getting the hang of it takes a few times but once you have easy to use

This is going to sound silly but I didn’t know it was still an option...I just used the implant for 4 years

I love female condoms. Used one back in the day and it was like a Tesco bag. Now they're smaller, less crackly. I actually didn't realise you could leave them in all day if you're having a session

Probably helps that I'm seeing someone who helped develop them in his early career...

isn’t that quite a high failure rate?

Out of interest because I've never considered this as a method of contraception really- why do you need to get it refitted if you gain/ lose weight? Does your cervix get fatter/ thinner too?

Every doctor and sexual health clinic advised against it. Basically the fitting and measuring is a hassle. Size can change with weight etc

I too think it is not good for women that they are out of fashion and there is no expertise around for fitting them. They were not right for everyone, but if they fit you well internally they were good and a blessing if you have bad reaction to hormonal contraception as I did. I used this for years with no accidental pregnancy as did my own Mum. Now there's only one nurse left at my large GP Practice trained to fit them I'm told and she's close to retirement, I seem to remember debates as to whether it was the barrier or the spermicide that contributed to the effect.

While not fully protective against STDs they did protect the cervix to an extent as studies showed some reduction in cervical cancer rates with those using them longterm.

@Morticiaismystyleicon

Yes, you need a bigger one if you lose weight and a smaller one if you gain weight.

There is more room in your vaginal vault when you're thinner and vice versa.

If you gain or lose 7lb you need to get a new size.

The failure rate is way too high. Typical use effectiveness of 71-88% means approx 20 women out of 100 will get pregnant using them within one year. It's not much better than natural family planning and I can't imagine many people suggesting that as a fantastic contraceptive.

Tried the diaphragm, found it uncomfortable and a dreadful faff, gave up very quickly.

@Morticiaismystyleicon yes you do change inside with weight change, I had to have a larger size when lost weight and a smaller when gained weight over the years

I mean the 5% failure rate was too high. The other rates are really shocking. That’s not factoring in the faff, op I think you have your answers.

you cannot feel it inside if it is properly fitted unless there is no shape that suits you so if it was uncomfortable it was not properly fitted or would not be suitable.

@LisaMontgomery

You've quoted incorrect failure rates.

www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/

My gynaecologist measured my vagina and told me what size to buy.

They really need a hysterically laughing emoji.

70 mm, if you're interested. I don't see what's so funny about that.

The failure rate is as quoted in the NHS link above. It is almost as reliable as condoms IF used correctly - a lot of people don’t put enough spermicide in and around it and either take it out too soon or don’t fit it correctly in the first place.

I learned at school (00s) that they are terribly prone to failure. I have 60% in my head as their effectiveness which must be wrong, especially now I've looked it up but I had this idea that they are really outdated and we have better options now.

However, when you're promoting something to people it REALLY pays to look at the actual use rates, rather than the perfect use rates. Nobody is perfect and when you're horny you're more likely to make poor decisions, apparently. The fact is if something has a drastically different typical vs perfect use failure rate, it means it's fairly likely that it will be used incorrectly and/or that it's quite difficult to get right. You can see this when you compare perfect and typical failure rates of something where no user action is required such as a coil or implant.

Here's a list with all contraceptives rated by typical and perfect use failure rates: en.wikipedia.org/wiki/Comparison_of_birth_control_methods

Note that failure rate percentages refer to number of couples using this method who become pregnant during one year of using this method. 5% per year isn't a chance I'd want to take if I really didn't want to be pregnant. I'd just use withdrawal if I wanted to take that kind of risk - with perfect use that's only 4% failure rate. Better than the diaphragm and you don't have to mess around with gels and so on - what's not to like?

Less reliable, fiddly, a bit antiquated really...

I can’t even use tampons so I’d really struggle inserting something like that. Couldn’t be arsed with the faff of it tbh and it removes the spontaneity from sex, like condoms do.

My reasons:

• I love hormonal contraception
• with 2 young kids sex is often very spontaneous and fast, wouldn't have time to put it in
• sounds like a mood killer
• I'm prone to utis and thrush and anything up my vag makes it worse
• failure rate is ridiculous

Natural Family Planning is actually more effective if you're doing all the steps (cervical fluid observation and basal body temperature)

My arms are shorter than most so I wouldn't be able to get it in. Plus I'm on my 2nd mirena coil. I've not had a period for 6 yrs. it's flippin ace.

im going to have a copper coil fitted soon but all the horror stories about coils put me off

I used one for years.

They were good for sex during your period: held back the blood.

Not good for oral sex because of the taste of spermicide.