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"Caps and diaphragms (often known as &amp;#039;female barrier methods&amp;#039;) were extremely popular methods of family planning during the 20th century. But their use has waned in recent years because new types of contraception have become available. However, they still provide a useful option for a minority of women, particularly the over-35s and a new version of the diaphragm was released in 2014. What types are available? There are two main types of contraceptive caps:  the diaphragm the cervical cap.  Diaphragms are a good deal bigger than cervical caps \u2013 they&amp;#039;re about as wide as the palm of your hand. You put the diaphragm into your vagina before sex, positioning it so that it keeps sperms from getting anywhere near your cervix. Cervical caps are much smaller \u2013 about the size of a small egg-cup. You have to put the cervical cap directly onto your cervix, so as to stop sperm getting in.  Cervical caps are much less commonly used than diaphragms \u2013 they&amp;#039;re mainly for women who, because of the shape of their vaginas, find it difficult to keep a diaphragm in place. Though there used to be many types of diaphragm and cap, there are currently only four brands which are readily available on the NHS (three diaphragms and one cap). Diaphragms What exactly are diaphragms? Diaphragms are &amp;#039;domes&amp;#039;, made of thin, soft rubber, or silicone. They form an excellent physical &amp;#039;barrier&amp;#039; to sperms \u2013 though you have to use a spermicide (chemical) with them as well. It would be unwise to just buy a diaphragm &amp;#039;off the peg&amp;#039; at a chemist \u2013 for the simple reason that women&amp;#039;s vaginas come in various sizes (particularly after they&amp;#039;ve had children). So you need to have your vaginal size assessed by a doctor or family planning nurse. She or he will then prescribe the size you need.  Most importantly, she must teach you exactly how to put the diaphragm inside \u2013 and how to get it into exactly the right place. If you haven&amp;#039;t been taught how to do this, you&amp;#039;ll probably position it so that it doesn&amp;#039;t cover your cervix; this would leave you wide open to conception. Although the diaphragm is less popular than it used to be, the most recent survey carried out by the Office for National Statistics showed that 3 per cent of women aged 16 to 49 were using it. Used properly, the diaphragm is an efficient and safe type of contraception. It has a success rate of roughly 95 per cent per year among women who&amp;#039;ve been trained to use it correctly. But if you just &amp;#039;stick it in&amp;#039; at the last moment, without being too sure where it&amp;#039;s going, then your success rate will be much lower. In general, if you are a sexually-active woman, there&amp;#039;s a lot to be said for inserting your diaphragm before you go to bed (and leaving it in all night) \u2013 in case you make love. Each diaphragm will last several years if it&amp;#039;s carefully looked after, so this is an inexpensive contraceptive method, apart from the expense of the spermicidal cream or gel that must always be used with it. (However, you can obtain the cream or gel free of charge on an NHS prescription.) A New Development: in June 2014, a new type of diaphragm was revealed at the European Society of Contraception meeting in Lisbon. This is the Caya contoured diaphragm.  It has been designed with careful consideration of the average woman&amp;#039;s anatomy, and as a result it is claimed that one size (in fact, the only size) fits most women.  So the alleged advantage of this new device is that you don&amp;#039;t have to go along to a nurse or doctor for a fitting.  Frankly, I think that is a slightly optimistic claim. Women&amp;#039;s vaginas do vary enormously in length and width, particularly after childbirth.  Our experience is that the Caya is quite difficult to fit into a plastic model of a woman with a small vagina.  Nevertheless, it does seem likely that around 80 per cent of women could use the one-size Caya contoured diaphragm. However, in one trial the pregnancy rate in a year was 13.7 per cent.  Who can use the ordinary diaphragm? Diaphragms can be used by most women without any kind of inconvenience or discomfort.  So, this is a good option for a woman who dislike condoms, or who cannot take the Pill for some reason or another, or for women who can&amp;#039;t use IUDs. How do you use a diaphragm? The diaphragm looks like a little hat without a brim. It is &amp;#039;bendy&amp;#039;, and can be folded so that it goes into the vagina easily.  Before you insert it, you need to smear spermicidal cream or gel onto it, to give you adequate protection \u2013 in other words, to prevent sperms from creeping round the edge. A diaphragm without spermicidal cream will not be very effective in preventing pregnancy. You put your diaphragm high up in your vagina, so that it covers the cervix. The top end of the dome goes behind your cervix, and the bottom end of the dome is tucked up behind your pubic bone. When the diaphragm is placed correctly like this, it cannot be felt by either the woman or the man during intercourse. It&amp;#039;s quite easy to take the diaphragm out after use \u2013 simply by hooking your fingertip round it. The nurse or doctor will show you how to do this. Generally speaking, you&amp;#039;re safer not to take it out until the morning. After taking it out, you wash it, dry it and put it away in its box, which is rather like a make-up compact. What are the advantages of this method? One of the key advantages to the diaphragm is that it can allow sex to be spontaneous.  A woman can easily insert the diaphragm whenever she expects she may be having sex that day. But if you insert it more than three hours before you make love, you should put in some extra spermicide \u2013 before your man enters you. Diaphragms should always be left in place for at least six hours after sex. However, if sex does not occur, it&amp;#039;s quite safe for a woman to leave her diaphragm in, and even to go to sleep wearing it.  But a diaphragm should not be left inside you for more than 30 hours, as this might possibly cause an infection and/or a discharge. There is another advantage for the many women who feel particularly sexy during their periods, but whose men might be squeamish at the sight of blood during intercourse.  With a diaphragm in place, there&amp;#039;s usually no sign at all that the woman has a period, so the couple can make love as normal. What are the disadvantages? Some women do have difficulty in coming to terms with the idea of putting a rubber dome inside their vaginas. But with a bit of practice, they usually become quite happy about it. Also, if you suddenly find yourself in a sexual situation and have to insert your diaphragm in a hurry before intercourse, that can interfere with spontaneity. Furthermore, there&amp;#039;s a risk that if you&amp;#039;re in a rush, you may not put it in correctly. Is the diaphragm an effective type of contraception? Yes, a diaphragm is indeed an effective form of contraception \u2013 if spermicidal cream is always applied before sexual intercourse, and if the device is left in the vagina for six to eight hours after the intercourse has finished.  If used correctly, the diaphragm is generally reckoned to be 92 to 96 per cent effective against pregnancy.  Obviously, the pregnancy rate is higher if it&amp;#039;s not used properly. But it is lower if you&amp;#039;re in your late 30s or your 40s \u2013 which is when many women use it.  Are there any side-effects?  A very few women have an allergy to the material that the diaphragm is made from. Cystitis is a problem for a few users \u2013 possibly because the front of the diaphragm presses against the urinary passage. Some people are sensitive to spermicides.  What types of diaphragms are there? In the UK, there are now only three types available:  type A diaphragm with flat metal spring type B diaphragm with coiled metal spring type C arcing spring diaphragm.  Sizes range from 55mm diameter to 95 mm. It&amp;#039;s mainly up to the doctor or family planning nurse to decide which type suits your vagina \u2013 and what size you need. But obviously, you must ensure that you feel comfortable with it. How long will your diaphragm last? Given luck, several years. You should keep an eye on your diaphragm to make sure it is OK.  Get a replacement immediately if it has perished or if it gets damaged in any way. Do not attempt DIY repairs! You will need to see your doctor or nurse for re-measurement if your weight changes by more than seven pounds (about 3kg) either way (since that may alter your vaginal &amp;#039;fit&amp;#039;) \u2013 or if you resume wearing a diaphragm after a pregnancy. Please note that if for any reason the diaphragm doesn&amp;#039;t suit your particular vaginal shape, there is the alternative of a cervical cap (see below). Cervical cap What is a cervical cap?  The closely related &amp;#039;cervical cap&amp;#039; is also a good method, but is used by fewer women. It is much smaller than the diaphragm, and looks rather like a very large thimble. It fits over your cervix \u2013 rather like an egg-cosy over a boiled egg \u2013 so you have to be very sure that you can find your own cervix with your fingers and put the cap snugly over it.  Nearly all cervical caps are prescribed and fitted in family planning clinics though a few GPs now fit them. The doctor or family planning nurse will help you find a cap, which is right for the shape of your vagina and cervix, and will advise you what size you need. In Britain, there is now (2014) only one brand which is widely available on the NHS. This is the silicone FemCap, which is manufactured in 22mm, 26 mm and 30 mm sizes. How do I put a cervical cap in? The family planning nurse or doctor will teach you how to do this.  Before insertion, you need to fill the little cap one third full of spermicide. Then you squeeze it between finger and thumb in order to get it into your vagina. Finally, you put it over your cervix \u2013 where it&amp;#039;s held in place by suction. Finally, put some more spermicide into your vagina. The clinic staff will also show you how to &amp;#039;hook&amp;#039; the cervical cap out with your finger, which is usually not too difficult. (As is the case with a diaphragm, it should stay in all night after love-making.)  Summing up Caps and diaphragms are pretty good methods, and are well worth considering, particularly if you are fed up with taking hormones. Other people also read: The mini-Pill \u2013 progestogen-only pill (POP): why take the mini-Pill? The morning-after pill: who is it useful for? Contraceptive coils (IUDs): are there any side-effects? Contraception \u2013 ths IUS: find out how it works. Last updated 21.07.2014 "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.netdoctor.co.uk/conditions/sexual-health/a2215/contraception-8211-diaphragms-and-cervical-caps/>