A diaphragm renaissance?

One of the most embarrassing Sex and the City scenes was the one in which Carrie enlists Samantha’s help to remove her diaphragm. Not because the situation seemed a little intimate, even for two close friends, but because it revealed that Carrie’s chosen birth control method was the diaphragm. I mean, how retro was that? Despite conversations about ticking biological clocks and complaints about twentysomething women, the characters had always seemed pretty young to me. Until this talk of a retro method of contraception that doesn’t even prevent most STDs.
Or could it? Last week at TAP Online, Beth Schwartzapfel wrote about how the diaphragm is being re-designed using more flexible materials so that one-size-fits-all. This might make it a more convenient option for women who can’t or don’t want to use hormonal birth control. But perhaps more promisingly, it could help curb HIV infection rates in Africa:
Because the cervix is much more susceptible to HIV infection than the vagina, cervical barrier methods like the diaphragm could be of great help. Beth writes,

Not only could it offer American women yet another contraceptive option, but it could prove a powerful tool in reducing HIV infection rates both at home and abroad. In a large-scale clinical trial that’s the first of its kind, researchers are currently testing the impact that diaphragm use has on HIV infection rates in Africa — where methods of protection that women can initiate without requiring their partners’ consent are badly needed.

That’s enough for me to consider the diaphragm on its way back to cool again.

Join the Conversation

  • soupcann314

    I always thought that Carrie used the diaphragm because she was a smoker, and hormonal birth control methods, while they can cause blood clots for anyone, were especially bad for smokers.
    But now I’m revealing that I know way more than should be allowed about Sex and the City… =-)
    And that’s great about it possibly helping to curb the HIV rate, if they do create a diaphragm that’s one size fits all.

  • VT Idealist

    Hopefully, a new redesigned diaphragm will prove effective in preventing pregnancy and HIV. Let’s hope we can be effective in getting a new and improved diaphragm to Africa (and to the US market as well) and that it doesn’t suffer the same fate as condoms and the HPV vaccine. Because telling girls that if they have sex they’ll get horrible diseases and die is much better than actually preventing said horrible diseases.

  • NDFeminist05

    This is fantastic news, as a major problem with condoms in Africa (assuming they actually get there) is women’s powerlessness to insist that their partners use them. Many married women are not “allowed” to deny their husbands sex (even if he is HIV positive), let alone demand protection. Diaphragm’s would give women the ability to protect themselves despite cultural norms.

  • EG

    Well, maybe. But diaphragms aren’t as easy as that. They have to put in between 30 minutes and two hours before having sex, they have to be left in for at least four hours but no more than eight hours after sex, and you’re supposed to put in more spermicide before each penis-in-vagina intercourse. They’re kind of a pain, in my opinion. Better than nothing, definitely.
    Maybe the redesign will help with some of these complications.

  • Aerik Knapp-Loomis

    It’s the maintenance issues with diaphragms that really concerns me about using them to help stem HIV/AIDS in Africa. Who’s going to give the money and provide all the spermicide? Can we reasonably expect access to spermicide for African women/couples? The logistics warrant some looking into.

  • donna darko

    You feministing gals just keep it coming, don’t you?
    Very, very impressive.

  • Vervain

    Maybe I’m repressed or something, but I just can’t imagine asking a friend, even a very close one, to help me remove something from my vagina. A lover or a doctor, sure.
    But a friend? That’s just bizarre.
    I don’t watch the show, though. Maybe it makes more sense if you do?

  • EG

    I don’t recall it making a whole lot of sense, and I did watch the show pretty regularly!
    At the risk of telling you more than you want to know, that was always my problem with the diaphragm. I always ended up having to try and get it in my office bathroom in the morning, and it was very, very difficult. Maybe it’s for women with longer fingers than I have.

  • String_Bean_Jen

    Indeed, diaphragms have always seemed old-fashioned to me. In addition to that Sex and the City episode, recall that Seinfeld episode where Elaine tells the story to Jerry’s virgin girlfriend of her diaphragm falling out of her purse in front of everyone?
    I remember finding my friend’s mom’s diaphragm with my friend. We had no idea what it was, but it sure was big and scary.
    My sister is currently using a diaphragm, and I haven’t seen it so I don’t know if it is a redesigned one. She hasn’t complained about all the procedures outlined by EG above, though I told her about them before she went in to have one fitted. So it worries me that she may not be following all the procedures to a T.
    Because the pregnancy prevention rate with the diaphragm is not as high as with the condom, even if used consistently and correctly every time. And that worries me.

  • SassyGirl

    “At the risk of telling you more than you want to know, that was always my problem with the diaphragm.”
    Me too. I was almost in tears trying to get that thing out! It was a nightmare!
    The thing that is good about it is that it can be put in hours before having intercourse, so you don’t have to say anything like “Hold that thought, I need to put in the ol’ diaphragm”.
    If it can help empower these women, then I am all for it! Unfortunately, they won’t get any aid from our government to get the diaphragm or for the required spermicide, Bush wants to teach them abstinence, as if they have a choice.

  • kirsten

    When I moved to the UK my new doctor kicked me off the combined pill and told me I had to take the progesterone-only pill. After 2 weeks of mood swings and general horribleness I went back and told him that there was no way I was using the progesterone-only pill any more and I wanted to be fit for a diaphragm.
    He responded that because I was married he would *let* me use a diaphragm instead of the pill.
    No wonder people think diaphragms out of style if that’s what the doctors say.
    (I now love my diaphragm. Then again, I have long fingers)

  • http://misterniceguy1960.blogspot.com misterniceguy1960

    I have only had one lover who used a diaphragm, but I remember being dazzled by how enormous it was. I think it had to do with the unusual angle and placement of her cervix.
    A one-size-fits-most diaphragm would definitely make it more marketable.

  • donna darko

    They come in three sizes. I remember they’re messy but not inconvenient. You put it in a half hour before and take it out a half hour later.

  • EG

    You gotta leave it in for longer than half an hour after, I think.

  • donna darko

    You’re right. It was a long time ago! You can also put it in hours before.

  • http://crazyindustry.blogspot.com jennie1ofmany

    they actually come in a whole range of sizes (my doctor’s fitting case has way more than three sizes in it.)
    And yeah, used on their own, they’re not great protection, especially for a woman who has multiple partners. But used in conjunction with a condom, a diaphragm can provide just that little bit of extra security, and since one can put the diaphragm in well before one’s boyfriend gets home, or while he’s getting out of his trousers, or whatever, they’re a bit more convenient than foam.
    Unfortunately, you do have to leave the wretched thing in for six hours after intercourse, which can lead to some less-than-ideal removal scenarios (memorably, for me, on hour four of a 14-hour Greyhound trip back from a visit.)
    I’ve never had many physical difficulties getting the thing out. Just situational ones.
    I do hope that anyone promoting a diaphragm + barrier cream/spermicidal jelly approach to STI transmission in Africa is planning on making the goop available inexpensively to the groups that are currently distributing condoms.

  • curlygirl

    I just had to clarify, because I think the diaphraghm is pretty kick ass: you can put it in up to six hours before you have sex and leave it in six hours after. if you want to you could leave it in for a total of 24 hours. like i said, pretty kick ass.

  • MrsTarquinBiscuitbarrel

    I used a diaphragm for more than twenty years, with brief trials of the pill and a Copper-7 IUD along the way.
    Most memorable diaphragm-buying experience: when the Safeway pharmacist announced in a very loud voice to a crowd of shoppers that she’d have to order one, because “no one uses these any more.”
    “Nobody?” I replied, amid all those muffled sniggers. “NOBODY?” I do have to champion this fabulous little device: No unplanned pregnancies for me. And the Ortho model comes in lots of sizes.

  • braufrau

    Hmm, this already exists as the Lea’s Shield. http://www.leasshield.com/
    I haven’t tried it because none of the pharmacies near me stock it and my doc hadn’t even heard of it.

  • MrsTarquinBiscuitbarrel

    braufrau, thanks for the tip. Heartening to know that there’s something new under the sun for contraception.

  • emjaybee

    Hormone pills make me crazy and mean, even the lowest dose. Like PMS all the time, and no sex drive. Diaphragms can be a pain, but they have advantages:
    1. No hormones, no daily pill.
    2. Cheap! You buy one a year, about 60.00, plus maybe two tubes of spermicide a year (about 10.00 apiece). Compared to 30/month for pills, a serious bargain.
    3. You really can leave it in for a long while…like till your shower the next morning. And your spermicide comes with a reapplication plunger thingy so you don’t have to take the diaphragm out when you have sex multiple times; you just add some spermicide.

  • EG

    Huh. I was always told (by my doctor) that I shouldn’t leave it in for longer than eight hours, because otherwise I was at risk for UTIs, TSS, and other things.
    The spermicide never worked for me–it’s so caustic.

  • http://elizabethslittleblog.wordpress.com/ elizabeth199

    I used the diaphragm for a while and I don’t remember having to put it in a half-hour before. As far as I know, it starts working right away – the spermacide doesn’t take any time to “activate” and the barrier part of it starts working right away. That said, you can put it in way ahead of time.

  • dhsredhead

    Yeah, so women should wear diaphragms so their partners can be off the hook when it comes to birth control…and so women can just back down when it comes to demanding that their partners wear condoms? Some how, I don’t see this as a good thing. Even if it might help prevent AIDS, it doesn’t do much for women gaining equality in their relationships, part of what has caused the AIDs epidemic in the first place.

  • Ledasmom

    I never had any problems removing my diaphragm, and I do have stubby fingers. It was always more a matter of, well, technique rather than length, as with so many things.

  • MrsTarquinBiscuitbarrel

    dhsredhead, I should have pointed out that I came of age sexually well before HIV transmission became a known risk issue for heterosexuals. Before and since, I’ve been married and monogamous; both of us tested HIV-negative.
    Many women (more than the aforementioned lady at Safeway knew about, but it’s common knowledge at Planned Parenthoods and other clinics) recommend the use of a diaphragm & contraceptive jelly while the partner uses a condom. I should have pointed that out.
    My husband split the cost of contraceptives with me even before we married, and had both a joint checking account and insurance. For women who can tolerate and prefer the Pill, the Pill/condom combo is perhaps better known as a two-for-one that hopefully will prevent pregnancy AND transmission of HIV–but again, neither Pill/condom nor condom/diaphragm combos are less than effective in preventing passing along HPV (human papilloma virus).
    And Ledasmom, I lack long fingers, too. Bearing down upon the pelvic muscles while squatting over the toilet lowers the all-flex rim of the Ortho diaphragm and makes it easier to grab.
    Happy canoodling to one and all!

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