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Contraception - Management
What diaphragms and cervical caps are available?
- Diaphragms and cervical caps are barrier contraceptives that are designed to cover the cervix, thus preventing access of the sperm to the uterus.
- A variety of contraceptive diaphragms and caps are available (see Table 1):
- They vary in size and shape.
- Diaphragms consist of a thin, soft dome (made of latex/rubber or silicone) with an encased flexible steel ring around its edge:
- These are designed to fit between the posterior fornix of the vagina and the pubic bone:
- The diaphragm is held in place by the vaginal muscles, the tension of the ring, and the pubic bone.
- Three types of diaphragms are available:
- Flat spring: suitable for women with normal vaginal muscular support. These are generally offered first.
- Coil spring: can be considered for women for whom a flat spring diaphragm is not suitable, provided that there is good vaginal muscle tone. Coil spring diaphragms are more flexible and can be more comfortable than flat springs.
- Arcing spring: useful for women with poor vaginal muscular support or those in whom the length or the position of the cervix makes fitting a coil spring or flat spring diaphragm more difficult.
- Cervical caps are smaller than diaphragms and are a useful alternative for women who wish to use a barrier method but cannot use diaphragms or choose to use a cap:
- They fit directly over the cervix and are held in place by suction and by support from the vaginal wall.
- Latex and silicone caps are available.
[Belfield, 1999; SOGC, 2004; FFPRHC, 2007d]
Table 1. Diaphragms and cervical caps available on prescription in England and Wales.
Type | Products |
|---|
Contraceptive diaphragms |
With flat spring | Latex (type A)*: Reflexions® (55–95 mm, in 5 mm steps) |
With coil spring | Latex (type B)*: Ortho® (55–95 mm, in 5 mm steps) Silicone: Milex Omniflex ® (60–90 mm, in 5 mm steps) |
Arcing spring | Silicone: Milex® (60–90 mm, in 5 mm steps) |
Contraceptive caps |
Type A (latex/rubber): vault cap | Dumas® Vault Cap (55–75 mm, in 5 mm steps; size numbers 1–5) |
Type B (latex/rubber): cervical cap | Prentif® cavity rim cervical cap (22–31 mm, in 3 mm steps) |
Type C (latex/rubber): Vimule cap | Vimule® Cap (42–54 mm, in 6 mm steps; size numbers 1–3) |
Silicone cap | FemCap® (22, 26, 30 mm) |
* Complies with British Standard 4028:1989. |
© NHS Institute for Innovation and Improvement