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Contraception - Management
How should the woman use a diaphragm or cervical cap?

  • Detailed instructions for using diaphragms and cervical caps are included in each manufacturer's package, and will be advised during initial fitting by the healthcare professional.
    • The diaphragm or cap should always be used in conjunction with a spermicide:
      • Oil-based products should be avoided, as these rapidly damage rubber.
      • Common examples of oil-based products that are applied to the vaginal and rectal areas include baby oil, petroleum jelly, massage oils, and some topical antifungal, corticosteroid, and oestrogen preparations.
    • The diaphragm or cap (with spermicide) can be inserted at any time before sexual intercourse:
      • If inserted more than 3 hours before intercourse, the device should be reapplied with additional spermicide.
      • If further sexual intercourse takes place more than 3 hours after insertion, more spermicide should be inserted into the vagina, without removing the device.
    • The diaphragm or cervical cap must be left in place for at least 6 hours after the last episode of sexual intercourse.
    • Latex diaphragms and caps should be removed within 30 hours of insertion.
      • The silicone cap, FemCap®, can be left in for up to 48 hours.
    • After use, the device should be washed with mild unscented soap, rinsed well, and dried carefully, before storing in a cool place.
  • Should the diaphragm or cap be used incorrectly (including removal before 6 hours post-intercourse), consider the chances of becoming pregnancy, and consider whether emergency contraception is appropriate (see the CKS topic on Contraception - emergency).
Clarification / Additional information

Emergency contraception:

  • Women who rely solely on the diaphragm or cervical cap for contraception should be informed where emergency contraception can be obtained in case they think that their method might have failed.
    • Emergency contraception should be considered if the diaphragm or cervical cap is incorrectly inserted, damaged, dislodged, or removed within 6 hours of sexual intercourse.
    • Consider advance provision of oral levonorgestrel emergency contraception to use in these circumstances.
Basis for recommendation
  • These recommendations are based on the guidance issued by the the Faculty of Sexual and Reproductive Healthcare (FSRH), formerly the Faculty of Family Planning and Reproductive Healthcare (FFPRHC) [FFPRHC, 2007d].

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