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Size Matters. Why You NEED To Be Fitted For Your Diaphragm

To buy a diaphragm in the USA a prescription is needed but that's not the case in most European countries. However the need to have the correct sizing determined by a suitable Doctor is paramount.

Barrier contraceptives are a key element of our support of non-hormonal contraception. They can be used as a stand alone birth control solution, or as a secondary measure in addition to fertility charting and Fertility Awareness.


Condoms are the most popular barrier contraceptives, but diaphragms are also gaining popularity as more women opt for alternatives to hormonal contraception. The introduction of natural alternatives to spermicide such as ContraGel, and the replacement of latex with durable silicone, are making these options more viable for the consumer.


Diaphragms: Empowering Women

Diaphragms were invented in the mid 1800s and peeked in popularity around the 1930s. Then, with the rise of hormonal contraceptives and the pill, diaphragms fell into oblivion. Although they are one of the few female-controlled and extremely low-risk birth control options, many women view this form of birth control as old fashioned, or don't even know it exists.


The traditional diaphragm developed very little during its life, the circular device covers the cervix to prevent sperm from entering the uterus. Better and more comfortable springs and the transition to silicone over latex did improve on the basic functioning of the device.


The Janssen owned Ortho branded All Flex diaphragm may have been totally removed from the market recently, and we understand that the Reflections diaphragm will soon be withdrawn as well.


The Cooper Surgical owned Milex brand diaphragm is still in active production. Milex offers two diaphragm options, each with different spring mechanisms. The 'Arcing' style spring folds in the middle across one axis, and the' Omniflex' style is flexible and folds in all directions. The different spring mechanisms do not effect reliability, choosing between the two is a matter of personal preference. The Omniflex style generally the more popular choice.

Sizing across diaphragm brands is compatible. For example, an All-Flex user with a prescription for a 70mm diaphragm could use a 70mm Milex Omniflex diaphragm.


RDO Medical currently distributes all sizes of the Milex Omniflex and Milex Arcing diaphragms and the relevant fitting kits for clinical use as well as ContraGel Green natural contraceptive gel. Both are available for immediate shipping on a wholesale and retail basis.


Caya: A More Accessible Diaphragm

What makes the Caya diaphragm (named the SILCs diaphragm during its development and early testing) truly revolutionary is its single sized construction and design. The contoured device is suitable for users of the 65, 70, 75 and 80mm traditional circular diaphragms. Although an initial fitting is recommended, repeat fitting and dramatic size fluctuations should not effect the Caya's efficiency.


The new contoured design increases the contraceptive reliability compared to the old circular designs, and a dimpled section at one end makes removal easier and more comfortable which was always a major complain with the traditional styles.


New materials and a smarter design process mean that a lighter and more flexible frame can be incorporated, covered with a softer yet stronger silicone based membrane.


We currently distribute the Caya as well as ContraGel Green natural contraceptive gel, available for immediate shipping on a wholesale and retail basis.


Fitting and Using Diaphragms

The sizing of a diaphragm depends upon the size of the vaginal cavity of the user. A Doctor or Gynaecologist  is needed to ascertain the correct size. Every 6-12 months the user should check to see if that size is still correct and in addition if there has been any weight loss or gain of more than a few kilos or a pregnancy, abortion or miscarriage, then the sizing should be checked again.

You will need to be refitted if:

  • You gain or lose 10 pounds (4.5 kilos) or more
  • You have pelvic surgery
  • You give birth or have an abortion
  • You have repeated urinary tract infections
  • You or your partner feel pain or pressure during sex


You should NEVER guess your correct size and you should NEVER assume it will stay the same. An incorrectly sized diaphragm WILL increase the risk of pregnancy.

During the check up to ensure that a diaphragm is the best barrier contraceptive choice for you and to measure the correct size, the Doctor or Gynaecologist will also be able to show you how to correctly insert and remove the diaphragm. Not inserting it or removing it correctly will increase the risk of pregnancy.


It is crucial that a Doctor or Gynaecologist is consulted to confirm a diaphragm is a suitable contraceptive method for you, to correctly measure you for your diaphragm and to instruct you in its correct use. DO NOT attempt to purchase or use a diaphragm until after such a consultation.


Diaphragm Effectiveness

Contraceptive Technology reports that the method failure rate of the diaphragm with spermicide is 6% per year. The actual pregnancy rates amongst diaphragm users vary depending on the population being studied, with yearly rates of 10% to 39% being reported.


Unlike some other cervical barriers, the effectiveness of the diaphragm is the same for women who have given birth as for those who have not.


The low effectiveness can usually be traced to incorrect usage, therefore it is imperative to check with your doctor or sexual health care consultant in order to be shown how to correctly use the device and become a successful diaphragm user.


A properly sized diaphragm, used correctly with spermicide and removed correctly afterwards can be a very efficient contraceptive method.


Side Effects Associated with Diaphragms

If you or your partner has a latex allergy, do not use a latex diaphragm.

Diaphragms should not be used during menstruation because it would interfere with the natural flow of menstrual fluid.


Toxic shock syndrome (TSS) occurs at a rate of 2.4 cases per 100,000 women using diaphragms, almost exclusively when the device is left in place longer than 24 hours.


Diaphragms are associated with an increased risk of urinary tract infections (UTIs). Urinating before inserting the diaphragm and also after intercourse may reduce this risk. The increased risk of UTIs may be due to the diaphragm applying pressure to the urethra, which is common if the diaphragm is too large, and causing irritation by preventing the bladder from emptying completely. However, the spermicide Nonoxynol-9 (N-9) is itself associated with increased risk of a UTI, yeast infection, and bacterial vaginosis so avoiding N9 can have benefits, for this reason you ought to research natural alternatives such as ContraGel.


Diaphragms MUST be used with a spermicide or natural contraceptive gel such as ContraGel


ContraGel: Enabling Effective Diaphragm Usage Without Chemicals

Many couples are prevented from using barrier methods of contraception because of the simple fact that those barriers need an additional component of a spermicidal gel, and many report skin irritations as a result of spermicide usage. The active ingredient in most traditional spermicides, Nonoxynol 9, is a chemical that kills sperm on contact. Not surprisingly, a chemical that kills sperm can also cause unpleasant side effects on intimate areas.


ContraGel is a spermicide alternative that does not contain Nonoxynol 9 at all. Its natural ingredients don't need the overkill of such powerful pharmaceuticals, the barrier is sealed with the ContraGel and the viscosity of the gel and its low pH immobilise the sperm, ensuring no live sperm complete their intended journey.


The 60 gramme tube of ContraGel typically provides 15-20 applications. These numbers are based on the typical requirements of three to four ml applied to diaphragms and cervical caps for each act of intercourse. Additional ContraGel should be applied to the barrier with a finger or vaginal applicator if more then one act of intercourse occurs.

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