Жатыр мойнына орналастырылатын контрацепциялық құралдар

Cervical barrier type of birth control
Side effects are usually very few. The diaphragm came into use around 1882. It is on the World Health Organization's List of Essential Medicines.

Before inserting or removing a diaphragm, one's hands should be washed to avoid introducing harmful bacteria into the vaginal canal. The rim of a diaphragm is squeezed into an oval or arc shape for insertion. A water based lubricant (usually spermicide) may be applied to the rim of the diaphragm to aid insertion. One teaspoon (5 mL) of spermicide may be placed in the dome of the diaphragm before insertion, or with an applicator after insertion. The diaphragm must be inserted sometime before sexual intercourse, and remain in the vagina for 6 to 8 hours after a man's last ejaculation. For multiple acts of intercourse, it is recommended that an additional 5 mL of spermicide be inserted into the vagina (not into the dome—the seal of the diaphragm should not be broken) before each act. Upon removal, a diaphragm should be cleansed with mild soap and warm water before storage. The diaphragm must be removed for cleaning at least once every 24 hours Silicone diaphragms may last much longer—up to ten years.

The diaphragm does not interfere with a woman's menstrual cycle, therefore, no reversal or waiting time is necessary if contraception is no longer wanted or needed. The diaphragm only has to be used during intercourse. Many women, especially those who have sex less frequently, prefer barrier contraception such as the diaphragm over methods that require some action every day. Because pelvic inflammatory disease (PID) is caused by certain STIs, diaphragms may lower the risk of PID. Cervical barriers may also protect against human papillomavirus (HPV), the virus that causes cervical cancer, although the protection appears to be due to the spermicide used with diaphragms and not the barrier itself. Diaphragms are also considered a good candidate as a delivery method for microbicides (preparations that, used vaginally, protect against STIs) that are currently in development. Urinating before inserting the diaphragm, and also after intercourse, may reduce this risk. For this reason, some advocate use of lactic acid or lemon juice based spermicides, which might have fewer side effects. It has also been suggested that, for women who experience side effects from nonoxynol 9, it may be acceptable to use the diaphragm without any spermicide. One study found an actual pregnancy rate of 24% per year in women using the diaphragm without spermicide; however, all women in this study were given a 60 mm diaphragm rather than being fitted by a clinician. Other studies have been small and given conflicting results. The current recommendation is still for all diaphragm users to use spermicide with the device. In the early 1920s, Marie Stopes claimed that when wearing a diaphragm, the vagina is stretched such that certain movements made by the woman for the benefit of the man were restricted by the diaphragm spring. In later years there was some discussion of this, with two authors supporting this concept and one opposed. One of them argued in the later 1920s 1930s that while the muscle movement by women is restricted it does not make all that much difference since most "women (in the 1920s) are not able to operate their pelvic muscles voluntarily to the best advantage" (during sex). However, Stopes anticipated this rebuttal, and in so many words classified it as a lame excuse.

Diaphragms are available in diameters of 50 mm to 105mm (about 2–4 inches). They are available in two different materials: latex and silicone. Diaphragms are also available with different types of springs in the rim. An arcing spring folds into an arc shape when the sides are compressed. This is the strongest type of rim available in a diaphragm, and may be used by women with any level of vaginal tone. Unlike other spring types, arcing springs may be used by women with mild cystocele, rectocele, or retroversion. Arcing spring diaphragms may be easier to insert correctly than other spring types. A coil spring flattens into an oval shape when the sides are compressed. This rim is not as strong as the arcing spring, and may only be used by women with average or firm vaginal tone. Reflexions also manufactured a flat spring diaphragm up until 2014. A correctly fitting diaphragm will cover the cervix and rest snugly against the pubic bone. A diaphragm that is too small might fit inside the vagina without covering the cervix, or might become dislodged from the cervix during intercourse or bowel movements. Diaphragms should be re fitted after a weight change of 4.5 kg (10 lb) or more. Diaphragms should also be re fitted after any pregnancy of 14 weeks or longer. The correct size for a woman is the largest size that she can wear comfortably throughout her cycle. In the United States, diaphragms are available by prescription only. Many other countries do not require prescriptions.

The spring in the rim of the diaphragm forms a seal against the vaginal walls. The diaphragm covers the cervix, and physically prevents sperm from entering the uterus through the os. Traditionally, the diaphragm has been used with spermicide, and it is widely believed the spermicide significantly increases the effectiveness of the diaphragm. Insufficient studies have been conducted to determine effectiveness without spermicide. It is widely taught that additional spermicide must be placed in the vagina if intercourse occurs more than six hours after insertion. It has long been recommended that the diaphragm be left in place for at least six or eight hours after intercourse. No studies have been done to determine the validity of this recommendation, however, and some medical professionals have suggested intervals of four hours or even two hours are sufficient to ensure efficacy. One manufacturer of contraceptive sponges recommends leaving the sponge in place for only two hours after intercourse. However, such use of the diaphragm (removal before 6 hours post intercourse) has never been formally studied, and cannot be recommended. It has been suggested that diaphragms be dispensed as a one size fits all device, providing all women with the most common size (70 mm). However, only 33% of women fitted for a diaphragm are prescribed a 70 mm size, and correct sizing of the diaphragm is widely considered necessary.

The idea of blocking the cervix to prevent pregnancy is thousands of years old. Various cultures have used cervix shaped devices such as oiled paper cones or lemon halves, or have made sticky mixtures that include honey or cedar resin to be applied to the cervical opening. However, the diaphragm—which stays in place because of the spring in its rim, rather than hooking over the cervix or being sticky—is of more recent origin. An important precursor to the invention of the diaphragm was the rubber vulcanization process, patented by Charles Goodyear in 1844. In the 1880s, a German gynecologist, Wilhelm P. J. Mensinga, published the first description of a rubber contraceptive device with a spring molded into the rim. Mensinga wrote first under the pseudonym C. Hasse, and the Mensinga diaphragm was the only brand available for many decades. In the United States, the physician Edward Bliss Foote designed and sold an early form of occlusive pessary under the name "womb veil" starting in the 1860s. American birth control activist Margaret Sanger fled to Europe in 1914 to escape prosecution under the Comstock laws, which prohibited sending contraceptive devices, or information about contraception, through the mail. Sanger learned about the diaphragm in the Netherlands and introduced the product to the United States when she returned in 1916. Sanger and her second husband, Noah Slee, illegally imported large quantities of the devices from Germany and the Netherlands. In 1925, Slee provided funding to Sanger's friend Herbert Simonds, who used the funds to found the first diaphragm manufacturing company in the U. S., the Holland Rantos Company. Diaphragms played a role in overturning the federal Comstock Act. In 1932, Sanger arranged for a Japanese manufacturer to mail a package of diaphragms to a New York physician who supported Sanger's activism. U. S. customs confiscated the package, and Sanger helped file a lawsuit. In 1936, in the court case United States v. One Package of Japanese Pessaries, a federal appellate court ruled that the package could be delivered. In 2014 Janssen Pharmaceuticals announced the discontinuation of the Ortho All Flex Diaphragm, making it very difficult for women in the US to have that option as a birth control method. Unreliable source: date=August 2014

The single sized, silicone diaphragm was developed by PATH during the late 2000s. It was licensed to Kessel Marketing & Vertriebs GmbH of Frankfurt, Germany, which began to market it as the Caya Diaphragm. The diaphragm was approved for contraception in Europe in 2013 and in the United States the following year. Since then, Kessel has also developed a traditionally circular, multi sized diaphragm made from the same materials that they released in Germany in 2020 under the name Singa.

In the United Kingdom, they cost the National Health Service less than £10 each. In the United States, they cost about US$15 to $75 and are the birth control method of 0.3% of women. These costs do not include that of spermicide.