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» Scarleteen Boards: 2000 - 2014 (Archive) » SCARLETEEN CENTRAL » Safer Sex & Birth Control » Some Questions, Diaphragm and BC-related

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Author Topic: Some Questions, Diaphragm and BC-related
Member # 45441

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Thanks for directing me to the birth control experience forums. I've settled on the diaphragm because my mom outlawed the IUD (she didn't want me to risk a perforation of the uterus), but I've had a few unsettling experiences so far.

As I was being fitted for my first diaphragm, two different OB-GYNs at school told me that I had an odd vaginal canal that just wouldn't accommodate diaphragms and that using the diaphragm alone would be "too risky." Then I went to my doctor at home and she told me they were crazy and fitted me right away. Is this just because so few women use the diaphragm nowadays? I think the other OB-GYNs at school were so used to prescribing the pill that they did a double-take when I asked for a non-hormonal method. All this confusion has led me to be a little concerned about the diaphragm, however. I was fooling around with the new diaphragm tonight, inserting it and taking it out and re-inserting it, etc. I was told that if the diaphragm fit snugly behind the pubic bone and you couldn't feel it when you walked or sat down, then it was working correctly and protecting you. I cannot feel it when I stand or sit, which is an excellent sign, and when I reached back, I could feel my cervix behind the rubber. Is this all I should check for when checking the effectiveness of my diaphragm? Sometimes it's hard to feel my cervix (I've got very small fingers, so it's a hard reach) and sometimes if there's too much lube involved, it's hard to tell what's being covered by the rubber and what isn't. What is the best position to be in for me to feel my cervix behind the diaphragm: standing up or sitting down?

I know hormonal methods tend to be more effective when used on their own, but I just couldn't stand the side effects! I'm wondering if I can bump the effectiveness rate of the diaphragm up by doing the following things:

1. using a condom
2. being aware of my ovulation and not having sex then
3. using spermicide with the diaphragm

Should this bump things up to the pill's level of effectiveness?

Finally, I'm a little concerned about my weight right now. I gained a LOT of water weight while on the pill (easily 10-15 pounds) and am planning to get into a good exercise and eating pattern this spring to lose that uncomfortable bloated feeling. My worry is that I might have to get a new diaphragm then, and the doctors at my school are completely incompetent w/r/t fittings. Will I be at a high risk for pregnancy if/when I lose this weight?

I'm so relieved to be off hormones, but I'm a little concerned about switching to a barrier method. Am I taking the right steps to make this as effective as the pill?

Posts: 17 | From: USA | Registered: Jan 2010  |  IP: Logged | Report this post to a Moderator
Executive Director & Founder
Member # 3

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The first two things you listed will absolutely increase the diaphragm's effectiveness. Essentially, you're talking about using three methods, condoms, a cervical barrier and fertility awareness. If you use all of them even just typically, but combined, you'll have a rate of effectiveness higher than the typical use rate of hormonal methods alone, and about the same as their perfect use rate.

Using spermicide with a diaphragm won't up it's effectiveness rate because that rate includes using spermicide already.

It sounds like your barrier fits you just fine, and to check it, sitting (especially while leaning back just a little) will usually give you the best angle and make it easier to reach your cervix than standing.

(It also does sound like the doctors at your school probably just did not know jack about diaphragms.)

Per the weight, I replied to your other post, but when it comes to the diaphragm, the usual recommendation for needing to be evaluated for a new one with weight changes is with a weight change of 20-25 pounds. But that's not about water weight, to my knowledge, but about muscle and/or fat changes.

Heather Corinna, Executive Director & Founder, Scarleteen
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Posts: 68290 | From: An island near Seattle | Registered: May 2000  |  IP: Logged | Report this post to a Moderator
Member # 45441

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Wonderful. Thank you, Heather!
I'm just shocked that the doctors at school are so clueless about diaphragms. More and more girls are opting for non-hormonal or "non-invasive" methods of birth control, especially in college.

Posts: 17 | From: USA | Registered: Jan 2010  |  IP: Logged | Report this post to a Moderator
Member # 45441

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I forgot to ask one last question - it would be nice to get your input on this.

Although I've been sexually active for over a year, I still consider myself a novice w/r/t a lot of things. My mom has told me countless times that once I find a method of birth control that works for me, then said method will just "settle into the background" and I will be able to lead my sexual life comfortably. Right now, I've got a bit of a neurotic approach to my birth control methods: I check them and re-check them and just wonder how a small pill or a cup-shaped piece of plastic could possibly work (even though I know full well how they work, it still boggles my mind that they could work for ME). I'm not at all paranoid and upset while having sex or after having sex - I know that I can trust clinical methods of contraception - but I'm still getting used to using all these strange...contraptions, let's say...and I'm wondering when this feeling of newness and neurosis will go away.

Posts: 17 | From: USA | Registered: Jan 2010  |  IP: Logged | Report this post to a Moderator
Member # 13388

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Hi eve, here's some feedback if you don't mind my jumping in. [Smile] I would agree with your mom here about the method settling into the background over time, both as your gain experience and confidence in a method. However, if there's some underlying reason you're fearful or anxious about pregnancy, then I'd say the fears wouldn't go away but that's something you can also explore with time. I know you've also been through some big challenges (and positive realizations) regarding your body image, and while I can't say they're completely interconnected, stuff like that can affect how you feel about other things to possibly include safer sex.

On a personal note, I always felt very comfortable with condoms and with EC for back-up, I was set! I was gungho on diaphragms but changed my feelings with time, although there are plenty of women who use them very happily throughout their sexual lives. However, when I realized I wanted a method that had a lower failure rate and more ease for my life, I just reviewed my options and switched BC methods, easy-peasy. Also, if you're backing up a diaphragm with a condom, you've got some extremely effective BC. [Smile]

Here are these if you haven't seen them yet:
The Buddy System: Effectiveness Rates for Backing Up Your Birth Control With a Second Method

Chicken Soup for the Pregnancy Symptom Freakout's Soul
Ready or Not? The Scarleteen Sex Readiness Checklist

Posts: 3318 | Registered: Jun 2003  |  IP: Logged | Report this post to a Moderator

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