Get on Top by Meika Hollender & Alexandra Zissu

Author:Meika Hollender & Alexandra Zissu
Language: eng
Format: epub
Publisher: Touchstone

— Diaphragm —

Perfect use: 94 percent

Typical use: 88 percent

These are barriers, typically made from silicone, that are used with spermicide. They come in several sizes—you get fitted at an appointment with your doctor. There’s also a one-size-fits-most version that does not technically require a fitting, but does require a prescription. You might want to do a test run at your doctor’s office anyway, just to make sure it’s comfortable and you can insert and remove it without issue. For the multisized kind, you need to be refitted if you gain or lose a considerable amount of weight or if you have a child. They can for sure take some getting used to. You fill it with spermicide (a deal breaker if you’re allergic to spermicide) and insert (with clean hands) within two hours before you know you’re going to have sex. If you put it in before that two-hour window, like up to three to six hours before sex, that’s OK, too, but you’d need to reinsert spermicide. If you wind up having a few rounds of sex, you’ll also need to insert additional spermicide in your vagina (do not remove the diaphragm!), which can get things pretty lubed up. Then, after all is said and done, you leave it in place for another six hours. Next, you have to remove it (you unhook it with your finger and try not to spill the body-temperature spermicide it’s holding as you slide it out), wash it, and store it. You can’t leave it in for more than twenty-four hours because it elevates the risk of toxic shock syndrome (see page 79). If you’re using lubricant with a diaphragm, it has to be water- or silicone-based. Oil-based lube can break down the silicone. Some women are sensitive to the spermicide even if they’re not fully allergic to it. It can change vaginal pH and create irritation. Diaphragms can also increase risk for urinary tract infections. Some men claim they can feel them inside their partners, but thankfully if you put it in correctly you yourself won’t feel it. It can also be knocked out of place by very energetic sex. The good news is that it’s effective immediately after you insert it. Once you get used to the routine, using a diaphragm and knowing how to check it for leaks becomes, well, routine.

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